• Modern History of Cannabis in Medicine

    Below are excerpts of the 2010 American Society of Addiction Medicine (ASAM) white paper republished by The Journal of Global Drug Policy and Practice about the Modern History of Cannabis in Medicine:

    In the early part of the 19th century, the European medical community became aware of the therapeutic potential of cannabis-based medications. Dr. William O’Shaughnessy, an Irish physician, conducted clinical and nonclinical work in India with cannabis preparations and upon his return to England, the results of his studies became widely known. Across Europe and North America, interest increased in the therapeutic potential of these materials. Pharmacist and early pharmaceutical companies developed oral cannabis extracts and tinctures for various medical conditions. These cannabis preparations were unstable and unreliable, however, because unlike opiates, cannabinoids are not water-soluble, and they are sensitive to degradation by heat and light. Because of these characteristics, and the limited technology available at that time, the active ingredients in cannabis preparations were unknown, the preparations lacked standardization, and patient response was variable.

    Reports often blame the enactment of the federal Marijuana Tax Act of 1937, which imposed administrative limitations on the prescription of cannabis preparations, for the contraction in the use of marijuana in medicine. The main reasons for this disappearance were the variable potency of cannabis extracts, the erratic and unpredictable individual responses, the introduction of synthetic and more stable pharmaceutical substitutes such aspirin, and the recognition of important adverse effects such as anxiety and cognitive impairment. Accordingly, cannabis preparations gradually fell out of use by the medical profession.

    Because of the technological challenges involved in the cannabinoid formulation and research, it was not until 1964 that the primary psychoactive ingredients in cannabis, delta 9-tetrahydrocannabinol (THC), was identified and synthesized. Coincidentally, popular interest in smoked cannabis began to increase significantly. A number of individuals reported that smoking cannabis for recreational purposes seemed to alleviate some of their medical symptoms. Interest grew in finding therapeutic uses for smoked cannabis.

    More advanced technology in the 1800s and early 1900s might have led to a range of cannabinoid medications and cannabis smoking might have been relegated to the realm of non-dependent non-medical use for pleasure.  Thus, the “lag” in the technological capabilities of modern science probably contributed to the controversy of “medical marijuana.” The technology has now arrived, and the era of modern cannabinoid medication development is well on its way.

    Source:  http://www.globaldrugpolicy.org/Issues/Vol%205%20Issue%204/ASAM%20with%20front%20page.pdf

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