History of medical cannabis use

Cannabis is believed to have pre-dated humans and was almost certainly one of man’s first medicines.

DNA studies suggest the plant evolved somewhere around 20 to 25 million years ago, as DNA fossil records suggest it diverged from its closest relative Humulus or hops 27.8 million years ago. Fossil pollen for cannabis is sparse and points to the northeastern Tibetan Plateau as a centre of origin.

Its first known use as a food and for psychoactive potential was around 6,000 years ago, according to ancient Chinese texts.

It may have originated around China – certainly central Asia – and spread westward from there. All the old-world cultures used it, including the Scythians who took it from Siberia into China, India and Mesopotamia.

In India, cannabis has been used for many thousands of years, including as part of the spring festival of colours, Holi. It was also used in ancient Egypt, as a medicine, particularly for pain, epilepsy, eye conditions and as an anti-anxiety drug.

Hebrews used it in ritual ceremonies and as a simple medicine, while ancient Romans and Greeks used it in food, wine and as a surgical analgesic. It was also used to treat tumours, childbirth complications, headaches and as a muscle relaxant.

Various civilisations have banned it over the centuries, including the Muslim cultures of ancient Egypt, and in France during the Napoleonic era. Nevertheless, by the 19th Century, its use as a medicine remained largely popular. 

William O’Shaughnessy, an Irish physician working in India for the British East India Company, noticed local doctors using cannabis extract for a range of medical problems.

He became the first to publish on the use of cannabis in modern medicine and used it himself to treat patients in his hospital in Kolkata.

One of his early descriptions involved a baby girl with infantile convulsions. He commented: “The child is now in the enjoyment of robust health and has regained her natural plump and happy appearance.” This echoes with the childhood epilepsy cases that have helped to bring cannabis medicine to the fore today.

O’Shaughnessey brought cannabis seeds to Britain, helping cannabis medicine to become used by doctors in the UK. Somewhat questionably, he is reported to have suggested that Queen Victoria used cannabis for menstrual pains.

In the late 1800s to early 1900s, cannabis use started to dwindle, largely because of the development of new synthetic medicines such as aspirin, barbiturates and antibiotics. While not falling out of favour, the advent of modern drugs marginalised its usage.

By 1925, governments concerned about the international trade in opium began convening conventions designed to put international restrictions on the use and trade of opium. 

At one such conference, in Geneva in 1925, an Egyptian delegate bloviated that hashish, a cannabis product, was at least as harmful as opium and should be put in the same category of restriction. With no counter argument  offered, from that point onwards cannabis was labelled as a drug of equal danger and risk of addiction as opium and other narcotic agents.

In 1930, another obstacle for cannabis medicine’s progress emerged in Harry Anslinger. He was the first Commissioner of the Federal Bureau of Narcotics in the United States and had a fixation on cannabis. He spent many years in his role as commissioner demonising the drug. Some of his reasons were simply racist, and he latched on to the anti-Mexican and anti-black mood of the times.

Anslinger teamed up with famous newspaper magnate William Randolph Hearst, who produced a number of anti-cannabis newspaper articles. Anslinger was the man behind the now well-known films Reefer Madness, and Marijuana!, which had the tagline ‘weird orgies, wild parties and unleashed passions’.

The global problems with narcotics continued after the Second World War, and in 1961 this led up to the United Nations Single Convention on Narcotic Drugs, which still included Cannabis.

Cannabis was placed in its most restrictive level – Schedule 4 – which contained those drugs viewed as most dangerous, with high abuse potential and limited or no therapeutic value. As a result of the 1961 convention, most of the countries in the world had to put into place their own regulations to restrict the use of Cannabis. 

In the UK, this resulted in the Misuse of Drugs Act in 1971. Cannabis was classified as a Class B substance, a class that defines the penalty for possession and intent to supply. Even now, possession alone can carry a penalty of up to five years imprisonment with an unlimited fine. Intent to supply can carry a prison sentence up to 14 years with an unlimited fine, which compares to much lesser sentences for crimes such as brawling, grievous bodily harm and death by dangerous driving.

This essentially remained the picture until very recently. Several decades of outright prohibition suddenly gave way in November 2018, when a surge of publicity around the epileptic conditions of young patients like Alfie Dingley and Billie Caldwell created enough political pressure to effect changes. 

Cannabis was rescheduled to a Schedule II substance, enabling medical prescribing. This was a remarkable revolution for the substance, and while huge obstacles remain in establishing the necessary degrees of evidence for its approval for broader application by national regulators, after a long and tumultuous history, the future for medical cannabis looks positive. 

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