What is medical cannabis and what are cannabinoids?

Medical cannabis uses extracts of the cannabis plant in the treatment of diseases and their symptoms. Cannabinoids are the extracted compounds from the cannabis plant.

There are more than 113 identified cannabinoids in cannabis plants. Two of the better-known cannabinoids, cannabidiol (CBD) and tetrahydrocannabinol (THC), have been found in clinical trials to alleviate a variety of symptoms.

They do this by activating receptor sites in the body’s endocannabinoid system, bolstering the body’s natural ability to fight pain, regulate mood and fight inflammation, among other benefits.

What is the endocannabinoid system?

The endocannabinoid system is a complex cell-signaling mechanism identified in the early 1990s by researchers exploring THC. Because it was discovered only recently, scientists are still researching it and are learning more about its role in the body. However, it has already been shown to be active in regulating a range of your body’s functions and processes, including:

  • Sleep
  • Mood
  • Pain regulation
  • Appetite
  • Memory
  • Reproduction and fertility

Even if you don’t use cannabis, the endocannabinoid system still exists and is active in your body.

What are the benefits of medical cannabis?

Unlike opioid use, there is lower potential for abuse using CBD or THC in pain management. Those seeking gentle, non-toxic alternatives for managing chemotherapy side-effects can rely on medical cannabis for safe relief. Combinations of CBD, THC and other cannabinoids such as cannabigerol (CBG), cannabinol (CBN) and cannabidivarin (CBDV) have also been found to be effective in the treatment and regulation of:

  • Appetite and digestion
  • Metabolism
  • Chronic pain
  • Inflammation and other immune system responses
  • Mood
  • Learning and memory
  • Motor control
  • Sleep

  • Cardiovascular system function
  • Muscle formation
  • Bone remodeling and growth
  • Liver function
  • Reproductive system function
  • Stress
  • Skin and nerve function

Of course, this is not an exhaustive list as scientists continue to discover promising treatment applications for cannabinoids.

What is the history of medical cannabis in Cayman?

In 2017, the Cayman Islands Legislative Assembly amended the Misuse of Drugs Law (2017 Revision) to permit licensed physicians in the Cayman Islands to prescribe cannabis extracts and tinctures for therapeutic and medical purposes. Furthermore, the amendment permitted the possession and use of cannabis extracts and tinctures by individuals who have been prescribed it under a physician’s care.

Since 2017, more than 500 patients have benefited from this change of law permitting the prescription of cannabis where it has been used to treat a variety of otherwise hard-to-treat medical conditions such as multiple sclerosis, chronic pain, Crohn’s disease, irritable bowel syndrome, insomnia, anxiety and pain caused by chemotherapy.

Why is the cannabis plant not an approved medicine or the use of cannabinoids more widespread?

In the Cayman Islands, the use of the whole cannabis plant is not legal because of the limited medicinal benefits of smoking (as opposed to vaping) cannabis. Smoking cannabis produces toxic, acrid smoke which has limited therapeutic or medical benefits and could be harmful to patients’ lungs. Conversely, vaping cannabis extracts warms (but does not burn) the medicine, is gentle on the lungs and is much more likely to provide beneficial, medicinal effects.

Due to the relatively recent change in the legal classification of cannabis, scientific investigation into its uses and effects are still at a nascent stage. Scientists are only just starting to realise the full medical potential of cannabinoids.

Social and political stigmas have coloured perceptions of cannabis use, preventing patients who may otherwise benefit from medical cannabis treatments from taking advantage of its benefits. However, these mindsets appear to be changing as more and more countries legalise cannabis for medical use, thereby allowing further research and study of cannabinoid compounds.

Which countries and organisations support medical cannabis as a treatment option?

Over the last 10 years the European Union, Canada, Chile, Ecuador, South Africa, Israel, New Zealand, Jamaica and Cuba among others have legalised cannabis either entirely or for medical use.

Currently, 33 U.S. states allow the use of medical cannabis with a doctor’s recommendation, while a further 14 states allow the use of products with limited THC content.

Organisations that support medical cannabis use include the American Medical Association’s Council on Scientific Affairs. The American Cancer Society has called for further research into its use as a treatment option.

The FDA has also approved cannabis derivatives, nabilone and dronabinol, for use in medical treatment. These are generics and trade under several brand names.

What is the difference between ingestible oils and vaping?

There are many ways of consuming cannabis. In the Cayman Islands, only extracts and tinctures of cannabis (but not the whole plant or its flowers) are legal for medical use. For medical purposes, two methods of utilising cannabis extracts and tinctures are vaping and ingestion.

Ingestible oils contain one or more cannabinoids together with a carrier oil such as coconut oil, which is designed to be ingested orally. Because any medication taken orally must be absorbed (or metabolised) through the intestines, ingestible cannabis oils are filtered through the liver which detoxifies everything we ingest. After metabolisation, the reality is that only around 6% of the total amount orally ingested actually makes it into your bloodstream. Additionally, the metabolisation process takes hours, which makes oral ingestion of cannabinoids unsuitable for acute conditions such as pain or anxiety.

Conversely, vaporisation is a method of warming cannabis extracts to the point where a gentle vapour is created. This vapour is then inhaled, directly entering the blood stream (or systemic circulation) through the lungs and bypassing the liver. Because this method of dosing avoids the first-pass filtration of the liver, the bio-availability of vaped cannabinoids is around 10x higher than oral ingestion. Best of all, the effects of vaping medical cannabis can be felt within minutes. Vaping also has a number of other advantages over oral ingestion, which likely makes it the most effective form of delivery.

The FDA has also approved cannabis derivatives, nabilone and dronabinol, for use in medical treatment. These are generics and trade under several brand names.

What can I expect during a confidential medical cannabis consultation?

At Doctors Express, everything we do is from the patient’s point of view. Patient confidentiality, privacy and peace of mind is of paramount importance to us. This is why we provide state-of-the-art facilities and medical treatment in a comfortable and relaxing environment, with the highest levels of patient care.

Upon entering the facility, you will be warmly greeted by one of our highly-trained staff members who will be happy to answer any questions you might have about the process. You will be asked for identification and your health insurance details and will be asked to check-in on our iPad kiosks.

In our bright, spacious reception area, you can enjoy TV and Wi-Fi during your brief wait.

Next, a member of our clinical team will guide you to an exam room to take your vital signs, medical and medication history and other relevant health information in advance of your consultation with one of our physicians.

Once completed, you will be evaluated by one of our physicians who will review your symptoms, conduct a thorough examination and determine if any further diagnostics are required. For your convenience, Doctors Express offers laboratory testing, digital x-ray and full pharmacy services, on-site.

After the physician has completed their comprehensive investigations and reached a conclusive diagnosis, a member of our clinical team will return with the instructions and any prescriptions. As with any medicine, it’s critical to determine what is best for the patient as not all patients are a good fit for certain medicines.

If the physician determines your condition is suitable for treatment with medical cannabis, they will work with you to find the best options for your care. If the physician prescribes a vape product, you will have a follow-up consult with the pharmacist who will come to your exam room to ensure you learn how to properly care for your vape. Depending on your symptoms, you will leave with your prescription in-hand.

You will also be given a special, counterfeit-resistant medical cannabis photo identification card that will clearly identify you as a medical cannabis patient for presentation to law enforcement or your employer.

At times, patients may require a follow-up with, or referral to, another specialist. If required, Doctors Express will help facilitate that process for you.

As with all our patients, you will receive a personal phone call from your attending physician a few days after your appointment to see how your treatment is coming along.

At Doctors Express we are with you every step of the way to ensure you receive the care and attention you need.

Why does Doctors Express support medical cannabis treatment?

We, at Doctors Express, recognised early-on the potential for medical cannabis to provide a viable treatment option when compared to harmful, addictive and socially destructive medications such as opiates and benzodiazepines. Medical cannabis is a safer, more effective and non-addictive alternative to these medications.

In compliance with the laws of the Cayman Islands, we fully advocate the management of pharmaceutical grade cannabis use under a doctor’s care as opposed to self-medication with illegally imported cannabis of unknown safety, quality or provenance. Treatment with pharmaceutical grade medical cannabis remains one of the best methods of weaning-off harmful and addictive opiates and benzodiazepines to a safer, less harmful method of symptom management.

Our prescription, full-spectrum vaporisable medical cannabis extracts provide a legal way to access the benefits of medical cannabis under controlled and monitored conditions and precision dosages to assure that you have the same quality medication and experience every time.

Where can I learn more?

Here are a few scientific studies detailing the benefits of medical cannabis on different conditions.

“The Use of Cannabis as a Mood Stabilizer in Bipolar Disorder: Anecdotal Evidence and the Need for Clinical Research” in Journal of Psychoactive Drugs, June 1998.

“Pathways Mediating the Effects of Cannabidiol on the Reduction of Breast Cancer Cell Proliferation, Invasion, and Metastasis” published in Breast Cancer Research and Treatment Journal, August 2011.

“Preliminary Efficacy and Safety of an Oromucosal Standardized Cannabis Extract in Chemotherapy-Induced Nausea and Vomiting” published in the British Journal of Clinical Pharmacology, November 2010.

“Patient-Reported Symptom Relief Following Medical Cannabis Consumption” published in Frontier of Pharmacology, August 2018.

How do I know if medical cannabis is right for me?

Please complete this questionnaire to find out if you may be a candidate for medical cannabis treatment.

Go to the Cannabis Consultation Form