Pharmaceutical Chemistry: There's More in That Pill Than Drug and Ground Up Rock

[Letonna]

I have 9 ideas for a new lecture series. I'll list them below. I'll gauge interest in the irc channel if people want more. With all the talk of inactivity, I thought I might try to breath some life into the university.

Lecture Topics:
-Beta-Lactam Inhibitors
-Creams, Ointments, Lotions, Potions, Balms, and Powders
-Hormone and Steroid Therapy
-Phenethyamines: These ain't your grandpa's psychedelics.
-Therapeutic Sugar: Manitol, Glucose, Sucralose, Lactulose, and Sorbitol
-Non Enzymatic Drugs. The Red Headed Step Children of Pharmacology: PEG, Therapeutic Salts, simethicone, zinc oxide
-Herbal Medicine
-Aphrodisiacs
-Vaccines.

Beta-Lactamase Inhibitors, and Duct-Taping a Growing Problem

If you recall, in a previous, different lecture, I discussed antibiotics, and how they get their power chiefly as being critical enzymatic inhibitors. But, if you watch the news(or read), you likely have heard of antibiotic resistance. It is a problem that can’t really be comprehended with just half assd news reports and posters at your doctor's office.

The type of antibiotic resistance I’ll be talking about today is to a class of antibiotics called beta-lactams, specifically, penicillins and some others like:Penicillin(surprise), amoxicillin, ampicillin,piperacillin, ticarcillin.  These antibiotics interrupt cell division in cells with hard outer membranes, and essentially cause tears in their hard outer membranes until they explode under pressure.

What has been observed in the past half century is through artificial selection, cells who have a mechanism to break off the antibiotic from the enzyme survive the mass genocide of its peers. In the case of these antibiotics, it’s a new enzyme called Beta-lactamase. A enzyme whose sole job is to rip off antibiotic molecules from their target enzymes.

So, as is often the case in medicine, the most obvious solution is to reinhibit it. Beta-Lactamase inhibitors were introduced in the 70’s and 80, which inhibit the enzyme beta-lactamase.

So to recap, we have an enzyme, being inhibited by an inhibitor(antibiotic), but is susceptible to removal by a different enzyme, which we are inhibiting with a different enzyme inhibitor. Now, a curious mind might point out: “What if that new compound will itself become susceptible to removal by a new enzyme?” to which I say “God save us.”

Above Image: Tazobactam, the companion beta-lactamase inhibitor to piperacillin, seen below

Chemistry and pharmacology

Surprisingly, but perhaps not surprisingly, the chemical structure of beta-lactamase inhibitors is roughly the same as the antibiotics they protect. Notice from the image that the “lactam” rings are still intact, but instead, to the right of the penta ring we see some weird structures. These are meant to bind to key spots in the beta-lactamase enzyme, essentially paralyzing it.

In formulation, these drugs will usually come in formulation of 500mg, 1g, 2g, and really anything in between, with 100 mg ish of a beta-lactamase inhibitor. This is because there is less inhibition needed in the beta-lactamase inhibitors. The cell division process is much more laborious, so it hence has a higher dose of antibiotic than BLI.

It’s very likely you have taken a beta-lactam inhibitor and have not even known it. The widely popular prescription drug Augmentin is a combo pill consisting of(usually) 875mg of amoxicillin and a compound called clavulanic acid(or potassium salt) in 125 mg.

Clavulanic acid,seen above,  the companion Betalactamase inhibitor to Amoxicillin, seen below

Another popular one, although only used in hospitals in the united states, is a drug called unasyn, or ampicillin and sulbactam. Ampicillin by itself hasn't been useful in a widespread clinical application in years, except in some pediatric cases. But combined with sulbactam, it's been given a second life. This combination drug is especially popular, because by the end of production, the cost is relatively low, and the patient may only pay upwards of 100 USD for a complete treatment.

Conclusion

Bacterial resistance will never go away, it will always be there as long as we are. Luckily we’re clever enough to think of quick fixes. I like to think of these drugs as the duct tape of medicine. Enough to stop the leak, but you’ll probably want to replace the pipe sometime before it breaks.

[Red Mones]

Yay! I was hoping you would post more of these. They're very interesting.

[bigbaldben]

I like these.  I'd be interested in learning more about SSRIs and Aminoketone if they are in your wheelhouse.  Or anti-depressants in general.

[Letonna]

Phenethylamines: These Ain't Your Grandpa's Psychedelics

I this photo, you see my mostly empty book shelf. I’m still unpacking, but I got a lot of the important stuff on there. You’ll see some books I have for school, booze, and a book called PHIKAL. This book is very special to me. It’s one I’ve actually never read front to cover, and never will. It was a gift from a friend a few years ago.

Simply stating, it’s a book that is a step by step guide on how to make psychedelic drugs. The first third of the book is a semi fictional autobiography of the author's life, but the remainder is a step by step guide to making hundreds of psychotropic compounds. I’ve only read certain parts of it, and only refer to it once and awhile when I’m curious how the author describes a certain reaction. I really wish I had this book when I was taking organic chemistry because it’s all organic chemistry.[He wrote another book about another group of psychotropic substances he discovered but I don't have it.]

But how can such a thing be legal? Well, in many parts of the world it isn’t. Including some more developed nations like Australia. People have certainly tried to ban it for many years in the US, but they’ve also tried to ban the anarchist cookbook and that’s still around. Freedom of speech simply. The book doesn’t advocate for drug use or the distribution of drugs. It’s completely a chemical reference guide to a class of chemicals called phenethylamines. And even if you wanted to use it to make drugs to get you and your friends high, the language he uses is so dense, you need to have done extensive schooling to understand what the hell he is talking about.

I don’t own this book because I plan to make drugs, or teach people to make drugs, but because, pardon my language, it’s so fucking cool. It’s so rare to find a chemist, who not only made these drugs in his free time, but researched them extensively, cataloged them, tested them on him and his wife(she volunteered), but made a readily exercisable reference guide to them.

Anyway, to the science.

The above image is of phenethylamine. A very simple chemical consisting of 3 major parts. The aromatic benzene ring, a 2 carbon chain, and an amine group. This chemical alone is a little boring. It acts as a neurotransmitter in some parts of the brain, and is believed to play a role in dietary behavior and mental health. You can actually buy this drug as a herbal supplement. Between you and me it’s more or less ineffective in the concentrations sold, but we’ll save that for the herbal medicine lecture.

What happens when you start modifying this chemical (which is very easy and cheap to do) is it’s bioavailability and affinity for bonding to enzymes and receptors goes up drastically. Dr. Shulgin theorized he could make a drug so powerful, based off this design, you would only need a few molecules of it to get the high of a lifetime(he never succeeded before his death).

What’s so amazingly bizarre and truly amazing about these drugs is all of them do something slightly different. Through testing on himself he reported some of them helped him sleep, some made him hungry, some made him hallucinate, feel energized, taste amazing, feel happy, feel sad.

And he was only foreshadowing what recent medical discoveries have discovered. These drugs can be used for many things. In fact, one of them just got put on the market as an anti-obesity drug. And another as an ADHD medication. And another a treatment for asthma. And twice as many for depression.

Buproprion, or Wellbutrin, is a popularly prescribed phenethylamine used as a smoking cessation agent and antidepressant

I said earlier that additions and changes to the basic structure are pretty easy and cheap. And this is mostly true. Reagents used are simple things like dichloromethane, or phosphoric acid, or any number of small molecule reagents. Stuff you buy by the gallon. And they aren’t very hard reactions, simple pH shift, polymerizations, tautomerizations, and halogenating. I mention this because many pharmaceuticals are so expensive because the rare chemicals they use.

It’s some debate if these drugs will eventually become illegal. A lot of them are illegal, but many remain unclassified under the Scheduled Drug Act, mostly because so little outside of Dr. Shulgins work on them is known. Remember, that making them won’t get you in nearly as much trouble as distributing them. I’m sure someday they will be under more strict control, but for the meantime, they are the wild wild west of psyco-pharmaceuticals.

Dr. Alexander Shulgin

[Lindisfarne]

Great lecture!  Great initiative!
 
More of this!

[Letonna]

Aphrodisiacs: Gettin' Your Motor Runnin'

The most famous of the PDE5 inhibitors, Viagra

I can only think of a handful of other drug classes whose mechanisms have been studied so extensively than sexual enhancement medications. Sure you got your AIDS drugs and cancer drugs and male pattern baldness drugs. But when you want to rake in some quick cash(and you own a multi million/multi billion pharmaceutical company) you tinker with a class of compounds called PDE5 Inhibitors and crank out a winner.

What many people don’t understand about drugs, is that they’re really hard to make. By make I mean invent. It’s especially hard because you need to pick a disease or condition that enough people have that you can turn a profit on their betterment. That’s why there are so many cholesterol and high blood pressure medications. Because we all eat garbage and and sit on our ass and participate in fictional online governments. Anyway, I digress.

PDE5 drugs, also known as the ‘viagra’ drugs, are a simple class of compounds that dilate blood vessels. What vessels they dilate depends on the exact shape of the molecule. Viagra, the most famous, is a very crude PDE5 because it’s the most nonspecific vasodilator. Meaning it dilates lots of different blood vessels, although most prominently, the one to the johnson, or rod, or, you get the point. 

The exact mechanism is a little complicated, but I’ll boil it down to it’s most basic parts. These drugs help release nitric oxides into the bloodstream. These in turn activate an enzyme called guanylate cyclase which creates a chemical called cyclic guanosine monophosphate, which in turn leads to smooth muscle relaxation, allowing blood to flow more smoothly into a certain organ.

Cialis, a more modern PDE5

Now, the nitty gritty, the chemistry

The classic PDE5’s have a core compound consisting of a benzene aromatic ring with a sulfate on the 3’ carbon and ethoxy group on the 1’ carbon. There is usually a large nitrogenous aromatic structure bonded pretty close to that ring to. More modern versions of the PDE5’s have gotten rid of the sulfate group and ethoxy and replaced it with more diverse functional groups to the point where modern PDE5’s only vaguely look like their ancestors.

That first paragraph of this lecture wasn’t meant for just an anecdotal relief. There is a heavy saturation of these drugs on the market. So much so, that we know of so many more, but they’ve stopped going through clinical trials on them because there isn’t enough demand. Remember, you still have to con your doctor into writing one for you(or buy them on the internet from China).

Now, it wouldn’t be fair if I only talked about the men. Women have their own aphrodisiac now as well, although Ill do a follow up lecture discussing why this is and a little opinionated post on how medicine can be sexist. 

Filbanserin

Flibanserin, the first FDA approved medication for female hypoactive sexual desire disorder/female sexual interest and arousal disorder, known as addyi, is the newest addition to the sex-medicine family.

Flibanserin is a strong agonist of a receptor in the brain called the 5-HT1A receptor. Agonist, by the way, means it binds to a receptor meant for a different chemical, but activates it in either the same way or a different way. The drug binds to some other similar receptors, but it’s believed this is the key player. The drug helps boost neurotransmitters like norepinephrine and dopamine, yet decrease serotonin. These two neurotransmitters play an important part in keeping normal sex hormone release in normal ranges.

Think it of like this. If the whole sexual mechanisms in humans were compared to a car, female enhancements would be the keys to turn on the engine, and the males would be like the tires. You need both to drive to Denny’s, but saying they’re similar is not really accurate.

I can’t really do much of a chemistry discussion on this molecule besides what I can tell from the picture of it and what little is known of it. That trifluoromethyl group on the right is a big player. It’s common for a neurological drug to have organohalogen groups on them. Most antidepressants, feature chlorine or fluorine groups on them. It also features an azole group right in the middle, which is common in many antipsychotics. Both of these are key to get the molecule to bind in such a way that it keeps your delicate neurotransmitters in check.

The future of keeping your motor runnin’

Sex drugs are dangerous. If you haven’t assumed it already from me telling you that these drugs dilate your blood vessels and fuck with your brain chemistry then I don’t know what will. You’d be surprised how many men die from taking their viagra with medications or foods containing weakly bound nitrate groups. Or all the dangerous side effects of the female enhancement medication.

But I believe this won’t exist in the future. A new class of compounds are being researched now that will treat men and women equally, and with fewer side effects. These drugs bind to receptors called MC receptors, or Melanocortin 1-5 receptors. These receptors regulate different bodily functions, everything to body fat to skin pigment to getting it on.

Bremelanotide, a new experiment drug that will increase sexual desire in both men and women

Speaking of skin pigment, fun fact about these new medications. They were originally developed as medications to take to get tan without having to go in the sun. However, people the drug was tested on experienced very strong sexual desires, and the company’s focus was switched to developing it as a sexual arousal drug. Anyway.

These drugs are peptide based, meaning they look like primitive proteins, and are made of very simple parts(amino acids) all glued(estered) together. It’s believed they will eliminate the common problem with modern arousal drugs of low blood pressure. If you aren’t a fan of needles, I wouldn’t bother with it, because the company announces you’ll have to inject it yourself.

In a few days I'll follow up this lecture with why I think women have so few options when it comes to aphrodisiacs, and why so many people believe(and are probably right) drug research can be biased(sexist).

[The Empire]

This series is one of the most interesting stuff I've read online in years!

[Letonna]

Non-Enzymatic Drugs and Therapeutic Salts

Let’s have a little vocabulary discussion. The word drug originates from the 16th century French word droge, meaning a supply or stock, referring to supplies of of dried herbs mostly. Through good ol’ English word butchery, we get the word drug, meaning a substance that has an effect(biological) on the body. It gets a little more fuzzy when we think of the modern incarnation of drugs as being chemicals that affect other chemicals. Just about all new drugs nowadays are enzyme inhibitors. But there’s a small exclusive group of chemicals that affect on the body without really interacting with any of your own proteins. Each being really so unique that we can’t lump them together in one unified family.

Starting with perhaps one of my all time favorite chemicals: PEG, or polyethylene glycol. This lecture is going to make my high school English teacher proud, because we’re going to have lots of vocabulary discussions.

Polyethene glycol is a beautiful word. Chemicals are often doomed to have these obscure awkward names. But PEG’s name is so elegant, I refer to it first when explaining chemical nomenclature. Let’s break it down.

Poly: short for polymer, means a repeating linear chain of identical(usually) monomers, or pieces.
ethyl: means 2 carbons.
ene: This one is a little hard. It can mean a 2 carbon segment that has, or has lost a double bond to a strong oxidizer like oxygen.
glycol: This is tricky, because many ameature chemists believe it refers to sugar, but really in this case it refers to a dual set of hydroxyl groups, or OH- groups.

This chemical is used in just about everything. As a drug, as a food additive, rocket fuel additive, electrical resistor additive, and durable acid resistant plastic. It’s amazing, and it’s only getting better.

How we use it now is simply eating it. You buy it over the counter as miralax(other brands are available). It works its wonders by drawing a massive amount of water into the bowel. Many chemicals have what chemists like to call an electrical sphere of influence. A molecule with certain properties can attract smaller charged molecules(water) to them. This is because they are electrically charged. Polyethylene glycol has a lot of oxygen groups(hundreds if not thousands per molecule) which form a tightly bound pillow of water around them. when you eat concentrated PEG powder, this draws lots of fluid into your gut, allowing your to expel any obstructions.

But hold on, it’s about to get real weird. New scientific evidence has strong evidence this clumsy chemical can be our savior when it comes to repairing nerve damage. For reasons not yet fully understood, when injected into damaged spinal columns, it’s been shown to help repair damaged nerve cords, reducing the amount of nerve damage after trauma. Tests on guinea pigs have shown up to 70% nerves are saved.

If you follow the news, you’ll have heard of the russian man who will be the first human to have a head transplanted. He will be THE FIRST person this new discovery will be tested on. His head will be glued onto a new body with PEG being the glue. Will it work? I have no idea.

Simethicone

I have a soft spot in my heart for silicon chemistry. People play it down as that shitty grey metal that makes up sand and computer chips. But I know there’s a gem in the shit. Silicon is very similar to everyone's favorite element, carbon. It’s makes great polymers, makes great explosives, and makes great drugs.

Simethicone, a silicon-carbon polymer is another gastrointestinal drug. Instead of being strictly carbon and oxygen chain like PEG, simethicone is a 3 element chain, with oxygen, silicon and carbon. It acts as a foaming agent, reducing surface tension between air and water, allowing gas to be absorbed into liquids.

If you eat too fast, or you have trouble digesting certain foods like complex carbs and lactose, you’ll have known the pains of bloating and gas. The bacteria in your gut are going crazy because you just gave them their favorite foods: complex sugars. What happens is if your body isn’t good at digesting a certain type of carbohydrate, it makes it’s way to your large intestine, where essentially all hell breaks loose. Bacteria rapidly break it down into methane, carbon dioxide, oxygen, and hydrogen.

Simethicone absorbs hydrogen and methane gas, while helping other gasses dissolve in liquid, when they can make their way down the tube.

Therapeutic, non-enzymatic salts:

Zinc Oxide

It’s in everything, and for good reason! Sunscreen, paint, athletic tape, creams, ointments, powders, dental cavity filling, antibiotics, and shampoo. It’s in these products mostly for two essential reasons.

Firstly, bacteria hate zinc. Most life on the planet uses zinc in minute concentrations to make complex enzymes. But in large quantities, it’s very disrupting. Zinc Oxide doesn’t dissolve in water, or anything really. So if you’re a cell, it’s a huge pain to get rid of it. Nanocrystals of it clog major enzymes and just add extra baggage to an already cramped cell. Microscopic crystals of it are comparable to trying to fit tennis balls through a garden hose.

It’s used in antibiotic eye drops, ointments and creams because in combination with antibiotics that disrupt cell membrane functions, it’s a death sentence for the cell. It’s widely combined with the drugs ciprofloxacin, and bacitracin to increase their effectiveness.

Secondly, it absorbs ultraviolet radiation without the problem other sunscreens have of breaking down over time. Zinc oxide readily absorbs ultraviolet, among other forms of radiation.

Magnesium Citrate

Both magnesium and citrate are enzymatic. When consumed in the formulation it comes as, much of it will be absorbed by your body and used for whatever(the technical term). But what we often use it for is non enzymatic. Saline enemas and saline laxatives largely consist of magnesium salts like Magnesium citrate.  If you remember our discussion on PEG, you’ll know already that certain molecules can command a huge power on neighboring water molecules. citrate, the salt of citric acid, is an incredibly oxidized organic compound, with lots of oxygen. This in turn draws lots of water into the bowel.

Barium Sulfate

Although slowly being replaced but different chemicals, barium sulfate is an essential drug in the detection of gastrointestinal diseases.  Many people will remember drinking this thick, milk like solution called a barium meal.

Barium is very poisonous. Most salts of it are water soluble, and can cause various problems in muscles and nerves. However, when combined with sulfate, barium becomes insoluble, forming this thick white chalky mixture. This is essential, because it makes removing it from the body very easy.

Barium sulfate is used as a radio contrast agent. Meaning upon x-raying your abdomen, your intestinal tract with light up because of the radiation absorbed. This is useful in the detection of obstructions, leaks, and ulcers.

[bigbaldben]

Non-Enzymatic Drugs and Therapeutic Salts

Barium Sulfate

Although slowly being replaced but different chemicals, barium sulfate is an essential drug in the detection of gastrointestinal diseases.  Many people will remember drinking this thick, milk like solution called a barium meal.

Oh testify!  That stuff is nasty.

[Letonna]

I decided I'm just going to do these lectures on whatever drugs I feel like instead of adhering to a strict schedule.

Three Is The Loneliest Number: Z-drugs, The Easiest Narcotic To Get

Zaleplon, also known as Sonata, a prescription sleep aid

Z drugs, also known as non-benzodiazepine hypnotics are a diverse group of drugs whose sole purpose is to put you to sleep. Ambien(Zolpidem), Lunesta(esZoplicone), Sonata(Zaleplon) are the big ones. Although, however diverse their family, it’s a very lonely contest in the narcotic sleep drug world. So many of these drugs are known, but due to corporate mergers, copyright lawsuits, abandoning, lackluster clinical trials, birth defects and liver damage left many of these drugs dead(in the US at least). There’s really only 4 that have been proven safe enough to use and have been successfully approved.

Zolpidem, also known as Ambien

I guarantee most of you reading this will know someone on these medications. And chances are good they're on Zolpidem. Zolpidem is the oldest, easiest to obtain, and by far the cheapest of the nonbenzodiazepines. A month supply may cost you no more than 20 dollars with insurance.

Now I keep dropping this strange word: nonbenzodiazepine. This is really an umbrella term used to describe three class of compounds: Imidazopyridines, cyclopyrrolones, and pyrazolopyrimidines. Compounds that have a narcotic effect on the brain and help people sleep longer or better*. Before these drugs came around, people would use drugs called benzodiazepines. Valium, Ativan, Xanax, Restoril. Stuff like that. These drugs were very sedating, but were iffy on the quality of sleep they provided. Not to mention they were easy to become dependent on. So new narcotic sleep aids are now called nonbenzodiazepine hypnotics.

Zoplicone, also known as Imovane

Structure

These compounds are hard to compare to the untrained eye because they all look relatively different. And rightfully so, because they come from three different drug classes. But upon closer inspection, one notices a pattern. All of these drugs have a flat, aromatic plane consisting of usually 2 nitrogenous rings with a short polar tail. This is key to helping fit into the GABA receptor in your brain, responsible for relaxation, antianxiety, and many other functions.

Like many drugs and chemicals I write about, I find them fascinating. However, from experience in pharmacy and from what recently medical advancement have shown, they aren’t really very good drugs. They are widely over prescribed and abused. And many pharmacists and sleep specialists will argue they will only slightly help your sleep. Dependence and tolerance start after just a few weeks. And like many narcotic agents, that eventual withdrawal is a nightmare. I think they are valuable to have at our arsenal, but I feel many physicians will prescribe them to easy a cranky patient's mind without trying other non narcotic alternatives. I mean, after watching this commercial, don't you want to be on one of these drugs?

https://www.youtube.com/watch?v=-ojjrLARMzA

[Letonna]

The bad-rap-drugs: Pharmacology we don’t talk about in polite company

Opium, Ketamine, Methamphetamine, Pentobarbital, Dronabinol(THC)

All of the aforementioned drugs are technically legal in the United states. That was a bit of a bombshell to drop. Opium? The thing the British used to conquer China? Meth? The stuff Walter White makes in that show? Ketamine? That stuff I did that one time in Amsterdam? THC? That stuff Khem likes so much? Yes. All of it. It’s all legal. Provided you can con your doctor into hooking you up. Before you post how wrong I am, let me explain the dirty drugs your doctor won't talk about.

Opium:

“Opium” by itself isn't a drug. It’s a tincture of ‘opioids’. Tincture is a old pharmaceutical word for a solution for therapeutic use that holds a herbal extract, aided by a solvent, usually alcohol or acetic acid. Opium tincture is a medication usually used in gastrointestinal wards in hospitals as a last resort to aid in chronic diarrhea and water loss through the intestines. It’s a mixture of morphine, codeine, thebaine and papaverine, and some other molecules; all painkillers. This medication isn’t taken for pain however. Opioids have a most notable side effect of constipation through removal of fluids from the bowel. Hence, its use as an extreme anti-diarrheal.

Ketamine:

Ketamine is an amazing drug(>_>). No really. Yes it has been known as a party/rave drug. But it has so much to teach us how deep brain chemistry really works. It’s the holy grail of neurological medicine. It’s a sedative, hallucinogenic, antidepressant, anesthetic, bronchodilator, and pain killer. However, because of it’s controlled substance status in the United States, it’s uses under fair medical practice are limited to just pain and anesthesia. However, many groups at this very moment are researching its uses in severe depression that hasn’t responded to electroshock or antidepressants.

Methamphetamine:

Yes, really. Under the Scheduled Substance Act, Methamphetamine is a legal drug in the United States. It’s called Desoxyn, and the tablets look like this.

 If I remember right they come in 5mg tabs, but don’t hold me to that.  It’s used on-label(meaning how the FDA says it should be used) for ADHD and weight loss, and off-label for Hypersomnia and narcolepsy. it has the pleasant side effect of being a nasal decongestant, and the unpleasant side effect of stinking up your RV parked in the hot Arizona sun.

Pentobarbital:

Pentobarbital is notoriously known as one of the three drugs in the three drug cocktail of death, AKA, the lethal injection. In therapeutic dosages, pentobarbital is a very potent sedative, often meant to keep intensive care patients asleep or sedated if their injuries require it. However, in excessive dosages, it can be such a potent sedative, that brain activity regulating lung functions slows or stops, suffocating you. In recent years it’s been difficult to procure because the major manufacturer, based in Europe, forbids sales to the US government that are intended for execution. Although they still occur, many US correctional institutions have switched to other similar drugs.

Dronabinol(THC):

Dronabinol, also known as Marinol, or THC, is a cannabinoid extract from the famous Marijuana plant. It’s main usages is in terminal or severely incapacitated patients who do not naturally feel hunger. It’s a very potent apatite generator. Most commonly given to people suffering or dying from cancer, aids, crohn's, or other terminal illness. I’ve been asked by inquisitive minds in the past why it’s not called just THC or “marijuana pills”. And in all my research I can only come to the conclusions is it’s an easier word to say in polite company(and we come full circle).