This article was written in collaboration with Leafwell.co
Did you know that, historically-speaking, cannabis has been legal for longer than it’s been illegal? It’s only over the past 100 years or so that cannabis has been prohibited in the Western world. Prior to the beginning of prohibition, cannabis was thought of as medicine. In fact, cannabis was listed as a medication in the US Pharmacopeia until the 1950s. The idea that cannabis is a new medication is therefore inaccurate - we’ve been using cannabis as medication for thousands of years!
Why is there skepticism towards the idea of medical cannabis in the first place?
There are two main reasons why there is such skepticism towards the idea of medical cannabis:
- Propaganda, stemming mostly from the U.S. in the 1930s, which put cannabis in an extremely negative light
- No real understanding of how cannabis works in the body until the late 1980s
With a combination of unscientific thinking and an unwillingness to understand cannabis scientifically in the first instance, it’s no surprise that there has been such a misunderstanding about cannabis.
In fact, the Nixon-appointed Shafer Commission, which was set up to confirm negative biases about cannabis, found instead that cannabis users were not the antisocial, criminal stereotype that came to prominence in the 30s. The Shafer report recommended the decriminalization of cannabis based on its findings. Needless to say, the Nixon Administration would ignore this report.
What effect has cannabis prohibition had on scientific research?
When cannabis was made into a Schedule I substance in the 1970s, it became immensely difficult to research it properly. Huge amounts of paperwork needed to be filled out, and the restrictive red tape made research into cannabis almost impossible. Moreover, any research that was funded by the U.S. government tended to focus on the negative effects of cannabis - most research looking at its therapeutic applications would not get funded. This led to researcher bias.
Furthermore, the research on cannabis which has focused on its negative effects would typically study only cannabis with moderate to high levels of tetrahydrocannabinol (THC) and not other chemotypes that would be less intoxicating. In fact, even to this day, THC is unfairly demonized. THC is a potent anti-inflammatory and painkiller, making it an excellent alternative to opioids and sedatives. Nevertheless, physicians in the U.S. prescribe addictive opioids and sedatives on a daily basis, and many people accept that these substances have medical uses which outweigh the side effects.
Cannabinoids like cannabidiol (CBD), cannabigerol (CBG), cannabinol (CBN), and cannabichromene (CBC) and so many others were ignored, and the only people interested in this sort of thing any time from the 1950s till the early 2000s were a handful of scientists and doctors, growers, cannabis nerds, and those who had personal experience of the plant’s medical potential. Politicians and most of the general public would balk at the idea of medical cannabis.
Striking down skepticism with research
This is where Prof. Raphael Mechoulam and The Hebrew University of Jerusalem comes in, as does the UK’s Prof. Roger Pertwee who was working at Oxford University in the 1960s. At the time, not many people really understood how cannabis worked, so scientists in The Hebrew University of Jerusalem set out to find out!
By the 1970s, tetrahydrocannabinol (THC) and cannabidiol (CBD) had been isolated, and researchers were looking to find unique medical uses for these cannabinoids, focusing on conditions that are particularly difficult to treat. Tetrahydrocannabivarin (THCV) was also of interest due to its unique properties. Researchers were particularly interested in these cannabinoids and despite all the attempts at finding negatives, few were found.
Glaucoma, cancer, epilepsy and AIDS/HIV were the first medical problems where cannabis treatments were researched in the modern era, and the results were promising. In fact, it would lead to the U.S. government to eventually patent synthetic THC (dronabinol and nabilone, which would be sold) for its antiemetic (anti-nausea/vomiting) and pain killing properties, and CBD in the 1990s for its antioxidant and anti-inflammatory properties.
So, while the U.S. government prohibited and demonized cannabis, they were well-aware of its therapeutic potential. Cynics could argue that the U.S. government did this purposefully, as they wanted it for themselves and their preferred research partners - essentially a monopoly.
Come the late 80s/early 90s, and Professors Raphael Mechoulam, Lumir Hanus and William DeVane would discover the body’s own, naturally occuring endocannabinoid, anandamide. After this, the CB1 and CB2 receptors were discovered, and it was found that our naturally-occuring endocannabinoids and cannabinoid receptors (called the endocannabinoid system) were involved in homeostasis - the way in which the body maintains a balanced, consistent internal environment.
The negatives of cannabis - is there something to what the skeptics say?
As with anything in life, there are going to be pros and cons to using cannabis. For some people, cannabis may be useful. For others, it may not. Essentially, cannabis is like any other medication: it’s not for everyone
Here are a few potential negatives that could arise from cannabis use, and how to approach these negatives rationally rather than skepticism-for-the-sake-of-skepticism.
Many people are afraid that consuming high amounts of THC may trigger a psychotic episode, whether from short-term or persistent use. There may be some merit to this for those who are already predisposed to illnesses involving psychosis (e.g. schizophrenia, bipolar disorder), but this is not a huge section of the population. Moreover, tobacco and alcohol can also trigger psychotic episodes, yet these aren’t banned!
While some studies show there is some possibility that heavy cannabis use may increase the risk of psychosis, this is not necessarily played out in real life in all instances. Not every cannabis user is using the same type of cannabis, and there may be a significant number of people who do not use high-THC cannabis, and/or who use cannabis in a controlled manner. Also, CBD has antipsychotic properties, and low- or no- THC varieties of cannabis may be of immense use for schizophrenia, bipolar disorder and psychotic depression.
This is an interesting one, as cannabinoids are touted as a treatment for some types of cancer, and there is certainly a significant amount of evidence showing that this is definitely the case, and could actually reduce cancer risk!
The main criticism here comes from the smoking of cannabis. Now, cannabis smoke is not the same as tobacco smoke, but from a logical point of view, inhaling burning plant matter is generally not advisable in most circumstances. Some damage to the throat and lungs certainly occurs, but whether or not inhaling cannabis smoke alone causes cancer is not known. Caution is to be advised when it comes to smoking cannabis, though.
To say cannabis is highly addictive is not at all accurate. To say that cannabis has no addiction potential whatsoever is also not entirely accurate. Tolerance to cannabinoids like THC certainly occurs, meaning that increasing consumption is needed to get the same effects. However, this is not always a negative (e.g. for cancer), and some amount of tolerance may need to be built to prevent the feeling of over-intoxication.
Withdrawal can also occur, with about 12% of heavy cannabis users showing cannabis withdrawal as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), and this was associated with significant disability as well as mood, anxiety and personality disorders. Cannabis dependence develops in about 9% of users, significantly less than that of heroin, cocaine, alcohol, and prescribed anxiolytics.
This makes cannabis less addictive than many prescription drugs, and the abuse potential is quite low, too. Moreover, for most people, stopping cannabis use is not hugely difficult. Yes, there may be some withdrawal symptoms, but with a few exceptions most people find these tolerable. In fact, cannabis could be an exit drug that helps people wean off other, more addictive substances!
Why are people still skeptical of cannabis?
There are few compounds as safe as naturally-derived cannabinoids. Even though cannabis has a long history of medical use, there are few double-blind, placebo-controlled studies that definitively prove cannabis can be used for so many conditions. Predominantly, the evidence is anecdotal, but in large enough a number to say for certain, “There’s something here that needs to be looked at further.”
There are still many hangovers from attitudes formed during prohibition. Even as more evidence comes out showing cannabis’ therapeutic and medical potential, people remain skeptical of cannabis due to its perceived and often overinflated negative effects. However, the plant’s healing properties far outweigh its potential adverse effects; and sometimes the “adverse effects” like appetite stimulation, drowsiness, and dissociation are in fact what the user may be looking for, depending on their symptoms.
Unfortunately, when it comes to cannabis, many people don’t treat it like most other medications; people are more skeptical. The skepticism isn’t always unwarranted, but it is not necessarily an entirely rational skepticism.
What makes cannabis medicine?
In the early 2000s, Dr. Ethan Russo posited the theory of Clinical Endocannabinoid Deficiency (CECD) in order to explain why people suffer from difficult-to-treat conditions like fibromyalgia, epilepsy, migraines and irritable bowel diseases (IBDs), amongst others.
The theory is that a lack or dysregulation of naturally-occurring cannabinoids can lead to widespread inflammation. Cannabinoids derived from the cannabis plant can help replace these lost endocannabinoids. What’s more, cannabis is relatively safe, with no practical chance of deadly overdose.
There are few if any medications available on the market that have the broad range of uses and safety profile of cannabis. The cannabis plant contains up to 150 different cannabinoids, many of which are non-intoxicating, but still have many medical uses. Cannabis is quite literally a pharmacy in a plant. That we don’t research it further is certainly due to political reasons, not scientific ones. This is beginning to change, though, and we here at Chicago Cannabis Company and Leafwell hope it changes further.