Student Education Series: The Basics of Medical Cannabis

Suraj Tandon

On January 30, 2024, the Association of Cannabinoid Specialists hosted our quarterly virtual Student Education Series.  ACS was proud to welcome Suraj Tandon, MD, FRCPC, DABIM as its speaker on the topic of Basics of Medical Cannabis.  To watch the full presentation, click here.

6000 years

A History of Cannabis Use

Dr. Tandon started his talk by introducing several medicinal plants, such as foxglove, opium poppy, and, of course, cannabis.  He briefly touched upon the biology of the cannabis plant, including species and chemovars, before diving into the vast history of ancient cannabis use.  Throughout the ancient world, cannabis has been used as a medicinal herb to treat a wide array of health issues.  Beginning as far back as 2900 BC in China, and continuing through Egypt, Greece, Rome, Persia, and Mesopotamia, the cannabis plant has been utilized by many cultures over a great span of time to improve quality of life for patients, just as we use it today.  Interestingly, Dr. Tandon notes that the plant was not used recreationally until more modern times.

Fast forwarding to North America in the 1850s to 1900s, cannabis had a history of being used by pharmaceutical companies for issues like opioid addiction, alcoholism, migraines, gout, and much more.

Dr. Tandon also went into the complex history of legal medical cannabis in Canada, bringing us up to current events.

Vitruvian man

The Endocannabinoid System

Dr. Tandon then moved on to discuss the endocannabinoid system, which is a system that maintains homeostasis in the body.  The endocannabinoid system is found in all vertebrates.  Dr. Tandon discussed in detail the different parts that make up the endocannabinoid system: endogenous cannabinoids, exogenous cannabinoids (including phytocannabinoids and synthetic cannabinoids), receptor targets, and enzymes.  Phytocannabinoids include THC and CBD, as well as over 100 other compounds, each with its own potential array of medical properties.  Other important compounds include terpenes and flavonoids.  Dr. Tandon touched on the entourage effect, where these chemicals combine to give a greater effect than on their own. 

He also discussed CB1 and CB2 receptors, CB1 being in the brain and throughout the body in adipose tissue, liver, and GI tract, and CB2 being in the immune cells, spleen, and tonsils, as well as how THC affects these receptors.

One size does not fit all

Cautions and Take Away

Dr. Tandon included in his talk a variety of items that could be a concern for a doctor when prescribing cannabis.  Pharmokinetics and drug interactions need to be reviewed prior to prescribing cannabis to a patient.  Additionally, we should be cautious with prescribing to those with risk factors, such as pregnancy or breast feeding, as well as a number of mental health disorders.  As with many medications, there is possibility for addiction, so risk factors must be discussed.  

The main reason for prescribing cannabis is to improve quality of life for our patients.  Dr. Tandon also stresses that there needs to be an individualized and tailored approach to each patient.  We must remember that one size does not fit all.

To watch the full presentation, click here.


Dr. Tandon is a native of Toronto, Canada. He completed his Honours Bachelor of Science from McMaster University and went on to work as a researcher and co-investigator assessing physical and mental health disparities amongst South Asian immigrants for the Hamilton Public Health Department and Center for Addiction and Mental Health (CAMH).

After earning his medical degree, he completed his residency in Internal Medicine from the Frank H. Netter MD School of Medicine in Connecticut, followed by an additional chief residency year from the Hampton Veterans Affairs Medical Center and Eastern Virginia Medical School in Norfolk, Virginia.

Upon completing his residency, Dr. Tandon pursued additional fellowship training to further his interests in assisting patients suffering from complex chronic diseases. He went on to complete several fellowships in both Hospice and Palliative Medicine in New York at Weill Cornell Medical College of Cornell University with additional pain medicine training at both Memorial Sloan Kettering Cancer Center in New York City including the University of Toronto where he is now a lecturer and staff palliative medicine physician. Dr. Tandon is Board Certified in both the United States and Canada and is also a Fellow of the Royal College of Physicians & Surgeons of Canada.

With respect to cannabinoid medicines and access he has helped develop healthcare reform and public policy making in Canada and is a strong supporter and advocate for furthering the education including research on the efficacy of cannabinoid therapies. He has given a number of community and national talks on the evidence-based literature pertaining to the use of medical cannabinoids both within the United States and Canada.

He currently practices as a medical cannabinoid consultant and palliative medicine physician and is also one of the clinical site investigator lead physicians at McMaster University & The Michael G. DeGroote Centre for Medicinal Cannabis Research. Dr. Tandon also has experience working as physician advisor for several Canadian cannabis licensed producers and his current interests aside from cannabis also include the use of psilocybin for medical purposes. Lastly, Dr. Tandon remains actively involved as a lecturer at the university where he teaches training physicians and has had a pioneering role in introducing medical cannabinoid education into the residency program curricula. He is also a member of the Board of directors for the Association of Cannabis Specialists.