Cannabis is one of the oldest known medicines in the world. The history of its use stretches back thousands and thousands of years, to some of the earliest recorded civilizations. Archeological evidence traces the first use of the plant back to ancient Asia, where on the island of Taiwan a village was discovered that scientists believe to be 10,000 years old. Among the artifacts unearthed from the ruins, were tools and pottery indicating that the villagers had been using cannabis to create the fiber commonly known as hemp. The first medical use of the plant is attributed to the legendary Chinese emperor Shen-Nung born in the 28th century BC. While no original writings have been found by the emperor known as the father of Chinese pharmacology and thought to have lived to be 140 years old, many subsequent texts attribute the discovery of medical marijuana to him. China was long referred to as, “the land of mulberry and hemp,” because of the silk produced from feeding mulberry leaves to silkworms and the fibers created from cannabis. The first records of using cannabis for pain management were also recorded in China, where a mixture of wine and cannabis was used as an anesthetic before surgery. In modern medicine, cannabis has not been found to work well as an anesthetic, so it is believed that patients were most likely given huge doses of the mixture. Ancient use of cannabis was also recorded in India, the Middle East, North Africa, and Greece. The plant was brought to the new world by colonists who used hemp to make rope and ship sails.
Recent years have seen modern medicine make great strides in understanding the chemical makeup of Cannabis. In 1898, Scientific American published an article on cannabis stating, “As a whole, cannabis is one of the most valuable of drugs, but is sadly handicapped by the uncertainty that attends all pharmacopoeial preparations.” Basically, clinical testing was extremely difficult because it was hard to produce standardized doses of cannabis and results would vary. At the time, Cannabinol (CBN) had been discovered from extracts of the plant, but not THC or CBD and there was basically no understanding of how these compounds, known as cannabinoids, interacted with the brain. Cannabidiol (CBD) was first discovered in 1940 and two years later Tetrahydrocannabinol (THC) was found. However, it wasn’t until the 1960’s that these constituents were isolated in their pure form. This breakthrough prompted a resurgence in clinical studies, where the effects of the different cannabinoids could be measured. Through these tests, it was found that CBD was non-psychoactive and in fact, THC was the intoxicating constituent in cannabis. During this period, THC was the focus of most research and it was often studied as a recreational drug rather than a medicine. Meaning, research often looked at how addictive it was and what the dangers of the drug were, more than, how it could be used to help treat various conditions. It hasn’t been until recently that CBD has begun moving to the forefront of cannabis-based research.
Another major breakthrough in the study of cannabis came in the 1980’s when evidence of the endocannabinoid system was discovered. For the first time, researchers were now understanding how cannabinoids interacted with the brain through neurotransmitter receptors that proved to be more plentiful than any other receptors in the brain. Then, in 1990 the CB1 receptor that interacts with THC was officially isolated and cloned. With this breakthrough, scientists were able to irrefutably find that THC was, in fact, responsible for the psychoactive effects of cannabis. Three years later, in 1993 another receptor name CB2 was discovered that was found to interact with CBD. The CB2 receptor was found to help in the regulation of pain management and appetite. Without the study of cannabis, this incredibly important group of neurotransmitters would have never been found. Since the discovery of the endocannabinoid system the study of cannabis has reached has made many strides forward. For instance, scientists were able to genetically modify rats to be born without the CB1 receptor, then when they gave the rats THC there were no observable psychoactive effects, leading them to conclude that it was, in fact, the CB1 receptor that interacted with THC and that THC was responsible for the psychoactive effects produced by cannabis. This greatly helped the production of medicine as patients who would suffer adversely from the effects of THC could now take CBD and have virtually no psychoactive side effects. Products such as CBD oil have begun to be marketed as dietary supplements and until recently were federally legal. However, recent laws have federally outlawed CBD oil, although in states where cannabis has been legalized CBD oil is readily available. Along with CBD oil, other CBD extracts exist such as CBD tinctures, dried cannabis flower containing high amounts of CBD, and other CBD extracts such as Charlotte’s Web.
With the discovery of the CB2 receptor and the realization that it interacted with CBD and was related to pain regulation, CBD and CBD oil have become the focus of many studies surrounding pain management. A large amount of anecdotal evidence exists suggesting that the use of CBD oil for pain is highly effective. One person, I spoke with lately testified that he has been experiencing severe back pain for a long time, he has begun using CBD to help regulate the pain and it has been highly effective. He says that after taking a CBD tincture he is able to stand up straight without pain, something that would be near impossible without the CBD. The lack of side effects and potential for physical dependency associated with CBD make it a very attractive alternative to opioids that have drastic side effects and can lead to devastating addiction and death. Along with the huge number of anecdotal reports that CBD and CBD oil is a great option for pain management, several clinical studies have come out proving the same thing. The difference between anecdotal and empirical, or clinical, results is that anecdotal results are mainly based on patient testimonials of results they have personally noticed outside of an official study; empirical results, on the other hand, are based on official, clinical studies that follow guidelines set out by government entities. Since the Controlled Substance Act was put into place during the 1970’s cannabis has been a Schedule I drug, meaning according to the government it has no medical value and a high potential to be abused. This is obviously not true, as there are scientific reviews going back to the 19th century talking about the great medical potential demonstrated by cannabis. The main reason marijuana was kept a Schedule I drug was for political purposes. By associating the anti-war movement with marijuana, the government was able to arrest leaders of the movement and disrupt their actions. A council even approached President Nixon with this information and he chose to ignore it and pursue his own agenda.
The classification of marijuana as a Schedule I drug has made researching the drug incredibly difficult. Even back in the day when it was legal, marijuana was a challenging drug to study, due to the fact that results vary widely based on a number of factors; including, how the cannabis is administered, making sure the dosage is consistent, and finding unbiased patients with whom to create a baseline. To make matters worse, the legality marijuana makes it very hard to find research-grade cannabis. In fact, there is only one current source of research-grade cannabis, which is through the National Institute of Drug Abuse (NIDA). The NIDA has only one source that produces their cannabis for them and that is the University of Mississippi. Having to obtain marijuana from this source presents another problem that is the marijuana being studied is not the same marijuana that users of recreational and medical marijuana are using. Researchers are unable to do testing with current products on the market, many of which have much higher cannabinoid content than that produced at the University of Mississippi. Not being able to test the products on the market makes it incredibly challenging to come to a consensus, on what these products are actually doing, and if it matches with the results gained from the NIDA’s marijuana. Therefore, the majority of claims surrounding the health benefits of marijuana come from patients reports and not lab testing. The high amount of anecdotal evidence does not necessarily mean these claims are false or untrustworthy. A large number of scientific discoveries over the year were first recording anecdotally and later confirmed in the lab. With the easing of marijuana’s legal status in many states, a renewed interest in the scientific study of marijuana is underway.
Many are questioning whether marijuana should still be considered a Schedule I drug. The Federal government, however, is not. Earlier this year the DEA made the use and sale of CBD oil illegal and included it in the list of Schedule I drugs. Previously, CBD oil had inhabited a legal grey area, because it was produced from food grade hemp, very low in THC, and not high THC marijuana. Over the past few years, many people have been selling it as a dietary supplement. Many CBD oils contain as little as 0.3% THC, making them virtually non-psychoactive. Some people report dizziness from taking CBD oil, but it certainly doesn’t get you stoned the same way smoking marijuana does. However, since THC is a Schedule I drug anything containing it is illegal. No one has yet to find a way to make CBD oil 100% CBD, if someone was able to do this, the product would be legal. This is a major blow to those living outside of states where marijuana is still illegal, as in some cases no other treatments have worked for these individuals other than CBD oil.
Synthetic cannabinoids have been created and marketed by major pharmaceutical companies. Often these synthetics come in the form of a mouth spray such as Marinol and Cesamet, both of which were approved by the FDA in the 1980’s. Another more recent pharmaceutical product is Sativex. Created by the UK based GW Pharmaceuticals, the mouth spray is the first product of its kind to be made from actual cannabis as opposed to synthetic cannabinoids. Sativex has been marketed for use in treating cancer pain and is still illegal in the United States, due to clinical tests being non-conclusive as to its effectiveness in treating pain. Along with being used for cancer pain, Sativex has also been shown to help reduce patients spasms associated with multiple sclerosis. Sativex uses a 1:1 THC to CBD ratio and developers say the oral delivery method makes the product less likely to abuse since it takes up to an hour to feel any effect from the spray. It is believed that those looking to get high would be far more likely to simply smoke cannabis as it passes the blood-brain barrier far faster. Sativex also contains compounds called terpenes, aroma molecules that are thought to help in the uptake of CBD and THC. Studies suggest that using real cannabis extracts such as Sativex produce higher positive results than using the synthetic cannabinoids. There are hundreds of chemical compounds in cannabis and researchers are still trying to understand what these different compounds do. Research seems to indicate that these compounds work together to produce the effects of cannabis. Hopefully, as research moves forward we will have a better understanding of how different combinations of these chemicals interact with one another and based on this be able to produce medicine from cannabis that better targets certain ailments.
One compound that researchers are beginning to learn quite a bit about is CBD. Since isolating the CB2 receptor that CBD interacts with, scientists have been able to go much deeper into understanding what CBD is and how it interacts with the body. Clinical studies have conclusively proven that CBD can help with pain management, seizures, and nausea. These studies are often tested on patients whose conditions and symptoms have been resistant to other forms of treatment. These conditions often include multiple sclerosis and cancer as cannabis has over the years shown great potential in these difficult to treat conditions. A common method used in these tests is to give the patients alternating doses of THC, CBD, a 1:1 THC and CBD combination, and a placebo. This way researchers can understand how patients react to THC and CBD differently. Most evidence points to the 1:1 THC and CBD combination to be the most effective in treating pain, this is in line with the theory that the various chemical compounds in the plant interact together to produce the positive effects of cannabis and that whole plant extracts are the most desirable. That said, there has been evidence to suggest that CBD by itself can produce positive results in patients suffering from untreatable, chronic pain. These findings support anecdotal evidence that has been coming in for years and hopefully will help sway lawmakers and politicians to remove marijuana from the Schedule I list of drugs.
One of the most widely known medical marijuana stories is about CBD and a little girl named Charlotte Figi. Charlotte was suffering from hundreds of seizures a week due to a severe form of childhood epilepsy. None of the treatments doctors were giving her were doing any good. As a last-ditch effort, Charlotte’s family chose to try CBD oil. The results were almost immediate. Charlotte went from having hundreds of seizures a week to averaging only one. This is an example of anecdotal evidence, where although it would seem the CBD oil greatly benefited Charlotte there is no clinical evidence to support the claim and therefore, the company making the CBD oil now called Charlotte’s Web is unable to make any official claims as to the medical benefits of their products.
Humans have been using cannabis for thousands of years. Over that time it has helped countless people to enjoy a better quality of life. The politicisation of cannabis in the past century has done great harm to those who could be benefitting from its healing properties. Marijuana’s status as a Schedule I drug has also greatly diminished research efforts into understanding the plant and creating new more effective medicines. It is my hope that as we move into the future cannabis will be made federally legal and that politics will not get in the way of patients receiving the medicine they need.
To find out more about pain relief with Cannabis, read this article.