Modern History of Medical Cannabis : From Widespread Use to Prohibitionism and Back

Simona Pisanti and Maurizio Bifulco

Trends in Pharmacological Sciences, Cell Press,  2017, 38, 3, 195-198.

doi: 10.1016/j.tips.2016.12.002.

 

Over the history of pharmacology there are numerous examples of drugs being widely distributed, almost ‘trendy’, prescribed by physicians in a certain period as a sort of panacea, and then neglected, forgotten, or even forbidden as they become considered dangerous in the light of clinical observations. One of these drugs is Cannabis, which was very popular in the 19th century until disappearing from the official Pharmacopoeia at the beginning of the 20th century and reviving again in the new millennium. However, its modern history is peculiar since its medical use has been deeply influenced and hampered by economic, social, and ethical issues that are now being reconsidered owing to recently collected scientific evidence about the efficacy and safety of cannabinoid-based drugs. Untilvery recently, the destiny of Cannabis seemed that of a substance of abuse, powerful resource for the racketeering, demonized by the public opinion, condemned by governments, and neglected by the medical community. It has not always been this way and knowing its history is useful to understand the reasons for its contorted course. The millennial history of Cannabis, which effectively goes along that of human kind, testifies to its extensive usefulness for many purposes, as fiber, food, and medicine, beyond its use as a psychotropic substance. Now, the perception of Cannabis’s value and potential is changing all over the
world with are turn to the past. In particular, medical Cannabis is receiving an increased attention from patients, physicians, and governmental regulations, thanks to research efforts that have deduced the chemical characterization of the cannabinoids in the 1960s and discovered their natural target,the endo- cannabinoid system,in the1 990s. These new studies provided evidence of the safety and effectiveness of Cannabis in the treatment of numerous pathologies, using extracts with a known content ofvcannabinoids, or purified (oreven synthesized) active molecules. The main conditions with the current best evidence of Cannabis efficacy, as reported by an extensive systematic meta-analysis of all the randomized clinicaltrials conducted on cannabinoids uptodate, are spasticity associated with multiple sclerosis, chronic pain,nausea and vomiting caused by chemotherapy, and appetite stimulation in cancer or HIV patients [1]. Anecdotal data from patients and physicians suggest future uses for medical
Cannabis that need to beverified inclinical trials. Indeed, many of Cannabis’s therapeutic properties do not arise from new discoveries but rely upon the revival of empirical observations made through
its use for medical purposes through the centuries in all the main ancient cultures (Chinese, Indian, Scythian, Egyptian, Greek, Latin, Arabic) [2].

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