Delta-9-tetrahydrocannabinol (D9-THC) is the driving cannabinoid within cannabis that produces its psychoactive effects. However, the plant itself contains over 400 individual chemicals, many with unique pharmacological properties. Further complicating the cannabis market, chemical modifications have been identified to convert naturally derived cannabinoids to alternative cannabinoids and the collection of synthetic cannabinoids, manmade chemicals designed to act at cannabinoid receptors, continues to grow. Recent years have seen a rise in popularity of these alternative cannabinoids, and this trend is likely to continue with the continuing legalization of recreational cannabis throughout the United States. It is vital for medical providers to not only be aware of the wide range of available cannabinoid products, but to be conscious of their differing properties. The current work aims to identify commonly used alternative cannabinoids, examine their complicated legality, and summarize the available literature regarding their clinical effects.
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