Despite decades of recreational use that has contributed to marijuana’s disrepute, for thousands of years, Cannabis, a group of plants comprised of three species and seven sub-species, was, in fact, used in the disciplines of healing and medicine to treat a variety of ailments. These practices, have however, for the better part of the last century, been limited due to the classification of the drug as an illicit and banned substance.
In recent years, the healing properties and potential benefits of cannabis and their applications in medicinal and lifestyle products are garnering renewed interest which is rapidly changing the mainstream perception of this formerly ‘taboo’ substance. Cannabis is now being used in everything from wellness products to cosmetics; and scientific research is once again focussing on its therapeutic potential in the treatment of a host of diseases.
With cannabis gaining popularity as a medicinal remedy, it’s important to understand what cannabis actually is, how it works and whether or not it really can be of benefit in the management and treatment of your particular ailment.
The history of medical cannabis
According to historians, the use of medicinal cannabis originated in China as early as 2737 BC and then spread through Asia into the Middle East and Africa1. It was used to alleviate pain and treat a variety of conditions from gout and rheumatism to poor memory; although the healers of the time did caution users against overuse as they believed it caused people to ‘see demons’.
In the medieval times (100 – 1000 A.D) cannabis was integrated into folk medicine to treat jaundice, coughs and tumours, yet folk healers continued to warn against excessive use which, they believed, could cause sterility and numerous other undesired conditions.
In the 1500s, thanks to the Spanish, Cannabis reached the shores of South America. Hemp (another form of the plant not used for medicinal purposes, but rather grown as an agricultural crop for use in the manufacture of clothing etc.) was introduced to North America during the years of colonisation. It wasn’t until many years later that cannabis was introduced as a medicinal plant and psychoactive drug.
From the 1700s onwards, cannabis gained prominence in the treatment of various health issues from inflammation and nausea to incontinence.
In 1906, with North American populations already addicted to unregulated substances like morphine, opium and heroin, the United States government created the U.S. Food and Drug Administration (FDA) to control access to these substances. During this time Mexican immigrants introduced recreational marijuana to the country, although it was largely regarded as the preserve of ruffians and criminal elements.
In 1914 the drug use was officially declared a crime in the U.S. and many other countries followed over the next two decades. By 1937, 23 US states outlawed marijuana, although controlled forms of cannabis were still permitted for medical use. In 1970 the government classified marijuana as a Schedule 1 drug along with the likes of heroin and LSD, revoked the acceptable medical use of cannabis and restricted further research despite the fact that medical journals had begun to list its medical benefits. It was only in 2015 that the United States legalised medical cannabis, but still, with restricted use and only individuals suffering from certain medical conditions being given permission to obtain and use it to alleviate their particular ailment.
Medical cannabis today
Research into medical cannabis is still limited due to the restrictions placed on the drug that make it difficult for medical scientists to obtain. Recently conducted studies, have shown that cannabis may have therapeutic value in chronic pain management, the management of symptoms in certain diseases and the side effects of their treatment such as cancer and chemotherapy induced nausea2, as well as in the palliative treatment of some chronic diseases like multiple sclerosis3.
While the majority of people using cannabis for medical purposes (often for conditions other than those mentioned above) report a strong efficacy for a broad range of symptoms4,5 with few serious adverse side effects, most medical professionals agree that further formal scientific research is warranted to establish approved usage and dosage guidelines as well as identify interactions with other prescription medications.
What is medical cannabis?
Medical cannabis or medical marijuana is plant-based medicine that is derived from the whole, unprocessed plant belonging to either the Cannabis Sativa or Cannabis Indica species that is meticulously grown without exposure to toxic fertilisers and pesticides. It is used to alleviate the symptoms of, or treat, certain health conditions and diseases. It has three main active compounds (known as cannabinoids)6:
- Tetrahydrocannabinol (THC) – this is the psychoactive compound found in marijuana that is responsible for the high people experience. Nevertheless, it offers a variety of potential medical benefits.
- Cannabidiol (CBD) – this is a non-psychoactive compound of marijuana that does not have intoxicating properties and therefore does not cause a high. It is thought to be responsible for the majority of the plant’s medical benefits.
- Cannabinol (CBN) – this non-psychoactive compound is produced when THC is heated or exposed to oxygen. It does not bind as well to the body’s cannaboid receptors (think of these as ‘message receivers’ in the body that form part of the body’s endocannaboid system and are involved in a variety of physiological processes including mood, memory, pain-sensations and the regulation of metabolism and appetite) as THC and CBD but does have a powerful sedative effect that may be useful in the treatment of certain conditions.
How does medical cannabis work?
Our bodies are made up of a number of complex systems such as the nervous and digestive systems. Within the brain and greater nervous system (spinal cord and nerves) we have what is referred to as an endocannaboid system, which, as mentioned, is responsible for various physiological processes.
This system naturally produces chemicals similar to those found in cannabis that function as ‘messengers’ between the brain and various parts of the body via nerve cells (neurons) and receptors. These chemicals affect pain, inflammation and numerous other processes. In certain instances, medical cannabis can help these chemicals to work more effectively, hence the therapeutic benefits.
How is medical cannabis used?
Medical cannabis may be consumed in a variety of ways, although some are considered to be more effective than others:
- Oral ingestion: Medical cannabis pills or edible products may be swallowed or eaten.
- Administered under the tongue (sub-lingual administration) or in the mouth (oramucosal administration): Oils or tinctures are applied to and absorbed in the mouth using droppers or sprays.
- Topical application: Cannabis ointments, creams and poultices are applied to the skin to treat inflammation, pain and arthritis. It is still unclear how cannaboids are absorbed by the skin, and researchers believe the anti-inflammatory properties of topical cannabis products can be attributed more to its soluble terpenoids and flavonoids.
- Inhalation: Medical cannabis can be inhaled in one of two ways -
- Vaporisation: A vaporising device is used to extract the active components of cannabis without the combustion that occurs in smoking. This lowers the harmful effects of tar and carbon monoxide associated with smoking.
- Smoking: Medical marijuana may be smoked but this does expose the user to a variety of irritants and carcinogens (potential cancer-causing agents).
Uses of medical cannabis
Conclusive research findings on the efficacy of cannabis use are limited due to the fact that until recently, research has been hindered by the lack of legal access to marijuana. This is also the reason why many medical professionals, even those in countries where access to medical cannabis is available, have dismissed its use and steered clear of prescribing it.
Currently the use of medical cannabis is approved by certain governments in various countries* for the management and treatment of symptoms associated with a variety of conditions, some of which include:
- Terminal illness
- Cancer (specifically for those experiencing nausea and vomiting associated with chemotherapy or radiation treatment, or severe wasting of the body as a result)
- HIV / AIDS
- Parkinson’s disease (agitation)
- Amyotrophic Lateral Sclerosis (ALS / Lou Gehrig’s disease)
- Multiple Sclerosis (severe and persistent muscle spasms)
- Inflammatory bowel disease and Crohn’s disease
- Epilepsy (the treatment of seizures)
- Tourette Syndrome
- Autism with self-injurious or aggressive behaviour
*PLEASE NOTE: Different countries and states have different laws regarding the medical use of cannabis and the conditions it may be used to treat. The onus is on you to investigate these within your particular country of residence.
As research into this interesting field grows, many more may be added to this list.
- Earleywine, Mitch. Understanding Marijuana: A New Look at the Scientific Evidence. Oxford University Press, 2002. Print
- Abrams, D.I, 2016 Integrating cannabis into clinical cancer. Current Oncology. 23(Suppl 2): S8–S14. DOI: 10.3747/co.23.3099
- Mücke, Weier, Carter, Copeland, Degenhardt, Cuhls, Radbruch, Häuser & Conrad, 2017. Systematic review and meta‐analysis of cannabinoids in palliative medicine. Journal of Cachexia, Sarcopenia and Muscle. 9(2), 220–234. DOI: 10.1002/jcsm.12273
- Sexton, Cuttler, Finnell & Mischley, 2016. A Cross-Sectional Survey of Medical Cannabis Users: Patterns of Use and Perceived Efficacy. Cannabis and Cannaboid Research. 1(1): 131–138. DOI: 10.1089/can.2016.0007
- Minnesota Department of Health. June 2016. Most patients report benefits from medical cannabis. Retrieved from: http://www.health.state.mn.us/news/pressrel/2016/cannabis060616.html [Accessed 16.11.2018]
- World Health Organisation. 2015. Update of Cannabis and its medical use. Available at: https://www.who.int/medicines/access/controlled-substances/6_2_cannabis_update.pdf [Accessed 16.11.2018]