Dronabinol: Synthetic THC plus Natural THC and Its Medical Applications

Synthetic THC plus Natural THC and Its Medical Applications

Dronabinol is a synthetic form of tetrahydrocannabinol (THC), the primary psychoactive compound found in cannabis. While THC is naturally occurring in the cannabis plant, Dronabinol is produced in a laboratory to mimic the effects of natural THC. It is marketed under the brand name Marinol and is approved by the FDA (Food and Drug Administration – USA) for specific medical uses.

Differences Between Dronabinol and Natural THC

Source

Dronabinol is a synthetic compound, meaning it is chemically manufactured rather than extracted from the cannabis plant. It contains a single isolated form of THC, specifically the delta-9-THC isomer.

Natural THC, on the other hand, is found in cannabis plants along with hundreds of other cannabinoids, terpenes, and compounds. The combination of these substances, known as the entourage effect, is believed to contribute to the overall therapeutic effects of cannabis, with THC being just one component of the plant's complex chemical profile.

Composition

Dronabinol consists solely of synthetic THC. It does not contain any of the other cannabinoids or compounds present in the cannabis plant, such as CBD, which can modulate THC’s effects and provide additional therapeutic benefits.

Natural THC in cannabis is accompanied by other cannabinoids like CBD, CBG (cannabigerol), and CBN (cannabinol), which may enhance or balance the effects of THC.

Administration

Dronabinol is available in capsule form and is taken orally. It is standardized in dose, providing consistent and predictable effects.

Natural THC can be consumed in various forms, including smoking, vaping, edibles, tinctures, and oils. The method of consumption affects the onset, intensity, and duration of effects, which can be less predictable compared to the standardized dosing of Dronabinol.

Regulation and Legal Status

Dronabinol is a legal, FDA-approved medication for specific medical conditions. It is classified as a Schedule III drug under the Controlled Substances Act in the United States, indicating a lower potential for abuse compared to Schedule I drugs, which include natural cannabis.

Natural THC, found in cannabis, is classified as a Schedule I drug under federal law in the U.S., meaning it is considered to have a high potential for abuse and no accepted medical use at the federal level, despite its legality for medicinal and recreational use in many states.

Effects

Dronabinol produces effects similar to natural THC, including euphoria, relaxation, and altered perception. However, because it lacks the entourage effect from other cannabinoids and terpenes found in natural cannabis, some patients report that it feels different or less effective than natural cannabis, particularly in terms of managing pain or anxiety.

Natural THC is often preferred by some patients for its more holistic effects, as the presence of other cannabinoids may enhance therapeutic outcomes, reduce side effects like anxiety, and contribute to a more balanced experience.

Medical Applications of Dronabinol

Treatment of Nausea and Vomiting from Chemotherapy:

Dronabinol is primarily prescribed to manage nausea and vomiting associated with chemotherapy, particularly in cases where other anti-nausea medications have failed. Chemotherapy-induced nausea and vomiting (CINV) can be debilitating, and Dronabinol provides relief by activating the CB1 receptors in the brain, which play a role in controlling nausea and emesis. Its use is particularly valuable for patients who do not respond well to conventional antiemetics.

Appetite Stimulation in AIDS Patients:

Another key use of Dronabinol is in treating anorexia (loss of appetite) in patients with acquired immunodeficiency syndrome (AIDS). AIDS-related wasting syndrome involves severe weight loss and muscle wasting, and Dronabinol helps stimulate appetite, encouraging patients to eat and maintain a healthier weight. By binding to cannabinoid receptors in the brain, Dronabinol enhances the sensation of hunger, making it easier for patients to consume sufficient calories and nutrients.

Considerations and Side Effects

Effectiveness

While Dronabinol can be effective in treating nausea, vomiting, and anorexia, its effects are not always as well-rounded as those of natural cannabis. Some patients may find that the synthetic form lacks the full therapeutic benefits of whole-plant cannabis, especially for conditions like chronic pain or anxiety.

Side Effects

Common side effects of dronabinol include dizziness, euphoria, paranoia, drowsiness, and dry mouth. In some cases, it may also cause cognitive impairment, confusion, or mood changes. As with natural THC, dronabinol can cause psychoactive effects, which may be undesirable for some patients.

Onset and Duration

Because dronabinol is taken orally, the onset of effects can be slower compared to inhalation of natural cannabis. It typically takes about 30 minutes to 2 hours to feel the effects, which can last for several hours. This slow onset may be a drawback for patients needing rapid relief from nausea or loss of appetite.

Legal and Accessibility

As an FDA-approved medication, Dronabinol is more accessible to patients in regions where cannabis is still illegal or heavily regulated. It provides a legal alternative for those who cannot access natural cannabis but require THC for medical purposes.

Conclusion:

Dronabinol is a valuable pharmaceutical option for patients suffering from chemotherapy-induced nausea and AIDS-related anorexia, particularly when other treatments have failed. However, while it offers the therapeutic benefits of THC, it differs from natural cannabis in its composition, effects, and regulatory status. For some patients, the synthetic form may not fully replicate the therapeutic benefits of natural cannabis due to the absence of the entourage effect. Nonetheless, Dronabinol serves as an important tool in the medical management of specific conditions, offering relief in controlled and standardized dosages.