Medical Marijuana: Indica vs. Sativa

There are two main types of marijuana

Marijuana. Getty Images

Legalization of medical marijuana has made its sale and consumption increasingly sophisticated.  Nowadays, walk into any dispensary and prepare to be regaled with every top-shelf strain imaginable not to mention an endless array of edibles, oils, and tinctures.

For some time, scientists questioned whether various strains of herbal marijuana are in fact different from pure-cannabinoid preparations like Marinol or Nabilone.

 More recent research suggests that on a molecular level, Northern Lights, Purple Urkle, Afghan Kush, Trainwreck, Girl Scout Cookies and scores of other indicas, sativas and hybrids are in fact distinct from pharmaceutical preparations. However, at this point, the exact physiological effects of different types of marijuana seem to be more subjective.

Indicas vs. Sativas: Chemistry

Although various hybrids exist, in very broad terms, medicinal marijuana can be split into two categories or species: Cannabis indica and Cannabis sativa.  (For all you trivia aficionados, there also happens to be a third category called Cannabis ruderalis.  Ruderalis contains low levels of psychoactive cannabinoid and is rarely cultivated as a drug.)

The two principal psychoactive components in marijuana are delta(9)-tetrahydrocannabinol (THC) and cannabidiol (CBD). Of note, metabolic fingerprinting (gas chromatography), has identified various other minor cannabinoids and terpenes which may further contribute to "highs." All this being said, ultimately, the CBD/THC ratio is higher in sativas than it is in indicas.

In addition to chemotype differences, the gross botanical appearance of sativas and indicas differs, too.  Sativa plants are taller and more highly branched; whereas, indica plants are shorter and grow broader leaves. By the way, marijuana users typically smoke "bud" or marijuana flower.

Indicas vs. Sativas: Different Highs

In part, research on cannabis is limited—in other words, no large randomized-control trials have been performed—because the U.S. government discourages such research and poorly funds any such initiatives.

Instead, people tend to rely on the Internet, friends or dispensary personnel. Equally important, few marijuana dispensaries test product for quality and reproducibility—specifically, CBD/THC ratios.

Subjective results from a recent low-power (95 research participants) Internet survey put out by Western University of Health Sciences does shed some light on clinical differences between indicas and sativas.  Here are some notable results from the survey of online marijuana users:

  • With respect to specific medical conditions, survey respondents felt that indicas help with nonmigraine headaches, neuropathy, spasticity, seizures, joint pain and glaucoma.
  • With respect to medical conditions, survey respondents expressed sativa preference only for treating weight loss (think cachexia).
  • Online marijuana users expressed no difference between indicas and sativas when addressing HIV infection, migraines, multiple sclerosis, cancer, muscle pain, arthritis, fibromyalgia, trauma, orthopedic problems, and other painful conditions.
  • With respect to symptoms, respondents expressed indica preference for pain management, help with sleep, help with sedation and a "good high."
  • With respect to symptoms, respondents expressed sativa preference for enhancing energy.
  • Researchers concluded that indicas were preferred when treating medical conditions; whereas, sativas were preferred for recreational use (a finding that gels with popular belief).

Please keep in mind that the research presented in this article is intended only to provide food (bud?) for thought. The science underlying the treatment of medical conditions and symptoms with marijuana in general needs further research and is in its infancy. Moreover, the science underlying species-specific treatment (indica versus sativa) needs even more research and is merely at conception. Finally, as far as I can tell, from a physiology perspective, nobody has bothered to look at how hybrids (indica- or sativa-dominant strains) differ. However, purveyors of marijuana do tend to recommend different types of marijuana for different medical conditions. Thus, such recommendations should be taken with a grain of salt.

Click here to read about the safety of smoking weed with vaporizers.


Fischedick et al. Metabolic fingerprinting of Cannabis sativa L., cannabinoids and terpenoids for chemotaxonomic and drug standardization purposes. Phytochemistry. 2010.

Pearce DD et al. Discriminating the Effects of Cannabis sativa and Cannabis indica: A Web Survey of Medical Cannabis Users. The Journal of Alternative and Complementary Medicine. 2014.

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