Cannabis use has been traced to the Central Asian / Himalayan region as well as India and China. It was used as an analgesic (for neuralgia, headache, toothache), anticonvulsant (for epilepsy, tetanus, rabies), sedative-hypnotic (for anxiety, mania, hysteria), anesthetic and anti-inflammatory (for rheumatism and other inflammatory diseases), antibiotic (for topical use on skin infections, erysipelas, tuberculosis), anti-parasitic (for internal and external worms), antispasmodic (for colic, diarrhea), digestive, appetite stimulant, diuretic, aphrodisiac or anaphrodisiac, antitussive, and expectorant (for bronchitis, asthma) [1,2].
By 1839 publications in the english literature appeared describing the medical use of Cannabis and it was entered in the U.S. Dispensatory in 1854. Cannabis was usually available as a tincture comprised of plant extract. The medical textbook Sajous’s Analytic Cyclopedia of Practical Medicine listed numerous indications for cannabis, including [1,2]:
• Sedative or hypnotic: Insomnia, melancholia, delirium tremens, chorea, tetanus, rabies, hay fever, bronchitis, pulmonary tuberculosis, coughs, spasm of the bladder.
• Analgesic: Headaches, migraine, eye strain, menopause, brain tumors, neuralgia, gastric ulcer, indigestion, multiple neuritis, pain not due to lesions, dysmenorrhea, chronic inflammation, acute rheumatism, eczema and pruritus, tingling, numbness of gout, dental pain.
• Other uses: To improve appetite and digestion associated with “pronounced anorexia following exhausting diseases,” dyspepsia, diarrhea, dysentery, cholera, nephritis, diabetes mellitus, vertigo.
Some of these indications are still current today.
The medical use prohibition of medical marijuana culminated with the 1970 Controlled Substance Act that categorized marijuana, along with heroin, as a Schedule I substance. Drugs with a Schedule I designation are deemed to be highly addictive and devoid of medical value or safety. The “War on Drugs” was launched in 1968.
Well organized research in the last century defined patient contraindications, and identified the safety outcomes in recreational users that are inappropriate for generalization. With the 1999 founding of the Center for Medicinal Cannabis Research (CMCR) at the University of California, San Diego a cannabis clinical research program in the United States was launched to determine safety and efficacy trials of smoked cannabis in the treatment or management of the diseases and conditions. A similar program was started by the Canadian and Dutch government.
Extensive research was done from the 1969-1990 until a landmark 1999 IOM (Institute of Medicine) report described the scientific and clinical basis for supporting medical marijuana use. Despite its illegal status at the federal level, cannabis was reintroduced into medical use in 1996 by popular vote and legislative acts in California. This was codified by passage of Proposition 215, also known as the Compassionate Use Act.
It is the Compassionate Use Act which has permitted the use of Marijuana when recommended by a treating physician.