It's a bird ... it's a plane ... it's ... Captain Cannabis! OK, Captain Cannabis isn't a real superhero. However, medical cannabis advocates in Colorado, the most recent U.S. state to decriminalize the possession of small amounts of marijuana, have joked about creating one, based on a caricature of Denver police chief candidate Robert White. White had a false positive test for marijuana more than 25 years ago and says that he has never used drugs, so he's not really the best choice for a medical cannabis champion.
These same medical cannabis advocates -- the Medical Marijuana Assistance Program of America -- were also the butt of a joke on "Saturday Night Live" in early 2011. "Weekend Update" anchor Seth Meyers drew comparisons between the organization's efforts to get rural doctors to consider prescribing medical cannabis and "a guy selling weed out of a trailer" [source: Huffington Post]. Both of these news stories reflect many people's attitudes toward medical cannabis and the legal issues surrounding it -- that it's all a big joke.
It may seem like medical cannabis use started back with California's Prop 215, or the Compassionate Use Act, in 1996. That's when California law first allowed for the legal use of marijuana as recommended by doctors. However, it's far from the first time that cannabis has been used for therapeutic purposes. So what's the difference between the stuff that a doctor legally recommends to a patient to help with a medical condition and the herb purchased illegally for the purposes of intoxication? Part of it is the name.
Medical cannabis includes not only parts of the plant but also synthesized versions of the active chemical compounds present in cannabis, known as cannabinoids. When it comes to the legal issues, the difference between medical cannabis and marijuana is whether it has been recommended by a physician for a documented medical problem. If you're talking about the plant, though, when you get right down to it, there's no difference between the actual substances. Cannabis is the scientific name; marijuana comes from Mexican Spanish.
Numerous scientific studies over the decades, and around the world, have documented the therapeutic value of using cannabis to treat a host of illnesses and conditions. However, plenty of people have refuted those studies, claiming that they're inconclusive, there's a placebo effect at work or that it's just an excuse to get high. Critics also cite the potentially negative side effects of using cannabis as a medication.
Despite its controversy now, cannabis has been used medically for a very long time. Let's go way back -- as in, thousands of years back -- to look at the role cannabis played in ancient civilizations.
Ancient Times, High Times?
While it's easy to imagine that medical cannabis use got its start in more recent times -- the psychedelic '60s, anyone? -- in reality, people have been using cannabis to help cure what ails them for almost as long as the herb has been in use, period. The earliest records date back to about 2700 B.C., when Chinese physicians were recommending a tea made from cannabis leaves to treat conditions like gout and malaria (cannabis was already in use as early as 4000 B.C. in China as a source of cloth, rope, fiber and cooking oil). Around A.D. 200, Chinese physician Hua Tao wrote about using it as part of what was probably the first anesthetic.
While the earliest mentions of medical cannabis come from China, other regions of the world were not too far behind. Several medical papyri dating from 1000 to 1700 BC show that the ancient Egyptians used cannabis to treat foot and eye problems, as well as hemorrhoids. Separating medicinal use from magical and religious uses can be difficult in ancient literature, however, and this is certainly true in India. The "Atharva Veda," one of the sacred Hindu texts dating to around 2000 B.C., cites it as a sacred plant that combats "evil forces," which include those that cause both spiritual and health problems. More practical uses outlined in later writings like the "Sushruta Samhita" (an Ayurvedic medical text circa A.D. 300) include treating pain, insomnia and headaches, as well as another mention of cannabis as an anesthetic for surgical procedures.
Ancient Greeks may have been influenced by Indian use of medical cannabis, or vice versa. The first written record comes from Herodotus, who stated in 500 B.C. that Scythians, a group of ancient Iranian nomads, took vapor baths using marijuana. Other Greek writers mentioned using it to get rid of tapeworms, stop nosebleeds and reduce inflammation and pain in the ear. The seeds were even prescribed to "dry up semen" of teenage boys, possibly to reduce nocturnal emissions.
The use of cannabis as medicine became hotly debated in Islamic countries in the Middle Ages, as Koranic scholars were unsure whether it was in the same category as alcohol, which was forbidden. Ultimately, they drew a distinction between the use of medical cannabis and hashish (a strong form of marijuana made from resin) as used to get high.
Despite all of this ancient medicinal use, Westerners did not seem to catch on to the concept of medical cannabis until the 1800s, although the plant's other uses had been adopted. Next, we'll look at what most consider the very first scientific study of medical cannabis.
From Patent Medicine to Research Only
Much of the credit (or blame) for medical cannabis use in modern times falls on the shoulders of an Irish doctor named William O'Shaughnessy. As a physician with the British East India Company, he learned of its use while in India. In 1830, O'Shaughnessy first conducted experiments with cannabis on animals then tried it on his patients, claiming to successfully treat muscle spasms, pain, vomiting and diarrhea. Other Western doctors followed suit, setting off a flurry of studies. In the United States, the first conference on medical cannabis took place in 1863. Pharmaceutical companies got into the act, marketing patent medicines to combat many of the same conditions cited by O'Shaughnessy. Once aspirin was synthesized in the late 1800s, cannabis was used less popularly to treat pain and increasingly for recreational purposes.
The U.S. Food and Drug Administration (FDA) was formed in 1906, putting an end to the patent medicine industry, and laws were soon passed to tightly restrict cannabis use to FDA-approved research studies only. Not to be outdone, Canada made cannabis illegal in 1923, while the United Kingdom followed suit a few years later. Negative press about cannabis abounded in the tabloid papers of the 1930s, associating its use with Mexican immigrants -- which is how it became known as marijuana instead of cannabis -- and blaming the drug for driving people to commit crimes. However, the American Medical Association was still touting the safe medical use of cannabis into the 1940s. In 1961, the United Nations Treaty 406 Single Convention on Narcotic Drugs was signed, which pledged to eradicate both cannabis cultivation and use across the world in 30 years.
However, medical cannabis research (and use, of course) continued regardless of the drug's shifting changes in legal status. Researchers around the world felt that O'Shaughnessy and his ancient predecessors were on to something. For example, doctors in both (what is now) the Czech Republic and in Argentina independently published studies in the early 1960s that outlined the drug's antibiotic properties. Its use in reducing intraocular pressure, the main cause of glaucoma, was studied in the United States, Eastern Europe and among Jamaican communities from the 1950s through the 1970s. Although recreational marijuana use became associated with the hippie movement in the 1960s, returning Vietnam veterans were also using it to deal with muscle spasms caused by injuries as well as post-traumatic stress disorder (PTSD).
Since the 1980s, research into medical cannabis has focused mainly on two different types of use: to treat conditions that cause wasting and those that lead to muscle and skeletal problems, although other studies abound. Coming up, learn about just some of the ways that patients are using medical cannabis.
Medical Cannabis Today
You may be wondering if medical cannabis is used differently from recreational marijuana -- it really depends on the person and his or her condition. Many patients do smoke it or vaporize cannabis to extract the active compounds. This way, they can take in just as much as they need to manage their symptoms. People also drink medical cannabis in tea or consume it in food like brownies or cookies. There are also oils, capsules and medications made from the natural and synthetic cannabinoids.
Medical cannabis has been suggested, and used, for treating so many different diseases and conditions that it would be impossible to recount them all here. Some people who are terminally ill, regardless of the disease, find relief from severe pain and nausea when they use medical cannabis. Researchers have long been aware of cannabis' ability to reduce pressure in the eyes, which is the cause of glaucoma. Whether it's the best treatment for that condition, however, is unknown.
The joke is that cannabis causes "the munchies," but in many people, it does stimulate appetite. Patients suffering from wasting, or cachexia, have also been shown to benefit from using medical cannabis. Cachexia may include fatigue, weakness, loss of appetite and loss of muscle mass. It affects patients with HIV/AIDS, cancer and a host of other diseases. In addition, some of the treatments for these diseases, like chemotherapy in the case of cancer, have side effects like nausea and vomiting. Using medical cannabis may also suppress those symptoms, as well as reducing pain in these patients and others with chronic or acute pain.
Some use medical cannabis to treat muscle control disorders that cause spasticity (tight muscles), tremors and muscle spasms. These include Parkinson's disease and multiple sclerosis (MS). Researchers suggest that this may to be due to its anti-inflammatory qualities. However, some studies have also shown that the tremors caused by MS weren't actually reduced by using cannabis, although the patients felt that they were better. This may be due to the mood-enhancing effects of the drug.
And there lies some of the controversy inherent in medical cannabis. Next, we'll look at some of the criticism of its use and the legal issues.
Cannabis Criticism and Legality
For every study and claim that medical cannabis can benefit patients with various conditions, there are others to refute it. Many of the conditions and side effects that medical cannabis is used to treat are also treatable with legal, Food and Drug Administration-approved drugs. The Glaucoma Research Foundation, for example, has stated that using medical cannabis to lower eye pressure only lasts for a few hours, and the negative side effects outweigh the benefits. Using medical cannabis to combat some of the side effects of HIV/AIDS may suppress patients' already compromised immune systems and leave them open to lung infections, according to the Institute of Medicine.
These are just a few of the specific criticisms. People who smoke cannabis (still the most common way of using it) may also run the risk of damaging their lungs. Plants may harbor dangerous microorganisms. The U.S. Department of Justice declared in 1988 that cannabis was not toxic and that there had never been a documented death from cannabis. However, the American Society of Addiction Medicine points to the high potential for abuse and states that there hasn't been enough research to qualify it as a medication.
There's also the little fact that it's still illegal ... sort of. The United Nations drug convention classifies it as a Schedule IV drug, meaning that member countries can decide whether to allow its use for medicine or research. Currently 16 U.S. states have either medical cannabis laws or decriminalization laws, which remove or reduce the legal penalties for possessing certain amounts of cannabis or cannabis plants. Most states have specific requirements that patients must meet, and they must typically register with the state.
According to U.S. federal law, cannabis possession, use and growth is illegal; however, the Obama administration has generally stated that dispensaries -- stores that sell medical cannabis by prescription in a state where it is legal -- in compliance with local laws will not be raided. Numerous medical organizations, including the American College of Physicians, propose federally reclassifying cannabis to facilitate more research.
Medical cannabis' legality in other countries varies widely. In Canada, medical cannabis is legal for patients with certain conditions -- although currently its laws are being debated. In the United Kingdom, the only legal medical cannabis is the cannabinoid-derived drug Sativex. Other Western countries range from legalizing medical use to having decriminalization laws, including Israel, Belgium, the Netherlands and the Czech Republic. In some countries, there is simply a policy of non-enforcement regardless of whether the cannabis use is medical or not, especially with possession of small amounts.
While legal issues and controversy surrounding medical cannabis continue, there will always been those who claim its benefits and continue to use it ... regardless of the trends.
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