The use of cannabis has a long and rich history since it goes back as far as 3000 years. But it was in 1839 that W.B O’Shaughnessy, a surgeon working for the British East India Company in India, first learned of its medicinal properties. Given the benefits in the form of sedative, analgesic, anti-inflammatory, anticonvulsant and antispasmodic effects, its use was promoted in Western medicine.
However, the history of the use of cannabis has been marred by controversy in the United States. In 1937, the Marijuana Act was introduced by the U.S Treasury Department that imposed a tax of $1 per ounce of cannabis used for medicinal purposes. A tax of $100 per ounce had to be paid for non-medicinal use. The American Medical Association (AMA) opposed this Act as it required physicians to pay a tax for prescribing it but they had to use special order forms to obtain it while having to maintain professional records regarding its use. What the AMA also was concerned about was that there was no clear evidence in regards to the ill-effects of cannabis and this Act would bring to a close any research to determine its medical worth. Still, in 1942, cannabis was taken out of the U.S Pharmacopoeia due to concerns about its perceived ability to cause harm.
Not long after, in 1951, the Boggs Act was passed in Congress and that classified Cannabis as a narcotic drug. Nineteen years later, the Controlled Substance Act gave Marijuana the status of a Schedule I drug. Schedule I drugs are considered to have no medicinal use in the United States with some of these substances being LSD, mescaline, heroin and methaqualone.
Despite being classified as a Schedule I drug, the U.S government distributed cannabis to patients as a part of the Compassionate Use Investigational New Drug Program on a case-by-case basis in 1978. This program lasted until 1992 and after which the distribution of cannabis was stopped. Now, even though the federal use of cannabis is considered illegal, there are a number of states and territories that have permitted its use. There are other states that have only legalized one ingredient of Cannabis, known as cannabidiol (CBD). That said, some medical marijuana laws are considered to be broader than others. This is because there is a variance from state to state in regard to the type of treatments that are allowed for certain medical conditions.
As for cannabis’ medicinal properties, the main psychoactive constituent of Cannabis was found to be delta-9-tetrahydrocannabinol (THC). It shouldn’t be surprising that an isomer of THC, under the name of dronabinol, was licensed and approved for the treatment of nausea and vomiting that was associated with chemotherapy. It was during this time, in 1986, that researchers found that dronabinol, was probably the best antimetic agent available. This led to the treatment of medical conditions such as HIV and anorexia using this constituent found in Cannabis. Upon conducting clinical trials, patients not only experienced an improvement in appetite but also showed no substantial weight gain. Another nonpsychoactive drug known as CBD that is an analog of THC and classified as a cannabinoid, is found in Cannabis too.
And speaking of the neurobiology of cannabinoids, CB1, the first of the cannabinoid receptors to be discovered, was found in the brain in 1988 while CB2 was discovered in 1993. Given that CB2 receptors are located on natural killer cells and B lymphocytes, this suggests that it has a role to play in immunity. Apart from this, endogenous cannabinoids also control aspects such as movement, pain modulation, mood, bone growth, inflammation, neuroprotection, memory and feeding behavior.
That said, Nabiximols, a Cannabis extract prepared in the ratio of 1:1 of CBD:THC has been approved for the relief of pain for patients suffering from advanced cancer and multiple sclerosis under the Notice of Compliance with Conditions. Other countries in Europe as well as New Zealand and Canada have also approved nabiximols for spasticity of multiple sclerosis. This symptom of spasticity causes reduced mobility, pain and muscle stiffness and for which, therapy aren’t as effective.