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

See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/312350959 Modern History of Medical Cannabis: From Widespread Use to Prohibitionism and Back Article in Trends in Pharmacological Sciences · January 2017 DOI: 10.1016/j.tips.2016.12.002 CITATIONS READS 12 399 2 authors: Simona Pisanti Maurizio Bifulco Università degli Studi di Salerno Università degli Studi di Salerno 69 PUBLICATIONS 2,123 CITATIONS 275 PUBLICATIONS 7,660 CITATIONS SEE PROFILE SEE PROFILE Some of the authors of this publication are also working on these related projects: PRDMs and cancer View project Molecular mechanisms of melanoma brain metastases View project All content following this page was uploaded by Simona Pisanti on 15 February 2018. The user has requested enhancement of the downloaded file. TIPS 1400 No. of Pages 4 Science & Society cannabinoid-based drugs. Until very of Cannabis efficacy, as reported by an Modern History of recently, the destiny of Cannabis seemed extensive systematic meta-analysis of all that of a substance of abuse, powerful the randomized clinical trials conducted Medical Cannabis[2_TD$IF]: resource for the racketeering, demonized on cannabinoids up to date, are spasticity From Widespread by the public opinion, condemned by associated with multiple sclerosis, governments, and neglected by the med- chronic pain, nausea and vomiting Use to ical community. It has not always been caused by chemotherapy, and appetite Prohibitionism this way and knowing its history is useful stimulation in cancer or HIV patients [1]. to understand the reasons for its con- Anecdotal data from patients and physi- and Back torted course. The millennial history of cians suggest future uses for medical Cannabis, which effectively goes along Cannabis that need to be verified in clini- Simona Pisanti1,* and that of human kind, testifies to its exten- cal trials. Indeed, many of Cannabis’s Maurizio Bifulco1,2,* sive usefulness for many purposes, as therapeutic properties do not arise from fiber, food, and medicine, beyond new discoveries but rely upon the revival Over the history of[3_TD$IF] pharmacology there its use as a psychotropic substance. of empirical observations made through are numerous examples of drugs being Now, the perception of Cannabis’s value its use for medical purposes through the widely distributed, almost ‘trendy’, pre- and potential is changing all over the centuries in all the main ancient cultures scribed by physicians in a certain period world with a return to the past. In particu- (Chinese, Indian, Scythian, Egyptian, as a sort of panacea, and then neglected, lar, medical Cannabis is receiving an Greek, Latin, Arabic) [2]. forgotten, or even forbidden as they increased attention from patients, physi- become considered dangerous in the cians, and governmental regulations, The first modern descriptions of thera- light of clinical observations. One of these thanks to research efforts that have peutic properties of Cannabis, dating drugs is Cannabis, which was very popu- deduced the chemical characterization back to the 19th century with the work lar in the 19th century until disappearing of the cannabinoids in the 1960s and of the Irish physician William Brooke from the official Pharmacopoeia at the discovered their natural target, the endo- O’shaughnessy (1839) who, thanks to beginning of the 20th century and reviving cannabinoid system, in the 1990s. These his work in India and his experimentation, again in the new millennium. However, its new studies provided evidence of the more thoroughly made known to the modern history is peculiar since its medi- safety and effectiveness of Cannabis in European medical community the cal use has been deeply influenced and the treatment of numerous pathologies, countless pharmacological properties of hampered by economic, social, and ethi- using extracts with a known content Cannabis [3] (Figure 1). He noticed the cal issues that are now being reconsid- of cannabinoids, or purified (or even beneficial therapeutic effects of Indian ered owing to recently collected scientific synthesized) active molecules. The main Cannabis that he named Indian cannabis evidence about the efficacy and safety of conditions with the current best evidence or Cannabis indica, which in his opinion First concern in the UK First experimentations about hemp abuse: Gaoni and Marijuana tax act in on mental patients ‘The Indian Hemp Mechoulam discover the USA by Moreau Drugs Commission Δ9-THC Report’ Cannabis legalization in Colorado and Discontinuation of Washington ‘Cannabis Pharmacology of medical studies on experiences’ inhaled Cannabis Cannabis 1839 1840 1844 1847 1887 1894 1899 1906 1925 1937 1941 1945 1960 1964 1990 2012 ‘Club des Hashischins’ International drug Cannabis classified control treaty Endocannabinoid substance of abuse system discovery First experimentations Cannabis sativa on Cannabis indica Regulation of inhalation used by Cannabis out from by O’Shaughnessy Valieri to treat patients Cannabis medicinal products labeling USA Pharmacopoeia in the USA Figure 1. Timeline of Cannabis Modern History. Trends in Pharmacological Sciences, Month Year, Vol. xx, No. yy 1 TIPS 1400 No. of Pages 4 showed better medicinal properties than the others, by famous poets and writers anti-inflammatory, and antispastic drugs. Cannabis sativa, the variety common in like Victor Hugo, Alexandre Dumas, In 1899, the pharmacologist Walter Ernest Europe. He made a rigorous study of Charles Baudelaire, Honoré de Balzac, Dixon pointed out the particular efficacy Cannabis properties, first testing it in vari- Théophile Gautier, and the painter Ferdi- of inhaled Cannabis to obtain a consistent ous animal species, thus being the first, nand Boissard, who ingested hashish to and rapid pharmacological effect, to our knowledge, to apply the experi- experiment its psychotropic properties on whereas Shoemaker reported its efficacy mental method in studying Cannabis. themselves [5]. In addition, some Italian in a large number of patients treated for Having ascertained its safety in animals, scientists were leading in the medical neuralgia, migraine, gastralgia, enteralgia, he administered alcoholic tinctures of experimentation on Cannabis. Giovanni brain tumors, and herpes zoster. Cannabis to some selected patients Polli, physician and director of the scien- who suffered from epilepsy, rheuma- tific journal Annals of Chemistry Applied to However, around the end of 19th century, tisms, cholera, or tetanus and deduced Medicine, and Carlo Erba, a pharmacist, the use of medical Cannabis started to that the plant had interesting analgesic introduced in Italy the knowledge on Can- decline, because there was a remarkable and myorelaxant properties. Based on nabis properties. Both Giovanni Polli and variability in its effects among patients and this observation, he proposed that Can- Carlo Erba tested themselves its effects, also among different preparations of Can- nabis could be a powerful remedy for psychoactive and not, in a reported nabis, as their pharmacologically active seizures. Moreover, he investigated its experiment carried out in Milan on June principles were not known and thus not effects on tetanus; although Cannabis 19, 1847 [6]. Successively, several inquis- quantifiable. However, as reported in an was not able to cure the infection, itive doctors made similar ‘Cannabis editorial from the Medical and Surgical it relieved some serious symptoms, experiences’ in Italy. Such sessions of Reporter, published in New York, there suggesting that it could be used as an hashish ingestion were precisely followed has never been a case of poisoning adjuvant. A similar experimental and sys- and observed by an ample audience of recorded from Cannabis use, so its safety tematic approach was employed also by scientists and doctors, who promptly and was not a matter of discussion [7]. the French psychiatrist Jacques-Joseph accurately described its effects on the Beyond such pharmacological concerns, Moreau, considered the father of modern body. The Neapolitan physician Raffaele there was the emergence of the first wor- psychopharmacology, who in 1840 tried Valieri was a confident supporter of the ries about an uncontrolled diffusion of Cannabis on himself and later on his stu- medical properties of Cannabis. In 1887, Cannabis for recreational purposes dents and described in detail its acute he published a booklet entitled ‘About beyond its therapeutic value, fostered psychoactive effects, which he had pre- local hemp and its preparations in place by economic reasons. Indeed, the British viously observed in Arabic people who of Cannabis indica’ and launched a pro- government that had huge economic were customary to hashish use. Moreau gram for the inhalation of local C. sativa, interests in India was really worried about also treated his mental patients at the which was produced in Italy, particularly the effects of drug abuse, first of opium Hôpital de Bicêtre, observing that hashish in Campania, for patients with several and then of hemp used by Indian in moderate doses calmed patients, pathologies ranging from migraine, neu- people, so it commissioned a study helped them to sleep, suppressed head- ralgia, insomnia, hysteria to asthma, pul- ‘The Indian Hemp Drugs Commission aches, and increased appetite [4]. monary emphysema, and exophthalmic Report’, which was published in 1894 goiter, reporting good therapeutic results establishing that, ‘the occasional use or Thanks to the studies and the knowledge [6]. The

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