A Medical Cannabis Overview

Before recorded human history, Cannabis was cultivated as a resource for humankind. Some ancient examples include hemp textiles from roughly 7000 years ago to charred seeds from roughly 5000 years ago. Even an excavated grave from roughly 2700 years had a large cache of female cannabis plants buried with the person.

While each of these are circumstantial, we also have direct evidence of medicinal THC use starting at 400 A.D. in the form of ashes.

Deriving from and utilizing plants as medicine has been a common practice for most of human history. Consider the bark of the willow tree, whose medicinal properties were first utilized 3500 years ago. And, thanks to research and progress, we now have aspirin, the most widely used drug in the world.

While aspirin itself was released in 1897, continued research into it has found continued innovation, improvement, negative side-effects, and additional positive effects. For example, in 1978, nearly 80 years later, it was confirmed that aspirin was effective in preventing strokes or heart attacks. If you were to have one of these today, your doctor may prescribe you a low dose to help prevent another.

Knowing that cannabis has a long history so similar to that of the willow tree, what separates it? Cannabis and the active compounds (cannabinoids) can have a psychoactive effect on users and in the early 1900’s, a man named Harry J. Anslinger was effectively able to lobby against the plant. In 1937, it was made illegal by the Marihuana Tax Act.

Prior to this act, Cannabis was considered a medicine as noted in the United States Pharmacopoeia.

United States – Cannabis As Medicine

Medicine, generally speaking, has always been practiced throughout human history. Medical use of cannabis is evident throughout this history. Even in the United States, it was widely used throughout the 1800’s and early 1900’s. However, due to the legislation in the 1930’s, research into the use of cannabis is lacking.

Progress in chemistry, microbiology, and the understanding of the human body resulted in a significant medical boom in the 1960’s. Countless new drugs were developed, vitamins improved, and the ability to live longer and healthier was realized. This progress contributed to life expectancy for men improving by almost 10% from the 1950’s to the 1980’s.

However, in the 1970’s, cannabis was moved to a Schedule I drug, which greatly reduced and limited any research that could occur on it. With such a long history in medicine though, cannabis and the proponents for it continued to push for a reconsideration.

In 1996, California became the first state to legalize the use of cannabis under physician supervision. As of February 2023, 37 states now have some form of legal cannabis use.

In April of 2021, cannabis was removed from the Schedule I list, finally allowing some research to begin.

The Human Endocannabinoid System

Throughout our bodies we have a complex cell-signaling system called the Endocannabinoid System (eCS). This system utilizes two primary signaling pathways via the CB1 and CB2 receptors. CB1 receptors tend to be found in conjunction with the central nervous system, while CB2 receptors are found in immune cells and peripheral tissues.

Research suggests that the eCS plays an important role in systems like:

• Energy balance
• Appetite stimulation
• Blood pressure
• Pain
• Embryonic development
• Nausea and vomiting control
• Memory and learning
• Immune response

Cannabis has a large variety of its own cannabinoid compounds. The two most common are THC and CBD. When the cannabis plant is smoked or ingested, these compounds interact with our internal system.

Research shows, for example, that THC binds to CB1 receptors and activates them, leading to the psychoactive effects associated with cannabis use. CBD, on the other hand, does not bind directly to CB1 or CB2 receptors but can modulate their activity through indirect mechanisms, leading to a range of potential therapeutic benefits.

Other cannabinoids found in cannabis include cannabinol (CBN), cannabigerol (CBG), and cannabichromene (CBC), among others. Each cannabinoid has unique effects on the body and interacts with the eCS in different ways, leading to a range of potential therapeutic applications.

To date, there are three drugs that already interact with the eCS.

Marinol: It may be used to treat loss of appetite that causes weight loss in people with AIDS or treat nausea and vomiting caused by cancer chemotherapy.
Nabilone: It may be used to treat nausea and vomiting caused by cancer chemotherapy.
Dronabinol: It may be used to treat loss of appetite that causes weight loss in people with AIDS or treat nausea and vomiting caused by cancer chemotherapy.

With the development of these FDA approved drugs, we can see that the eCS is an effective gateway for medicines to target to improve our health.

Lastly, some research also suggests that problems with our eCS may result in more significant pathological conditions such as:

• Parkinson’s disease
• Huntington’s disease
• Alzheimer’s disease
• Multiple sclerosis

As legalization of cannabis continues to progress, new developments in genetics, chemistry techniques, and a deeper understanding of the human body, research into the field of the eCS and cannabinoids stands to be an excellent opportunity for medicine to explore.

Cancer, eCS, and Cannabis

One of the primary medical fields that cannabis is being explored in is related to cancer. Active research into the possibilities of utilizing cannabinoids is being pursued as some cancer cells utilize the eCS to impact their growth.

Cannabinoids interact with many of the same pathways that cancer utilizes for cell growth and survival. Some of these pathways involve cell proliferation, angiogenesis (the growth of new blood vessels), and apoptosis (programmed cell death).

In some preclinical studies, cannabinoids have been shown to inhibit the growth and spread of a variety of cancer cell types, including breast, lung, prostate, and brain cancer cells, among others.

While these results are primarily being seen in animal and cell cultures, not clinical trials, the implications may greatly improve cancer treatments as a whole if the results hold through clinical phases of research.

In addition to the possibility of assisting in cancer treatment directly, research suggests cannabinoid treatment may help to alleviate some of the pain symptoms of cancer and nausea side-effects of chemotherapy. As mentioned before, some man-made cannabinoid medicines have already been approved for such uses over 25 years ago.

It should be noted that while these results are promising, they do not constitute medical advice. If you are considering utilizing cannabis for any medical reason at this time, it is recommended you first consult your healthcare provider.

Looking Ahead

As we look ahead we can take the most recent actions by the U.S. Government in 2022 as a hopeful sign. Late in the year all convictions for simple possession of cannabis were pardoned, and a research bill was signed to make it easier to study the plant.

Given the length of time without being able to freely research, we hope that new uses are identified quickly and further open up the door for utilizing such an ancient and familiar plant to its fullest effect.

Outside of the U.S. many countries have also begun the process of full legalization over recent years, which we hope will compound the already exciting early news we are seeing regarding the research into cannabis.

References

Weil, A., M.D., Pollan, M., Grinspoon, L., M.D., & Pierre, A. S. (2010). The Pot Book: A Complete Guide to Cannabis (J. Holland M.D., Ed.). Park Street Press.

Bridgeman MB, Abazia DT. Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting. P T. 2017 Mar;42(3):180-188. PMID: 28250701; PMCID: PMC5312634.

Desborough, M.J.R.; Keeling, D.M. The Aspirin Story—From Willow to Wonder Drug. Br. J. Haematol. 2017, 177, 674–683