The beginnings
Cannabis has been used for medical purposes for nearly 5,000 years. As early as 2737 B. C, the Emperor Shen Neng of China was prescribing marijuana tea for the treatment of gout, rheumatism and malaria. The plant’s popularity as a medicine spread throughout Asia, the Middle East and down to the eastern coast of Africa. By the late 18th century, American medical journals recommended hemp seeds and roots for the treatment of a variety of conditions.
William O’Shaughnessy first popularized the medical use of cannabis in England and America – he found cannabis eased the pain of rheumatism and was useful for discomfort and nausea. Cannabis, or marijuana, was included in the American pharmacopoeia until 1942. Cannabis is currently available by prescription in the Netherlands, Canada, Spain, Chile and Israel.
A change in opinion
In 1937, the federal government passed the Marihuana Tax Act. Although the act did not outlaw cannabis outright, the effect was the same. It was done in spite of objections from the American Medical Association (AMA). The AMA legislative counsel, Dr. William Woodward, testified in front of Congress that “The American Medical Association knows of no evidence that marijuana is a dangerous drug.” During his testimony before Congress, Woodward warned that prohibition “loses sight of the fact that future investigation may show that there are substantial medical uses for Cannabis.”
In later decades, the U.S. government has somewhat ebbed and flowed with their position on cannabis as medicine. In 1976, the Investigational New Drug (IND) research program was created by the federal government. It allowed participating patients to receive up to nine pounds of cannabis directly from the government (grown on a farm at the University of Mississippi). Because the program ceased enlisting new patients, only five of the original participants are surviving and still receiving medical cannabis today.
The Drug Enforcement Agency’s (DEA) own Administrative Law Judge, Francis Young, ruled in 1998 that “Marijuana, in its natural form, is one of the safest therapeutically active substances known… It would be unreasonable, arbitrary, and capricious for the DEA to continue to stand between those sufferers and the benefits of this substance…” Despite Young’s strongly worded opinion and official position, the DEA refused to implement his ruling based on a procedural technicality. The agency has refused to consider the rescheduling of cannabis to this day.
A transition
Unfortunately, the IND program was shut down by the Public Health Service in 1991 after the Food and Drug Administration (FDA) received a large number of new applications from patients with HIV/AIDS in 1989. The IND program was deemed to undermine federal law. Despite the success of the program—and centuries of evidence regarding safe use of cannabis to treat a wide variety of ailments—cannabis continues to be classified as a Schedule I drug under the Controlled Substances Act, “indicating a high potential for abuse and no accepted medical value.”
In 1996 the tide began to turn in favor of patients desiring to medicate with cannabis. Gaining no relief or cooperation at the federal level, advocates turned to the states for help. Voter initiatives in California and Arizona approved laws that allowed for legal use of marijuana if accompanied by a doctor’s recommendation. Shortly thereafter, similar medical marijuana laws were passed in Alaska, Colorado, Maine, Montana, Nevada, Oregon, Washington, and Washington, D.C. Since that time, the legislatures of states including Hawaii, New Mexico, Maryland, Vermont, and Rhode Island have also passed laws to help sick patients legally medicate with cannabis. A total of 23 states and Washington D.C. have adopted medical cannabis laws and 16 additional states have passed laws allowing for the use of low-THC/high-CBD oils, and several of the remaining states currently have legislation of some type pending.
In 1997, the White House and the Institute of Medicine (IOM) commissioned the Office of National Drug Control Policy to study the efficacy of cannabis as medicine. It concluded that cannabis is both safe and effective as a medicine and, therefore, patients should have safe access and the government should be conducting research and even developing new drugs derived from cannabis.
Despite a lack of cannabis research at the federal level due to its continued Schedule I status, dozens of studies have been published worldwide (typically in countries outside the U.S.) that support the conclusions of the IOM study and call for further research. Despite the need for more studies and human trials, the medical efficacy of cannabis is overwhelming for a wide variety of diseases and ailments.
Current trends
We stay on top of advances in research, fueled by controlled studies, observational studies, reports, and peer reviews describing the efficacy of cannabis for the treatment of various medical conditions. While the studies continue to proceed in countries like Israel, the United Kingdom and Spain, clinical study efforts are still hampered in the U.S. due to the continued inclusion of cannabis as a Schedule I controlled substance. Numerous planned controlled clinical studies over the past decades have been frustrated by the inability to obtain FDA approval for such study or, if permission is received, to obtain quality test material from the government’s supply facility at the University of Mississippi.
In 2015, three U.S. Senators brought forth the CARERS Act, a bipartisan effort to protect those involved with state-based medical cannabis programs while rescheduling cannabis from a Schedule I to Schedule II substance. The support that the Act has received so far is unprecedented. Should such legislation be adopted, cannabis will finally be given the opportunity to take its place in traditional pharmacology in the 21st century.
Interesting fact:
Cannabis tinctures were available for over-the-counter purchase in pharmacies throughout the United States until the 1930s.