The History of Medical Cannabis

history of medical cannabis

How long have humans been using cannabis? For over 10,000 years.

Across their rich and ancient history, plants of the cannabis species have had many names Ma, Bhang, Shemshemet, Qunnabu and of course innumerable colloquial names that have entered, stuck or departed local lexicons as culture and societal norms change.

The relationship between humans and cannabis has coursed along a relatively stable trajectory for some 10,000+ years, we’ve used its consistently throughout history as medicine and as a fibrous resource with innumerable applications. 

Yet some 100 years ago we deviated from this course, the cannabis plant was demonised. Both society and medicine to a degree distanced themselves from a plant that had otherwise been linked to humans for eons. 

Now we see a returning and an interest in discovering, with a modern lens, what benefits this plant might offer to human health in the form of medicinal cannabis. Let’s take a galavant through history and see if we can learn some lessons from our past to inform our future.

 

Ancient cannabis with eastern origins

Asia is considered to be the ancient epicentre for the cultivation of cannabis. Archaeological evidence supports the use of cannabis species by humans as far back as 8000 BCE, with hemp fibres found in pottery artifacts in Taiwan and China. There’s some mention of hemp being found at sites dating 12,000 -20,000 years ago, though the validity of such reports is difficult to ascertain

Cannabis as crop

The famous late 20th-century scientist, Carl Sagan, proposed that cannabis may have been the world’s first agricultural crop with far-reaching implications on civilisation as we know it. 

He was quoted as having mused “It would be wryly interesting if in human history the cultivation of marijuana led generally to the invention of agriculture, and thereby to civilization”. Given the timing of the advent of both agriculture and the appearance of cannabis, it seems likely they may have contributed to each other’s origins.

Cannabis seeds are thought to have been an important and sacred source of grain in ancient Asia, particularly around the northern regions. The use of seeds for oil and foods further established in the proceeding 5000 years, with hemp textiles appearing about 4000 BCE.

Cannabis as medicine – enter “Medicinal Cannabis”

It was around the 27th century BCE when the earliest documentation of using cannabis as medicine was recorded. Emperor Shen Neng of ancient China is said to have noted the medicinal benefits of cannabis.

Given how much information was passed down through oral tellings there’s some controversy about the initial documentation in pharmacopeias – whether legend or fact, it is around this time that historians believed the use of cannabis for medicine began in earnest.

Cannabis in Traditional Chinese Medicine

In Traditional Chinese Medicine (TCM) cannabis is believed to have yin energy, being moistening, cooling and clearing Liver yang. Through reading these terms you’ll notice TCM offers very different conventions for looking at human health and treatment of disease. 

When assessing these TCM actions in terms of symptom presentation we find clearing excessive Liver yang as a way of treating constipation (moistening the colon) as well as reducing stress and insomnia. Both of these instances are reflective of the modern use of cannabis, with hemp seeds having a nutritional and functional benefit to constipation, and medicinal cannabis showing benefits for some anxiety and insomnia sufferers.

How did ancient Indians and Egyptians use cannabis?

By around 2000 BCE cannabis had established itself into ancient Indian culture, it is believed the plant was used as a food source, in ritual and Hindu legend well before it was first documented. The Atharva Veda – one of the ancient Vedic texts – notes cannabis among 5 sacred and essential plants, which provide relief from anxiety. Later texts reveal it was also used for insanity, anorexia, epilepsy and pain, among other conditions that we commonly associate with modern medical cannabis. 

The ancient Egyptians also used cannabis in multiple and diverse ways. The first note of the plant comes from the Papyrus of Ramesseum III, circa 1700 BCE, where it was noted as a wash for the eyes. 

The Ebers Papyrus is dated around 200 years later, and elaborates on the use of medicinal cannabis internally for a number of women’s health complaints in the form of pessaries, which modern science is now beginning to investigate for conditions like endometriosis. 

It seems the use of cannabis as medicines continued with gusto in ancient Egypt with a number of other papyri noting its use for ear pain, fever, tumours, inflammation and gastrointestinal conditions. 

Medicinal cannabis Australia A breif history

Cannabis heads towards Europe

By the 10th century BCE we see evidence of cannabis in the ancient regions of Mesopotamia, as both a food source and fibre. The Assyrians were thought to utilise cannabis for various medicinal purposes including neuralgia, spasticity and depression, labelled in one text as the ‘drug for sorrow’. Across a number of Mesopotamian cultures, it was also appreciated for its psychotropic effects in ceremony and sacred rites.

Around 600 BCE hemp rope appears in what is now southern Russia, in a similar timeframe cannabis residue has been found at a burial site in Beit Shemesh, Israel. There is evidence suggesting the use of hemp in central Europe from 5000 BCE, however the species isn’t endemic to the area and therefore doesn’t appear regularly as a medicine until its use by ancient Greek and Romans, circa 400 BCE.

As we venture into the common era (CE) we see cannabis being used more regularly in Mediterranean countries for medicine, ritual, possibly even recreation. However compared to the use of medicinal cannabis preparations in the East, Europeans didn’t approach cannabis medicines with as much enthusiasm. Instead, we regularly find reference to its use as fibre and fewer mentions as medicinal cannabis for pain presentations and sleep. 

Cannabis disseminates around the globe

The 9th and 10th Century was a time of growth for cannabis in Arabic pharmacology. Arabic medical texts show a sophisticated understanding of the biphasic nature of cannabis when applied as a medicine – providing one effect at a lower dose and the opposite or different effect at higher doses. 

There is mention of medical cannabis treating conditions that it has been used for in the modern-day: migraines, aching pains including dysmenorrhea, epilepsy, skin conditions. There is even the mention of the use of medical cannabis for external abscesses and internal tumours. Arabic physicians also discussed the use of medical cannabis to rid the body of worms, not the first mention of the use of cannabis as a vermifuge throughout history.

Let’s take a quick leap over the middle ages, during this time it seems cannabis as medicine grew in prevalence among herbalists and in textiles, particularly for ship sails around Europe, yet most of the well-documented use during this time continues to be centred around Arabic medical cannabis applications. 

Cannabis in the Americas 

The Spanish conquest of South America brought with it the arrival of cannabis on this continent. Whether there were already cannabis landrace strains endemic to the region, used by native peoples in ritual and ceremony, continues to be debated.

Around this time we also see cannabis being cultivated in North America by British and French colonies. As hemp fibre, it was broadly applied in the textiles, rope and paper. In fact, there were once laws requiring farmers to cultivate hemp, even George Washington was said to have thoroughly endorsed its cultivation.

Introduction to cannabis sativa

Back to Europe now, where botanist Carl Linnaeus first classified Cannabis sativa in 1753. During this time it was commonly used by herbalists for gout, inflammation and pain, particularly of the joints. 

Following this, it is believed Napoleon’s invasion of Egypt is what spurred the widespread use of recreational cannabis use in Europe. Soldiers reportedly brought back the practice after observing it being smoked on their deployment to Egypt.

Throughout the 1800s medicinal cannabis grew in use throughout North America and the Middle East. It was added to the US Pharmacopeia in 1850 and was used to treat pain, dysentery, excessive menstrual bleeding and reduce addiction to opioids.

Origins of medical cannabis

The use of cannabis medicine began in earnest in Britain following Dr William  O’Shaughnessy returning from British India with information on how it was used as a medicine there. This prompted the exploration of medical cannabis as a treatment for muscle spasm, epilepsy, rheumatism and disturbed sleep. It was even prescribed to Queen Victoria for her painful menses.

Towards the end of the 19th-century critics began to associate cannabis use with mental disturbances observed in India and Europe. With the advent of morphine and the syringe, pharmaceutical companies of the time began to explore other avenues of pain relief and drug delivery.

When things changed: 20th Century cannabis and prohibition

Now we arrive at more recent times, where the history of the prohibition of cannabis is entwined with racism in Northern America. This fact gets glossed over in the whirlwind of the “War on Drugs” that followed, yet people of colour bore the burden of racially biased arrests for cannabis-related crimes in the early 1900s.

The Mexican Revolution of 1910, saw an influx of Mexican immigrants into the US, bringing with them the term ‘marijuana’ and its recreational use. Prior to this cannabis was largely referred to by its scientific name, and the term marijuana was adopted by politicians to reduce the integrity of a product the population had otherwise long associated with medicine.

By the 1930s, the end to the prohibition of alcohol put Harry Anslinger, a staunch prohibitionist, on the verge of losing his job. With the growing use of cannabis outside the medical arena, Anslinger fed into racist tendencies directed towards Mexican refugees and other peoples of colour, and fear surrounding mental health.

Marijuana receives an unlikely supporter

By 1937 alcohol was back in, but cannabis was out. The Marijuana Tax Act of 1937 disallowed the cultivation of cannabis without a government licence, foreboding future restrictions.

At this time you might be surprised to know, the American Medical Association opposed the Act stating: “The American Medical Association knows of no evidence that marijuana is a dangerous drug” warning that prohibition of cannabis “loses sight of the fact that future investigation may show that there are substantial medical uses for Cannabis.”

Tide turns against cannabis globally – even medicinal cannabis

In 1961 the UN Single Convention on Narcotic Drugs ushered in the era of global cannabis prohibition. At the time many novel pharmaceuticals were being thoroughly evaluated, vetted and scheduled, but despite its long history of medical benefits, cannabis did not receive the same rigorous investigation and decisions were clouded by political leanings, racism and ‘reefer madness’ propaganda.

Thus cannabis was restricted under Schedule I and IV, classifying it within the drug classes of those that are most likely to cause damage, be abused and have little to no medical or therapeutic value. 

Cannabis bans hamper medical research

Despite the Convention stating research into its medical application should be continued, making cannabis preparations illegal on an international level did immeasurable harm to cannabis research, that is only now beginning to be recovered.

Despite, and perhaps in spite of international and local laws prohibiting its use making medical access unbearably difficult, research continued albeit with much difficulty through the mid-late 20th Century. The now-famous Israeli researcher, Raphael Mechuolam, isolated one of the primary cannabinoids, THC in 1964.

In 1971 the UK established its drug classification system where cannabis was listed as class B, but it wasn’t until 1973 that cannabis was officially removed as a medicine available via the NHS. 

America continued to dominate the cannabis conversation as we move through the rest of the 1970s. Nixon declared the ‘War on Drugs’ in the face of government-issued reports advising that it should be decriminalised for personal use. Propaganda, personal views and racist overtones continue to influence the discussion around cannabis in this decade.

The 1980s brought exciting research uncovering numerous medicinal benefits of cannabis, deeper understanding of the range of cannabinoids within the plant and something entirely unexpected, the Endocannabinoid System.

Modern medical and recreational cannabis regulations evolve

Fast forward and we can see regulatory changes happening worldwide, both for medical and recreational, or adult-use. The unveiling of the scientific basis for the therapeutic use of medical cannabis in epilepsy, gastrointestinal, autoimmune and psychological conditions surges and we’ve begun to observe a global acceptance of the safety of the non-intoxicating cannabinoid, CBD.

Still of course, there are pockets of strong political resistance against the medicalisation of cannabis, even CBD, let alone recreational possibilities. Still, people of colour are targeted and prosecuted at a disproportionate rate for cannabis possession and still, stigma for the plant rooted in racism continues to pervade certain areas of society. 

There are many challenges to overcome as our current society lays the foundation for cannabis history, to foster ease in this unfolding we can acknowledge that the medicinal benefits of cannabis are only just beginning to reveal themselves and we should stay curious to the possibilities of this plant.

With integrity and evidenced-based practise, cannabis business, researchers and lawmakers can set the tone for the future of cannabis, whether it be recreational cannabis or medicinal cannabis, THC, CBD or another cannabinoid.

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