PatientsCann UK | The Endocannabinoid System Visualizer Skip to content Science Interactive Peer reviewed sources The endocannabinoid system, explained by exploring your own body Every person reading this has an endocannabinoid system. It is a network of tiny switches, messengers and clean-up crews that keeps the body steady. Tap any part of the body below to see which switches sit there and what they do. PatientsCann UK Education, physiology Written for patients, carers and clinicians On this page The basics Body map How the signal works Makers and breakers What it balances Plant compounds Entourage effect Beyond CB1 and CB2 For clinicians Test yourself References What this page is, and is not This page teaches the science of how the body works. It is not medical advice and it does not recommend any product, dose or treatment. If you think medical cannabis might help you, speak to your GP, your specialist or a clinic on the General Medical Council register. Why this matters It is already yours The system is built into every human body from the first weeks in the womb. Cannabis did not put it there. It keeps you steady Sleep, appetite, pain, mood, movement, temperature and the immune response all get nudged back towards the middle. It is very old Versions of this system appear in animals going back around 450 million years, which is why it is found in so many species. It explains the effects Cannabis compounds work because they fit switches your body already has. Different switches, different effects. Start here Three parts, one job: keeping you steady Your body is a colony of billions of cells. Each cell has its own needs, and they all have to work together. To do that, cells send each other chemical messages. The endocannabinoid system, often shortened to ECS, is one of those messaging networks. Scientists often describe it as a lock and key. The receptor is the lock, sitting on the outside wall of a cell. The messenger molecule is the key. When the right key turns the right lock, something changes inside that cell. The three parts The locks (receptors). Two main ones, called CB1 and CB2. They sit on cell surfaces all over the body and each one changes what its cell does. The keys (endocannabinoids). Fatty messenger molecules your body builds itself. The two main ones are anandamide and 2-AG. The clean-up crew (enzymes). Tools that build the keys when they are needed and destroy them seconds later. The main destroyers are called FAAH and MAGL. The part that surprises people Most messaging systems keep a stock of messengers ready in tiny bags, waiting to be released. The ECS does not. Endocannabinoids are made on demand, cut fresh out of the fatty wall of the cell at the exact moment they are needed, used on the spot, and then broken down. Nothing is stored and nothing travels far. That is why the ECS is so precise. It does not act on the whole body at once. It acts in one small place, for a short time, only where something needs correcting. The word for it is homeostasis. It means keeping the inside of your body steady even when things outside change. Not too hot, not too cold. Not too much pain signal, not too little. The ECS is one of the body’s main tools for doing that. Where the plant comes in The keys your body makes fit the locks perfectly. Compounds from the cannabis plant, called phytocannabinoids, are shaped closely enough to fit the same locks, but they are not identical. Researchers sometimes call them a false key. They turn the lock, but not in quite the same way, not in the same place, and not for the same length of time. That single idea explains almost everything else on this page. Cannabis does not create new effects in the body. It leans on a control system that is already running. It is not the cannabis plant that has many effects, it is the endocannabinoid system that determines them. Dr Mariano Garcia de Palau, Fundacion CANNA Interactive body map Where the receptors are, and what they do there Tap a numbered marker on the body, or a name in the row underneath. CB1 markers are green, CB2 markers are purple, and places with a real mix of both are teal. Show Everything CB1 only CB2 only 13 regions to explore CB1 CB2 Both, in real numbers A note on the drawing. The illustration shows the main organs from the front. Each marker sits over the area that region covers, so a few point at parts that sit deeper in the body. The immune marker sits on a cluster of lymph nodes, and nerves and skin reach everywhere, so those markers show one place out of many. Step by step How one nerve cell tells another to calm down Nerve cells talk across a tiny gap called a synapse. Normally messages travel one way. The ECS is unusual: its message travels backwards. Step through it below. Presynaptic sending neuron Postsynaptic receiving neuron the synaptic gap vesicles CB1 receptor on the sending cell receptors glutamate or GABA Ca2+ up DAGL 2-AG cut from the cell wall backwards fewer messages sent MAGL broken down in seconds Back Next step Why the backwards direction matters. The cell that is getting too much noise is the one that turns the volume down, at the exact synapse where the noise is coming from. Nothing else in the body is affected. This is called retrograde signalling, and it is the reason cannabinoids can quieten over-firing nerves without shutting the whole nervous system down. The cast The makers, the messengers and the breakers Six molecules do most of the work. Two carry the message, two build them, two destroy them. Tap any name. The others, in brief Anandamide and 2-AG get the attention, but the body makes more: Noladin ether and virodhamine, both weaker relatives. Virodhamine may work against

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Skip to the explorer PatientsCann UK · Patient education From Seed to Patient: the UK medical cannabis pipeline Every legal prescription in the UK travels the same route: a controlled growing room, a licensed factory, an accredited laboratory, a border, a specialist clinic and a pharmacy. This explorer walks you through all six stages, compares the seven formats a patient can be prescribed, and shows you how to read the paperwork that proves it. 6 regulated stages 7 patient formats Quality and science inspector This is education, not medical advice. Onset and duration figures are typical ranges reported for each route. Your own response depends on your dose, your product and your body. Never change how you take your medicine without speaking to your prescriber or pharmacist. See all patient resources 1 The seed to shelf journey 2 Formats and delivery pathways 3 Quality and science inspector The six stages of a legal UK prescription Select any stage to open the detail. Each one has its own quality standard and its own regulator, and a batch cannot move forward until the stage before it has been signed off. 1Genetics and GACP growing 2GMP processing and extraction 3Laboratory testing and CoA 4Licensed import and border 5Specialist prescribing 6Pharmacy dispensing Stage 1 of 6 1 Genetics, breeding and GACP cultivation Where the medicine starts: a known plant, grown the same way every time. Standard GACPRegulator DEFRA and origin inspectors What happens here A licensed grower keeps a small number of mother plants and takes cuttings from them, often through tissue culture, so that every crop is genetically the same plant rather than a new cross. Growing rooms are closed loop: light, temperature, humidity, carbon dioxide and air filtering are all controlled and logged. Mother plant care and cutting or tissue culture cloning Batch to batch genetic stability, checked crop by crop Sealed rooms with filtered air and monitored water feeds Quality standard GACP (Good Agricultural and Collection Practice). It sets how the plant is grown, fed, harvested and handled. In practice it means no synthetic pesticides, and soil, water and fertiliser chosen so the plant does not draw heavy metals up into the flower. Where the flower is dispensed as it is, GACP alone is not enough: the maker has to write down the point at which production of the active substance begins, and for whole flower that point is the growing room. Who regulates it DEFRA in the UK, alongside the agricultural inspectors of the country the crop is grown in. Growers are inspected and have to keep records for every batch they release. One decision sets the whole rulebook What the crop is going to become decides where pharmaceutical rules start. It is the single most important point in the chain, and the one most often got wrong. If the flower itself is the medicine The plant is the active substance Propagation Cultivation and flowering Harvest, drying, curing Packed flower, dispensed as it is Annex 2, biological medicines Nothing downstream can purify or sterilise a dried bud, so quality has to be built in from the cuttings onward. Annex 2 recognises that manufacture can begin at propagation. If the flower will be extracted The plant is a starting material Propagation Cultivation and flowering Harvest and drying Extraction and formulation Annex 7, herbal starting materials Here quality is defined later. Extraction, filtering and purification can take impurities out, so the plant is grown under GACP and pharmaceutical rules begin at the processing step. Why sameness matters A prescription only works as medicine if the next jar behaves like the last one. Controlled genetics and controlled rooms are what let a pharmacist put a fixed cannabinoid percentage on a label. Illicit supply has none of this: the same street name can be a different plant, grown a different way, with a different strength every time, and nobody has tested it. Next: GMP processing 2 Pharmaceutical processing and GMP extraction The crop becomes a pharmaceutical product in a cleanroom. Standard EU and UK GMPRegulator MHRA What happens here Harvested flower is dried and cured at a set temperature and humidity, then milled to a controlled particle size for vaporising. For oils and cartridges the plant material goes through supercritical carbon dioxide extraction, then winterisation to strip out fats and waxes, with any solvent recovered and accounted for. Controlled drying, curing and precision milling Cold carbon dioxide extraction under pressure Winterisation, filtration and solvent recovery Standardising the extract to a fixed cannabinoid strength Quality standard EU and UK GMP (Good Manufacturing Practice). Work happens in cleanrooms with ISO class 5 and class 7 air handling and positive air pressure, so air always flows out of the clean space rather than into it. Every step is written down, signed and traceable to the batch. The rulebook is EudraLex Volume 4: Part I for finished medicines, Part II for active substances, and Annex 2 for medicinal cannabis intended for use as whole flower. Quality risk management sits across all of it. Who regulates it The MHRA, the UK medicines regulator. A site that makes or releases a medicine for UK patients has to hold and keep its GMP certification through inspection. Three routes out of the same growing room Where GACP stops and GMP starts depends on what the batch is going to become. Requirements tighten at every step closer to the patient. GACP, pre harvestGMP, post harvestGood distribution practice Bulk flower for extractionMother plantsRooting and hardeningLarge scale cultivationharvestFast fan assisted dryingMachine trimmingBulk packaging and shippingExtractionActive ingredientFormulationFilling and packaging Sold on as feedstock, so the later GMP steps happen at another site. Extracts, including oils, hash and rosinMother plantsRooting and hardeningLarge scale cultivationharvestFast dryingMachine trimmingExtractionActive ingredientFormulationFilling and packagingDistribution Processing can remove impurities, so the finished extract is standardised before it is filled. Finished packaged flower (Flos)Mother plantsRooting and hardeningSmall scale cultivationharvestWet hang harvestSlow cool dryingHand trimmingCuringPackagingDistribution Covered end to end by GMP Annex 2. The flower itself is the finished medicine, so nothing can be cleaned out of it

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