Stockholm Medical Cannabis Conference

Five arguments for, and one argument against, renaming the Endocannabinoid System

By referring to the endocannabinoid system with its current name, we ignore the fact that it is a natural and integral part of our biology that can be affected by many factors. A more inclusive and accurate name would reflect this reality. In this blog post, I will present five reasons for why a change of its name might benefit the scientific community and its acceptance as an important physiological system in medical education, as well as one reason to stick with its current name.

Reason 1: Despite its name’s connotations, the ECS is completely unrelated to cannabis. Although cannabis compounds like THC and CBD affect the ECS by mimicking or changing the effects of cannabinoids produced by our own bodies, there are also many other types of molecules that can influence it. Endogenous cannabinoids, such as anandamide and 2-AG, are molecules that our bodies produce and that bind to cannabinoid receptors. These cannabinoids play important roles in regulating physiological and psychological functions, like pain, mood, memory, and synaptic plasticity. However, the ECS is not limited to interactions with phytocannabinoids or endogenous cannabinoids. Other types of molecules, including terpenes (found in many plants), flavonoids (antioxidant plant pigments found in many plants), dietary fatty acids, and small molecule drugs, (e.g., Ibuprofen or a metabolite of paracetamol) can also affect the ECS. Not to mention diet, lifestyle, exercise, stress, and social interactions that all are known to impact the status of the ECS. Naming the ECS after cannabis overlooks the fact that it is a natural and important part of our biology, and that it can be affected by many different factors. A more precise and comprehensive name would better represent the diverse interactions with various molecules that happens within the ECS.

Reason 2: The name of the ECS ignores the complexity and diversity of its components. The ECS is composed of an expanding set of different types of molecules and receptors that work together to regulate various functions in our body and brain. The most common receptors that are part of the ECS are called CB1 and CB2. These receptors are like locks that can be opened by different keys. The keys are molecules that can bind to the receptors and activate or inhibit them. Some of these keys are made by our own body (endogenous cannabinoids), some come from plants (cannabis compounds), and some are made in laboratories (synthetic cannabinoids). However, CB1 and CB2 are not the only receptors that can be affected by these keys. There are other types of receptors that can also interact with them, such as TRPV1, GPR55, GPR18, 5HT1, ion channels, and so on. These receptors have different shapes and functions than CB1 and CB2, but they can also influence how we experience pain, inflammation, temperature, mood, or appetite. Moreover, there are also different types of keys that can bind to these receptors. Some of them have similar structures to the classical endogenous cannabinoids (e.g., N-arachidonoyl dopamine), while others have completely different structures (e.g., ibuprofen, pregnenolone or beta-caryophyllene). Therefore, the name of the ECS does not reflect the variety and richness of its components. By naming it after cannabis, we simplify and reduce its scope and potential. A more comprehensive and accurate name would acknowledge this diversity and complexity.

Reason 3: The name of the ECS does not reflect its evolutionary origins and conservation. The ECS is not a recent invention of nature. It has been present in animals for hundreds of millions of years, long before cannabis plants evolved. The ECS is one of the oldest and most widespread systems in the animal kingdom. It can be found in vertebrates (animals with backbones) and invertebrates (animals without backbones), such as fish, amphibians, reptiles, birds, mammals, insects, and worms. Even plants(!) have been discovered to produce endocannabinoid-like molecules with specific receptors that respond to them (Liu et al. 2020). The ECS has been highly conserved across different phyla and species, meaning that it has maintained its basic structure and function over time. This suggests that the ECS is very important for survival and adaptation. The ECS helps animals cope with different environmental challenges and stresses, such as changes in temperature, food availability or predators. Therefore, the name of the ECS does not capture its historical and biological significance. By naming it after cannabis, we ignore its ancient and universal presence throughout the evolution of animals. A more respectful and appropriate name would recognize this fact.

Reason 4: The name of the ECS limits our understanding and appreciation of its potential therapeutic applications. The ECS is not only a target of cannabis compounds, but also a source of new and promising treatments for various diseases and disorders. The ECS is involved in many pathological conditions, such as chronic pain, epilepsy, multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, schizophrenia, depression, anxiety, and addiction. By modulating the ECS with different molecules of lifestyle-interventional strategies, we can potentially improve the symptoms and quality of life of millions of patients. For example, some synthetic cannabinoids have been approved by the FDA to treat nausea and vomiting caused by chemotherapy or to stimulate appetite in AIDS patients. Some cannabis compounds have been shown to reduce seizures in children with rare forms of epilepsy or to protect neurons from degeneration in animal models of neurodegenerative diseases. Some endogenous cannabinoids have been found to have anti-inflammatory or antidepressant effects in rodents. Endocannabinoid levels have been shown to be dysregulated in many pathological conditions, as have cannabinoid receptor levels. Therefore, the name of the ECS does not convey its medical relevance and value. By naming it after cannabis, we restrict our perspective and curiosity about its therapeutic possibilities. A more optimistic and inspiring name would encourage this exploration.

Reason 5: The name of the ECS hinders its public acceptance and incorporation into medical education. Other important discoveries in human physiology have not taken this long to be incorporated into courses in human physiology, suggesting that the connotations to cannabis are stigmatizing and contributing to its lack of acceptance as a fundamental physiological system. The ECS is not a well-known or well-understood system. Many professionals are oblivious to its existence or function. This is partly due to the lack of education and information about the ECS in medical schools and higher education, which is intertwined with the stigma and prejudice associated with cannabis. Cannabis is an illegal substance in many countries and states and is often portrayed as a dangerous and addictive drug that primarily causes harm and impairment. Many people have negative attitudes and beliefs about cannabis and its users. These attitudes and beliefs can also affect how they perceive and judge the ECS. They may think that the ECS is something bad or unnatural that should be avoided or suppressed. They may also be reluctant or fearful to learn more about the ECS or to support its research and development. Therefore, the name of the ECS does not facilitate its social recognition and appreciation. By naming it after cannabis, we create barriers and biases that prevent its public awareness and recognition in medical education. A more neutral and acceptable name would overcome this challenge.

Reason to keep the name ECS: The ECS has historical and cultural significance and wide-spread recognition among scientists and academics. The discovery of the ECS stems from the research on cannabis and its pharmacological effects in humans and animals. The name “endocannabinoid system” acknowledges and honors this contribution and connection between cannabis and biology. Moreover, the name “endocannabinoid system” has been widely used and accepted by researchers, clinicians, and educators for decades. Changing the name of the ECS may cause confusion and inconvenience among these groups and their audiences.

Stefan Broselid, Ph.D.
Editor-In-Chief, Aurea Care Medical Science Journal

Liu Q, Wang F, Ahammed GJ, et al. An endocannabinoid system is localized to the hypodermal cells of Arabidopsis roots. Plant Signal Behav. 2020;15(2):1720278. doi:10.1080/15592324.2019.1720278