Section 04
Scientific Library
Evidence-based summaries, mechanism of action deep dives, and peer-reviewed study breakdowns. Modeled on clinical research standards—no hype, no anecdote.
Research Disclaimer: Information presented is for educational purposes only and does not constitute medical advice. Evidence levels reflect current peer-reviewed literature. Consult a qualified healthcare provider before making any medical decisions.
Chronic Pain
Substantial evidence supports cannabinoids for chronic neuropathic and non-neuropathic pain. THC and CBD combinations show superior outcomes to either alone.
Mechanisms
- ›CB1 receptor modulation
- ›Inflammatory pathway inhibition
- ›Descending pain pathway activation
Dosing Framework
THC 2.5–20mg/day; CBD 5–40mg/day (titrate slowly)
Cautions
Tolerance development; cognitive effects at higher THC doses
Anxiety Disorders
CBD demonstrates anxiolytic properties in human trials. Low-dose THC may reduce anxiety; high doses can exacerbate symptoms. Context and set/setting matter significantly.
Mechanisms
- ›5-HT1A receptor agonism (CBD)
- ›Amygdala activity modulation
- ›HPA axis regulation
Dosing Framework
CBD 25–75mg/day; avoid high-dose THC
Cautions
High-dose THC contraindicated; individual variability high
Epilepsy (Treatment-Resistant)
FDA-approved CBD (Epidiolex) demonstrates significant seizure reduction in Dravet syndrome and Lennox-Gastaut syndrome. Strongest evidence base in cannabis medicine.
Mechanisms
- ›GPR55 antagonism
- ›TRPV1 desensitization
- ›Sodium channel modulation
Dosing Framework
CBD 10–20mg/kg/day (Epidiolex protocol)
Cautions
Drug interactions with clobazam; liver enzyme monitoring required
Sleep Disorders
THC reduces sleep onset latency; CBD shows mixed results. Long-term use may suppress REM sleep. CBN shows emerging evidence for sleep maintenance.
Mechanisms
- ›Adenosine reuptake inhibition
- ›CB1-mediated sedation
- ›Circadian rhythm interaction
Dosing Framework
THC 5–15mg before bed; CBN 5–10mg
Cautions
REM suppression with chronic THC use; rebound insomnia on cessation
PTSD
Preliminary evidence suggests cannabinoids may reduce nightmare frequency and hyperarousal. Ongoing VA-funded trials. Mechanism involves fear memory extinction.
Mechanisms
- ›Fear memory extinction (CB1)
- ›Noradrenergic system modulation
- ›HPA axis normalization
Dosing Framework
Under investigation; nabilone 0.5–1mg studied
Cautions
Limited long-term data; psychosis risk in predisposed individuals
Nausea & Vomiting (Chemotherapy-Induced)
FDA-approved dronabinol (synthetic THC) and nabilone are established antiemetics. Strong evidence for chemotherapy-induced nausea and vomiting (CINV) refractory to standard treatment.
Mechanisms
- ›CB1 agonism in dorsal vagal complex
- ›Serotonin pathway modulation
- ›Gastric motility regulation
Dosing Framework
Dronabinol 5–15mg/day; nabilone 1–2mg twice daily
Cautions
Psychoactive effects; not first-line — use when standard antiemetics fail
Multiple Sclerosis (Spasticity)
Nabiximols (Sativex) — a 1:1 THC:CBD oromucosal spray — is approved in 30+ countries for MS spasticity. Significant reduction in spasm frequency and severity.
Mechanisms
- ›CB1-mediated muscle relaxation
- ›Spinal interneuron modulation
- ›Anti-inflammatory effects
Dosing Framework
Nabiximols: titrate to 8–12 sprays/day; oral THC:CBD 1:1 ratio
Cautions
Dizziness, fatigue; not approved in US for this indication
Inflammatory Bowel Disease
Observational studies show symptom improvement in Crohn's disease and ulcerative colitis. RCT data is limited but promising for symptom management. Does not appear to induce remission.
Mechanisms
- ›CB2 receptor modulation in gut mucosa
- ›Intestinal permeability regulation
- ›Cytokine suppression
Dosing Framework
CBD 10–20mg/day; THC low-dose for symptom relief
Cautions
Smoking route contraindicated; limited remission induction evidence
Glaucoma
Cannabis reduces intraocular pressure (IOP) but only for 3–4 hours, requiring dosing 6–8x daily. Short duration and systemic side effects make it impractical vs. standard treatments.
Mechanisms
- ›CB1-mediated aqueous humor reduction
- ›Vasodilation of ocular vasculature
Dosing Framework
Not recommended as primary treatment due to short duration
Cautions
Systemic hypotension; impractical dosing frequency; standard treatments preferred
Cancer (Palliative)
Strong evidence for pain, nausea, and appetite stimulation in cancer patients. Preclinical evidence for anti-tumor properties; no human RCT evidence for anti-tumor effects.
Mechanisms
- ›CB1/CB2 apoptosis induction (preclinical)
- ›Appetite stimulation via hypothalamic CB1
- ›Pain pathway modulation
Dosing Framework
Individualized; THC:CBD combinations for pain; dronabinol for appetite
Cautions
Anti-tumor claims not supported by human trial data; do not delay conventional treatment
Alzheimer's Disease
Preclinical evidence suggests cannabinoids may reduce neuroinflammation and amyloid plaque accumulation. Small human trials show behavioral symptom improvement. Larger RCTs needed.
Mechanisms
- ›Neuroinflammation reduction via CB2
- ›Amyloid-beta clearance (preclinical)
- ›Neuroprotective antioxidant effects
Dosing Framework
Under investigation; low-dose THC:CBD studied in small trials
Cautions
Insufficient human evidence; cognitive effects of THC may worsen symptoms in some patients
Opioid Use Disorder
Observational data suggests cannabis use associated with reduced opioid consumption. CBD shows promise for craving reduction. States with medical cannabis laws show lower opioid overdose rates.
Mechanisms
- ›Opioid receptor cross-talk
- ›Craving reduction via CBD/5-HT1A
- ›Pain management reducing opioid need
Dosing Framework
CBD 400–800mg/day studied for craving; adjunct use only
Cautions
Not a substitute for evidence-based addiction treatment (MAT); use as adjunct only
Scientific Sources & Evidence Standards
All research is sourced from PubMed/NCBI, ClinicalTrials.gov, Cochrane Library systematic reviews, and peer-reviewed journals. Evidence levels follow GRADE methodology. Studies are indexed weekly and verified for quality.