The History of Cannabis

By Dr. Rachel Knox, MD, MBA, MCBA Medical Chair

The documented use of cannabis as medicine dates back to 2737 BC, first recorded in the ancient Chinese text, the Shennong Bencaojing. The text noted, in particular, the use of cannabis to treat gout, rheumatism, pain, constipation and memory loss. Records even show cannabis was once considered among China’s 50 most fundamental herbs for medical use. Detailed records also indicate that cannabis was widely used across Euro-Asia, from Greece, through India into Egypt, and northward into Spain and Russia. It was used for a variety of conditions and purposes including glaucoma, cancer, ulcers, wounds, hair loss, hemorrhoids, obstetric and urologic care, anesthesia, premenstrual syndrome and other menstrual disorders, epilepsy, depression, anxiety, pain, insomnia, and hundreds more maladies.

By 1850 AD cannabis made up 50% of the American Pharmacopeia — 50% of medicines in the US were cannabis extracts or contained cannabis as major formulaic constituents. From ‘hysteria” to migraine headache, or muscle spasms to alcohol withdrawal, cannabis treated, and even cured, a wide range of ailments, including venereal disease.

Despite its renown, world-wide prohibition cast a devastating blow to the use of cannabis as an effective palliative and curative agent. Without robust scientific research to back its historical and anecdotal efficacy, even the American Medical Association (initially taking up a strong position in favor of its continued medicinal use) succumbed to federal pressures to discontinue the use of cannabis in medical care. By 1942 cannabis had been wiped out from all American medical literature.

While prohibition prevented unbiased research and clinical study of cannabis in the United States, members of a group called the International Cannabinoid Research Society were granted investigatory freedom. In 1963, one such member, a biochemist at the Hebrew University in Israel named Raphael Mechoulam, and his team determined the chemical structure of the phytocannabinoid CBD (cannabidiol). Phytocannabinoids are cannabinoids (chemical compounds) that occur naturally in the cannabis plant. In 1964, Dr. Mechoulam further isolated and synthesized the phytocannabinoid THC (delta-9 tetrahydrocannabinol). There have now been discovered over 100 phytocannabinoids, and approximately 500 terpenes and flavonoids in cannabis plants that contribute to their medicinal properties.

Out of the biochemical study of phytocannabinoids came perhaps the most significant physiologic discovery of all time: the human body’s own Endocannabinoid System (or ECS), named after the plant that led to its discovery in 1989, and its subsequent mapping in 1990. The ECS is a chemical messaging system responsible for maintaining homeostasis in the bodies of all vertebrate organisms. This means it oversees functional balance and plays a restorative role when physiological processes in the body fall out of that balance. A network made up of receptors and locally derived and degraded chemical messengers called endocannabinoids, the ECS is now known to modulate all mechanical, physical, bioelectrical and biochemical pathways in the human body, regulating the cardiovascular, nervous, endocrine, reproductive, integumentary, and musculoskeletal systems.

Endocannabinoids are cannabinoids that occur naturally in humans and other animals, and act on cannabinoid receptors located throughout the body including the brain and peripheral nervous system, end organs and endocrine glands, the gut and immune cells, and even connective tissue. When working optimally, endocannabinoids will trigger cell death of aberrant cancer cells, prevent excess firing of pain signals, modulate embryonic implantation, and uplift a depressed mood to name just a few of its balancing acts. Phytocannabinoids of the cannabis plant mimic the activating role endocannabinoids would otherwise play in under healthy physiological conditions, and this is why cannabis has such great influence on seemingly every aspect of our human body, mind and even spirit.

Over 20,000 scientific publications exist on the study of cannabis, the ECS and its clinical application. The use of cannabis for intractable seizures has influenced CBD legalization in 10 states, while its use for a myriad of other conditions including, but not limited to, PTSD, Multiple Sclerosis, chronic pain, cancer, anorexia, and hypertension has led to legalization of the whole plant in 23 others.

Research continues to prove cannabis’ value in the treatment of a wide range of illness and disease, a fact users have known all along. Even since prohibition, cannabis consumers have been illegally and legally using cannabis for medical purposes. In fact, the federal government created a program in 1976 to provide cannabis for a small number of patients with protracted and intractable illnesses, leaving millions more to continue to medicate unlawfully. To address this hypocrisy and misregulation, efforts were made to bring federal legalization into fruition. In 1988, after extensive hearings, the DEA’s Chief Administrative Law Judge, Francis L. Young, ruled 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 sufferers and the benefits of this substance…” Despite his ruling, the DEA did not change its stance on cannabis. Multiple petitions have since been submitted to the DEA to deschedule cannabis from its Schedule I classification, a classification reserved for substances having a high potential for abuse and no accepted medical value — neither of which are true for cannabis. To date, despite irrefutable evidence and an ongoing federal program that treats patients on the basis of cannabis’ medicinal value, all petitions have been denied.

As states have taken the legalization of medical cannabis into their own hands over the past two decades, millions of people have finally been awarded lawful access to cannabis to treat their illnesses and chronic disease. Medical legalization is on the ballot for several more states in 2016, and the DEA has recently announced it will likely rule on rescheduling cannabis this year as well.

Regardless of outcome and the uncertainty of federal legalization, one thing remains unwaveringly true: cannabis is medicine — wholly safe and wholly effective when used responsibly. With continued education, advocacy, and adoption, it stands to become the most important and pivotal medicinal tool of our lifetime.

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