Cannabis is medicine

Cannabis has an incredibly long history in the U.S. and the world as an effective, natural medicine. In fact, the earliest uses of the plant for medicinal purposes date all the way back to the 1500s.

Cannabis Research in the U.S.

Between 1840 and 1900, more than 100 articles appeared in a number of important U.S. medical journals, advocating the medicinal efficacy of the cannabis plant. It was, quite frankly, the golden age of cannabis.

What’s even more interesting to note is that cannabis used to form part of the American pharmacopoeia, a series of teachings for doctors and pharmacists that lists some of the most effective drugs and how to make good use of them.

Unfortunately, cannabis research was put on hold with the passing of the Marijuana Tax Act of 1937, and in 1942 the cannabis plant was removed from the pharmacopoeia list.

Cannabis Research and the need for Clinical Trials

Naturally, the U.S. isn’t the only country in the world with a history of medicincal cannabis and an interest in the plant for wellness purposes. Canada, the U.S., Spain, Israel, Mexico have all advocated the benefits of cannabis in some way and the list continues.

Most countries have a history of using cannabis for medicinal purposes and all have been unable to pursue the clinical trials necessary. The hope is that as cannabis is legalized the world over, this reality will change and the undiscovered benefits of the plant will gradually be explored and solidified with hard evidence.

So far, research has shown that cannabis can help patients to decrease their dependence on conventional pharmaceutical treatments and drugs. The positive takeaway here is that so many of the conventional pharmaceutical treatments carry negative side effects. Cannabis is thought to expose the body to far less trauma, but more research is required to turn these beliefs into facts.

The good news is that things are moving in a positive direction, albeit slowly. As an example, in March 2015, the National Institute for Drug Abuse (NIDA), part of the University of Mississippi, was given $69 million by the federal government to cultivate more cannabis for cannabis research purposes. Time will tell and the results from studies will, no doubt, illuminate.

Cannabis Research and Clinical Data

The single most debilitating factor in the advancement of medicinal cannabis research has been its CSA Schedule I designation which, by default, places cannabis among other drugs that are said to have no medical value whatsoever.

However, advocates of the cannabis plant know this to be untrue and the clinical data that we do have, relating to the existence of more than 100 cannabinoids, more than 200 terpenes, and the receptors in the human body that form part of the endocannabinoid system, has helped to substantiate those beliefs. 

Indeed, NIDA modified a prior statement on medical cannabis, stating that “recent animal studies have shown that marijuana can kill certain cancer cells and reduce the size of others.”

Cannabis Research Institutions

A number of cannabis research institutions exist in the U.S. and have dedicated their funding and expertise to the study of cannabis as an effective form of natural medicine.

The International Cannabinoid Research Society was formed in 1991, the International Association for Cannabis as Medicine was created in 2000, and in 2001 the Center for Medical Cannabis Research was established at the University of California San Diego.

Institutions, like those mentioned above, work tirelessly, despite government restrictions, to explore the full potential of cannabis as a natural medicine. Studies and trials thus far have gathered promising evidence to show that cannabis has the ability to effectively treat diseases and symptoms that are poorly treated and cured by pharmaceutical drugs, but more work is needed.

Cannabis Studies

Studies have highlighted cannabis’ ability to reduce severe pain, to help those suffering from neurological disorders, including multiple sclerosis, epilepsy, and dystonia, and to greatly improve the day-to-day conditions of patients suffering from cancer and HIV/AIDS.

One particular 1999 report, published by the Institute of Medicine (IOM) and called Marijuana and Medicine, officially requested the federal authorization for more cannabis research, but the request fell on deaf ears. 

In 2008, the American College of Physicians (ACP) published a report that publicly demonstrated its support of cannabis research and the need for clinical trials. It was a report that asked for a change to the plant’s Schedule I classification and government investment to enable rigourous scientific evaluation.

Other groups, including the American Public Health Association, the American Preventive Medical Association, the American Academy of Family Physicians, the National Association of Boards of Pharmacy, the American Medical Association, the California Medical Association, the American Society of Addiction Medicine, and the Iowa Board of Pharmacy, have published similar studies, reports, and position papers, but very little has changed and very little can change until the federal government places its full support behind all endeavors.  

Studies

Despite decades of federal opposition in the U.S., international research into the efficacy of cannabis and cannabinoids has been plentiful. Research organizations in the United Kingdom, Israel, Spain, Italy, and other countries have conducted case studies and clinical investigations into the medical properties of cannabis for a multitude of conditions. These studies have proven the value of both whole-plant cannabis, as well as synthetic and derivative forms of the herb. Despite this, clinical trials involving humans are still grossly lacking, preventing the creation of standardized treatments for particular ailments.

In 1994, the Federation of American Scientists, based on evidence of its superior effectiveness and safety compared to other medications, recommended to the President that the Food and Drug Administration work with the National Institutes of Health to develop protocols to make available cannabis for severely sick patients under the advisement of their physicians. In 1995, the American Public Health Association encouraged robust research on the part of Congress to “move expeditiously to make cannabis available as a legal medicine.”

Since the mid-1990s numerous professional medical organizations and physician associations, including The American Academy of Family Physicians, have officially supported the use of medical cannabis in the treatment of particular conditions.

A 1999 report from the Institute of Medicine (IOM) entitled Marijuana and Medicine, proclaimed the medical value of cannabis and that further federally authorized research was warranted. The report was the result of two years of analysis conducted by the IOM at the request of the White House Office of National Drug Control Policy. Despite this, the federal approval for follow-up studies was sparse. While some studies have been conducted in the U.S. with animals or cell cultures, almost no human trials have been performed. As detailed in the report, “clinical studies of marijuana are difficult to conduct…there is a daunting thicket of regulations to be negotiated at the federal level”. Researchers and investigators have found it extremely difficult to get federal approval to conduct the studies and, when authorization is provided, it has historically been difficult to obtain quality cannabis samples from the government to conduct the sanctioned research.

The American Nurses Association took a pro-cannabis stance and supported health care providers wanting to recommend cannabis for patients. It declared support for “patients to have safe access to therapeutic cannabis” and called for additional research.

Significant support was provided from the American College of Physicians (ACP) in their position paper of 2008 in which the organization acknowledges that the therapeutic qualities of cannabis are well established and it’s time for studies designed to determine the best dose and route of delivery. The ACP further calls for changes to the Schedule I classification of the plant so badly needed rigorous scientific evaluation can begin immediately.

In response to the ACP’s position paper, Dr. Jocelyn Elders, a former U.S. Surgeon General, marked its significance by stating “large medical associations are by their nature slow and cautious creatures that move only when the evidence is overwhelming,” adding that “[t]he evidence is indeed overwhelming that…there is ‘a clear discord’ between what research tells us and what our laws say about medical marijuana…[i]t’s time to end that “clear discord” and put science ahead of politics.”

These are only a few of the health care and research organizations that have supported—and sometimes demanded, in strongly worded articles or proclamations—the legal use of cannabis by sick patients and more robust research involving human trials.

Other groups that have published similar studies, reports, and position papers include the American Public Health Association, the American Preventive Medical Association, the American Academy of Family Physicians, the National Association of Boards of Pharmacy, the American Medical Association, the California Medical Association, the American Society of Addiction Medicine, and the Iowa Board of Pharmacy.

All of these groups echo a common theme: Available evidence reveals a strong correlation between cannabis and patient benefit and that the need for additional research is paramount.

For additional relevant medical publications, contact our Community Outreach Coordinator, Christine Karhliker, ckarhliker@hcillinois.com.