Medical cannabis has been used to treat illness for more than 6,000 years

Carl Esprey is CEO of Botanical Holdings, which focuses on investment in the legal cannabis sector.

In 2020, cannabis as a legal medicinal treatment is more widely accepted in many countries than it has been for generations. Its use as a medical treatment for a wide variety of illnesses and conditions is now being researched all over the world.

Medical cannabis had a century-long hiatus because of strict legislation and lack of research. And while we’re getting back on track with it now, it’s not commonly understood just how long humans have been using cannabis to treat illnesses.

Where is medical cannabis legal today?

Countries that have legalised medical cannabis use include the UK, Thailand, Sri Lanka, Uruguay, Australia, Croatia, Canada, Chile, Greece, Italy, Germany, Israel, Jamaica, Uruguay and Israel among others. Other countries limit legalised medical use to specific isolated cannabinoids, such as Epidolex or Sativex.

In Canada, the Netherlands and Uruguay medical cannabis can be bought without a prescription. In the US, legalisation varies by state. At present, cannabis is legal for medical purposes in 33 states and another 14 states have stricter laws surrounding THC products. At a federal level in the US, cannabis is still prohibited, but the 2014 Rohrabacher-Farr amendment limits federal law in states that have legalised medical cannabis.

What does the phrase ‘medical cannabis’ officially mean?

Medical cannabis is defined by the National Institute of Drug Abuse as the use of “the whole unprocessed marijuana plant or its basic extracts to treat symptoms of illness.” There are actually more than 400 chemicals in the cannabis plant. Of these, approximately 70 chemicals are cannabinoids. Usually, Government-approved cannabis-based medicines use just one or two chemicals.

The wide variety of chemicals present in a cannabis plant is one of the reasons why it’s so complex to study and fully classify as a medical treatment. Research shows that medicinal cannabis can help patients with muscle spasms and chronic pain conditions. It also shows efficacy in relieving nausea associated with chemotherapy, boosting the appetite of people suffering from HIV or AIDS, aiding restful sleep and improving tics linked with Tourette’s syndrome.

Medical marijuana is taken in various forms, ranging from edibles, to capsules, lozenges or vaporizing. Synthetic cannabinoids are available via prescriptions in some countries under the names nabilone and dronabinol.

Medical cannabis has been used for upwards of 6,000 years.

In China cannabis is called má, which translates as ‘numbness’, cannabis’ or ‘hemp’. Its use is first recorded around 10,000 years ago in Taiwan. According to botanist Hui-lin Li, Chinese use of medical cannabis is likely to be an extremely early development. Ancient people ate hemp seed and the natural progression is to discover whether there are any medicinal properties to anything they ate.

In 2737 BCE, Emperor (and pharmacologist) Shen-Nung wrote a medical textbook that includes the medicinal use of cannabis. He said medical cannabis was effective for all kinds of illnesses, including rheumatism, gout and constipation. Cannabis is considered one of the 50 fundamental herbs in traditional Chinese medicine.

By 1550BCE, the Ancient Egyptians were using medical cannabis as suppositories to treat hemorrhoids, according to the Ebers Papyrus. Similar texts from ancient India clearly show that physicians understood the psychoactive effect of cannabis. It was used to treat a wide range of illnesses, including pain during childbirth, headaches and insomnia. Not to be left out, the Ancient Greeks used medicinal cannabis to treat wounds on their horses. They also used dried cannabis leaves for nose bleeds and cannabis seeds to expel tapeworms.

Different localised cannabis strains began to emerge

Cannabis sativa, a species that includes hemp and marijuana varieties was first used extensively by Arabic physicians from the 8th century onwards. As cannabis sativa has a higher concentration of THC it was used for its antiemetic, diuretic, anti-inflammatory and pain-killing properties. Cannabis sativa grows wild in tropical and humid areas of the world and has been cultivated by people throughout recorded history.

Landrace strains developed after cannabis use spread throughout Eurasia between 10,000 and 5,000 years go. Form around 2,000 to 500 years ago, cannabis spread further to Africa and the Middle East. Over centuries, localised strains developed in different regions.

Cannabis was introduced to Western medicine in 1842

We can trace the introduction of cannabis into western medicine back to an Irish doctor called William Brooke O’Shaughnessy. After discovering it in India in the 1830s and conducting many experiments on its efficacy as a pain killer, he brought a supply back to England in 1842. After this it spread quickly throughout Europe and the US. It was introduced into the United States Pharmacopeia just eight years later in 1850.

By the close of the 19th century, medical cannabis declined in popularity. This is likely down to the rise in popularity of opiates. People could easily inject a synthetic or natural opiate for pain relief, while cannabis can’t be administered in the same way. For a while, easy access to opiates trumped cannabis as a pain killer and treatment for many illnesses.

Legislation became stricter throughout the first half of the 20th century

Various legislative changes in the US meant medical cannabis use declined further. The Marihuana Tax Act of 1937 primarily focused on recreational use but also included prohibitive fees and regulations on doctors prescribing cannabis. Just four years later cannabis was expunged from the US Pharmacopeia and by 1970 was banned outright for any use under the Controlled Substances Act (CSA). 

As cannabis was considered a ‘Schedule 1’ drug under the CSA, medical research was halted. It was considered to have “no accepted medical use”. In the 1970s and 80s interest in cannabis as a medical treatment was revived particularly when it came to treating cancer and AIDs patients. Those suffering from the side-effects of chemotherapy and AIDS reported relief from cannabis use.

CBD1 and CBD2 cannabinoid receptors were discovered in 1988. We now known these are some of the most common neuroreceptors in the brain, which for some researchers opened medical cannabis up once again. In 1996 California defied Federal law and legalised medical cannabis. Canada became the first country to regulate medical cannabis use in 2001. After this other countries and states followed suit in legalising cannabis for medical purposes, although solely from licensed producers.

Now that the scientific community and many Governments are much more open to large scale research into medical cannabis, we can expect to see many more treatments on the market in the near future.

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