History of the Medical Use of Cannabis

The use of marijuana as a medicine is undergoing a resurgence at a grassroots level. The hemp plant has a very long and varied history. Its considerable psychoactive properties have been both a source of interest and public debate for centuries. Some believe the term “marijuana” is derived from the Mexican words for “Mary Jane” or from the Portuguese word marigu-ano which means “intoxicant”. And therein lies the problem in utilizing marijuana as a modern medicine, is it to be regarded as a therapeutic drug or an intoxicant?

The plant has been grown for fiber and as a source of medicine for several thousand years, but until 500 A.D. its use as a mind-altering drug was almost solely confined to India. Although the Chinese and Indian cultures knew about the properties of this drug from very early times, this information did not become general in the Near and Middle East until after the fifth century A.D., when travelers, traders and adventurers began to carry knowledge of the drug westward to Persia and Arabia. Several years after the return of Napoleon’s army from Egypt, cannabis became widely accepted by Western medical practitioners. With the rise of the literary movement of the 1840-1860 period in France cannabis became somewhat popular as an intoxicant of the intellectual classes. It also moved across North Africa, appeared in Latin America and the Caribbean, and finally entered the United States in the early decades of this century. Cannabis as a medicine was common throughout most of the world in the 1800s. It was used as the primary pain reliever until the invention of aspirin.  In the United States, medical interest in cannabis use was evidenced in 1860 by the convening of a Committee on Cannabis indica of the Ohio State Medical Society. Between the period 1840-1890, it was reported that more than 100 articles were published recommending cannabis for one disorder or another.

The medical use of cannabis declined in the early 20th century with the rise of other, more easily measured pharmaceuticals and it began to lose support of the medical profession. It was during the years between 1856-1937 that cannabis lost its image as a medicine and was left with a disreputable image as an intoxicant. Nevertheless, prior to 1937 at least 27 medicines containing marijuana were available in the US. Strong public reaction coupled with a campaign in the public press led to a federal anti-marijuana law in 1937. (The drug was illegal in many states before 1937). By the time the US banned cannabis (the third country to do so) with the Marijuana Tax Act the plant was no longer extremely popular. Thus, the medical profession was denied access to a versatile pharmaceutical tool with a history of therapeutic utility going back thousands of years. In 1972 Tod H. Mikuriya M.D. reignited the debate concerning marijuana as medicine when he published “Marijuana Medical Papers 1839-1972”.

Medical uses in the 20th Century

After 1937, with the passage of the Marijuana Tax Act and subsequent federal and state legislation, it became virtually impossible for physicians to obtain or prescribe marijuana preparations for their patients. Preparations became rarely available (cannabis preparation and synthetic THC are obtainable only for research purposes), and prescriptions are regulated by special tax laws. In the United States, the “Federal Food, Drug, and Cosmetic Act” makes the (FDA) the sole government entity responsible for ensuring the safety and efficacy of new prescription and over-the-counter drugs, overseeing the labeling and marketing of drugs, and regulating the manufacturing and packaging of drugs. The Controlled Substances Act of 1970 placed all drugs in “schedules”. Marijuana was placed in a Schedule I category, defining it as having a high potential for abuse, no currently accepted medical use in treatment in the US, and lack of accepted safety for use under medical supervision. The FDA has not approved smoked cannabis as a legitimate medicine for any disease.

Despite the fact that marihuana was made illegal in the United States in 1937, some research has continued on the medical uses of marijuana. The findings include various possible medical applications of cannabis and its chemical derivatives. Later, in the 1970s, a synthetic version of, the primary active ingredient in cannabis, was synthesized to make the drug Marinol. Marinol contains only a fraction of the bioactive cannabinoids that the whole plant offers and is considered by most to be a poor substitute. During the 1970s and 1980s, six US states’ health departments performed studies on the use of medical marijuana. These are widely considered some of the most useful and pioneering studies on the subject. Despite the many statements discounting cannabis’ therapeutic usefulness, some authorities maintain that its medical value might be reborn through further research and/or use. David Solomon, in his foreword to The Marijuana Papers (1968) argues that: marijuana should be accorded the medical status it once had in this country as a legitimate prescription item.

At a meeting in February 1997, a workshop sponsored by the National Institute of Health concluded that medical marijuana appears to be of benefit for the following conditions. These are

  1. To stimulate appetite and relieve cachexia
  2. To control nausea and vomiting associated with cancer chemotherapy
  3. To decrease intraocular pressure for relief of glaucoma
  4. As analgesia for chronic pain
  5. To treat neurological and muscular disorders, such as muscle spasticity and seizures

Public and scientific opinion has been moving toward the reintroduction of marijuana as a medicinal agent. A national Gallup poll released in November 2005 found that 78% of Americans support “making marijuana legally available for doctors to prescribe in order to reduce pain and suffering.”