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Cannabis as a medicine was used before the Christian era in Asia, mainly in India. The introduction of cannabis in the Western medicine occurred in the midst of the 19th century, reaching the climax in the last decade of that century, with the availability and usage of cannabis extracts or tinctures. In the first decades of the 20th century, the Western medical use of cannabis significantly decreased largely due to difficulties to obtain consistent results from batches of plant material of different potencies. The identification of the chemical structure of cannabis components and the possibility of obtaining its pure constituents were related to a significant increase in scientific interest in such plant, since 1965. This interest was renewed in the 1990's with the description of cannabinoid receptors and the identification of an endogenous cannabinoid system in the brain. A new and more consistent cycle of the use of cannabis derivatives as medication begins, since treatment effectiveness and safety started to be scientifically proven.
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History of cannabis as a medicine: a review
História da cannabis como medicamento: uma revisão
Cannabis as a medicine was used before the Christian era in Asia, mainly in India. The introduction of cannabis in the Western
medicine occurred in the midst of the 19
century, reaching the climax in the last decade of that century, with the availability and
usage of cannabis extracts or tinctures. In the first decades of the 20
century, the Western medical use of cannabis significantly
decreased largely due to difficulties to obtain consistent results from batches of plant material of different potencies. The identification
of the chemical structure of cannabis components and the possibility of obtaining its pure constituents were related to a significant
increase in scientific interest in such plant, since 1965. This interest was renewed in the 1990’s with the description of cannabinoid
receptors and the identification of an endogenous cannabinoid system in the brain. A new and more consistent cycle of the use of
cannabis derivatives as medication begins, since treatment effectiveness and safety started to be scientifically proven.
Keywords: Cannabis; Cannabinoids; Tetrahydrocannabinol; History; Therapeutic uses
Antes da Era Cristã, a cannabis foi utilizada na Ásia como medicamento, com grande importância na Índia. A introdução da
cannabis na Medicina Ocidental ocorreu em meados do século XIX, atingindo o clímax na última década deste século, com a
disponibilidade e o uso de extratos e tinturas da cannabis. Nas primeiras décadas do século XX, o uso médico da cannabis no
Ocidente diminuiu significativamente, em grande parte pela dificuldade na obtenção de resultados consistentes de amostras da
planta com diferentes potências. A identificação da estrutura química de componentes da cannabis e a possibilidade de se obter
seus constituintes puros foram relacionadas a um aumento significativo no interesse científico pela planta, desde 1965. Este
interesse foi renovado nos anos 90, com a descrição dos receptores de canabinóides e a identificação de um sistema canabinóide
endógeno no cérebro. Usos terapêuticos. Um novo e mais consistente ciclo de uso dos derivados de cannabis como medicamento
começa, já que a sua eficácia e segurança no tratamento começam a estar cientificamente provados.
Descritores: Cannabis; Canabinóides; Tetraidrocanabinol; História; Usos terapêuticos
Department of Neurology, Psychiatry and Medical Psychology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo
(USP), São Paulo (SP), Brazil
Rev Bras Psiquiatr. 2006;28(2):153-7
Antonio Waldo Zuardi
Financing: Conselho Nacional de Desenvolvimento Científico e
Tecnológico (CNPq) - Grant 300775/2004-0 and Fundação de
Amparo à Pesquisa do Estado de São Paulo (FAPESP) -
Grant 202/13197-2
Conflict of interests: None
Submitted: 4 October 2005
Accepted: 21 November 2005
Antonio Waldo Zuardi
Av. Candido Pereira Lima 745 – Jd. Recreio
14040-250 Ribeirão Preto, SP, Brazil
Rev Bras Psiquiatr. 2006;28(2):153-7
History of cannabis as a medicine 154
Before the Christian Era
Cannabis Sativa (cannabis) is among the earliest plants
cultivated by man. The first evidence of the use of cannabis
was found in China, where archeological and historical findings
indicate that that plant was cultivated for fibers since 4.000
With the fibers obtained from the cannabis stems, the
Chinese manufactured strings, ropes, textiles, and even paper.
Textiles and paper made from cannabis were found in the
tomb of Emperor Wu (104-87 B.C.), of the Han dynasty.
The Chinese also used cannabis fruits as food. These fruits
are small (3 to 5 mm), elliptic, smooth, with a hard shell,
and contain one single seed. The first evidence of the use of
these seeds was found during the Han dynasty (206 B.C. -
220 A.D.). In the beginning of the Christian Era, with the
introduction of new cultures, cannabis was no longer an
important food in China, although, until today, the seeds are
still used for making kitchen oil in Nepal.
The use of cannabis as a medicine by ancient Chinese was
reported in the world’s oldest pharmacopoeia, the pen-ts’ao
ching which was compiled in the first century of this Era, but
based on oral traditions passed down from the time of Emperor
Shen-Nung, who lived during the years 2.700 B.C. Indications
for the use of cannabis included: rheumatic pain, intestinal
constipation, disorders of the female reproductive system,
malaria, and others.
In the beginning of the Christian Era,
Hua T’o, the founder of Chinese surgery (A.D. 110 – 207),
used a compound of the plant, taken with wine, to anesthetize
patients during surgical operations.
The Chinese used mainly the seeds of cannabis for medical
therefore, it may be assumed that they were referring
to that part of the plant when describing its medicinal
properties. Until today, cannabis seeds continue to be used as
a laxative by Chinese physicians.
It is acknowledged that the
seeds are practically deficient in Δ
-tetrahydrocannabinol (Δ
THC), which is considered the plant’s main active constituent,
and is mainly composed of essential fatty acids and proteins.
Today some of these fatty acids are considered as having
therapeutic effects, such as the γ-linoleic acid, whose topical
use is recommended for eczema and psoriasis, and its oral
use for atherosclerosis, osteoporosis, rheumatoid arthritis, and
other inflammatory diseases.
In China, the medical use of
cannabis never reached the importance it did in India.
The first reference to the use of cannabis, as a
psychoactive drug, is also in the pen-ts’ao ching, as observed
in one of its phrases: (the fruit of cannabis)... if
taken in excess will produce visions of devils … over a
long term, it makes one communicate with spirits and
lightens one’s body…
In spite of this reference, there are
scarce citations of the use of cannabis as a hallucinogen
in ancient Chinese texts. One possible explanation is that
such use was probably associated to shamanism, a religion
of the people from Central Asia. During the Han dynasty,
this religious practice started to decline in China, and
became disbelieved and increasingly restricted. Ancient texts
rarely mentioned shamanism and, thus, there is no reference
to the use of cannabis as a hallucinogen.
shamanism became gradually more restricted in China, it
was rather common in the Northern nomadic tribes, which
may have contributed to the dissemination of cannabis in
Central and Western Asia and in India.
In India, the use of cannabis was widely disseminated, both
as a medicine and as a recreational drug. Such a broad use
may be due to the fact that cannabis maintained a straight
association with religion, which assigned sacred virtues to
the plant. The Atharva Veda (a collection of sacred texts of
unknown author) mentions cannabis as one of five sacred
plants, referring to it as a source of happiness, donator of joy
and bringer of freedom. Hence, cannabis use became part of
numerous religious rituals in that region.
The plant’s psychoactive effects were well-known in India,
possibly due to the way it was prepared for use, which included
at least three preparations. The weakest type, Bhang, consists
of dry leaves from which flowers are carefully removed. A
stronger type, Ganja, is prepared with the female-plant’s
flowers. The strongest of them all is the Charas, made
exclusively of the resin that covers female flowers.
These forms
of preparation guarantee the presence of active cannabinoids.
Currently we know that the plant has secreting hairs that are
located mainly on the female-plant’s flowers and, in a smaller
amount, on the leaves of its superior third. Solitary resin glands
most often form at the tips of the trichome stalks. These glands
have a considerable amount of active cannabinoids. Breaking
the glands liberates the active cannabinoids.
In India, the medical and religious use of cannabis probably
began together around 1000 years B.C.
The plant was used
for innumerous functions, such as: analgesic (neuralgia,
headache, toothache), anticonvulsant (epilepsy, tetanus,
rabies), hypnotic, tranquilizer (anxiety, mania, hysteria),
anesthetic, anti-inflammatory (rheumatism and other
inflammatory diseases), antibiotic (topical use on skin
infections, erysipelas, tuberculosis), antiparasite (internal and
external worms), antispasmodic (colic, diarrhea), digestive,
appetite stimulant, diuretic, aphrodisiac or anaphrodisiac,
antitussive and expectorant (bronchitis, asthma).
Furthermore, cannabis was traditionally considered sacred
in Tibet, although little has been written about its religious or
medicinal use. In Tantric Buddhism, which was developed in
the Himalayas, cannabis was used to facilitate meditation.
Though seldom reported, it is believed that the medical use of
cannabis in Tibet was intense due to the following reasons:
the concepts of Tibetan medicine stem from Hindi medicine;
botany was of great importance in its pharmacopoeia; and,
finally, cannabis was abundant in that region.
Evidence suggests that the Assyrians also knew about the
psychoactive effects of cannabis and used it as incense since
the ninth century B.C.
It is also possible that, before the
Christian Era, Assyrians used the plant externally for swellings
and bruises, and internally for depression, impotence,
arthritis, kidney stones, ‘female ailment’, and for the
‘annulment of witchcraft’.
In Persia, cannabis was also known before the Christian
The Persians knew about the plants biphasic effect, and
made a clear distinction between its initial euphoric and its
late dysphoric effects.
In Europe, historical and archeological evidence suggests
the presence of cannabis before the Christian Era. It seems
the plant was brought by Scythian invaders, who originated
from Central Asian and reached close to the Mediterranean.
In the year 450 B.C., Herodotus described a Scythian funeral
ceremony, and stated that they inhaled the vapors obtained
from burning cannabis seeds with ritualistic and euphoric
purposes. That description was later confirmed by archeologists
who found charred cannabis seeds in Scythian tombs in Siberia
and Germany.
Reference to the use of cannabis by the Greeks and the
Romans are scarce, suggesting that it was little used by these
155 Zuardi AW
Rev Bras Psiquiatr. 2006;28(2):153-7
In the beginning of the Christian Era, there are two
references of the use of the seed’s juice for earache and to
drive worms and insects out of the ears.
Beginning of the Christian Era to the 18
In this period, the medical use of cannabis remained very
intense in India and was then spread to the Middle East and
Africa. In Arabia, well-known physicians mentioned cannabis
in their medical compendiums, as Avicena, in the year 1000
Muslim texts mention the use of cannabis as a diuretic,
digestive, anti-flatulent, ‘to clean the brain’, and to soothe
pain of the ears. In 1464, Ibn al-Badri reported that the
epileptic son of the caliph’s chamberlain was treated with the
plant’s resin, and stated: it (cannabis) cured him completely,
but he became an addict who could not for a moment be
without the drug’.
Cannabis is known in Africa at least since the 15
and its use was, possibly, introduced by Arab traders,
somehow connected to India. This is evidenced by the
similarity of the terms used for preparing the plant in Africa
and India. In Africa, the plant was used for snake bite, to
facilitate childbirth, malaria, fever, blood poisoning, anthrax,
asthma, and dysentery.
In the Americas, the use of cannabis probably began in
South America. In the 16
century, the plant’s seeds reached
Brazil; brought by African slaves, especially those from Ango-
la, and its use was considerably common among Blacks in
the Northeastern rural area. Most synonyms for cannabis in
Brazil (maconha, diamba, liamba, and others) have their origin
in the Angolan language. There are reports of the use of
cannabis in that region’s popular religious rituals, especially
the ‘Catimbó’, which includes cult to African deities and pre-
sumes the value of the plant for magical practice and treatment
of diseases. In the rural environment, there are reports of the
use of cannabis for toothache and menstrual cramps.
In Europe, during this period, cannabis was cultivated
exclusively for fibers. Muslims introduced the manufacture
ofpaper from cannabis, in 1150, first in Spain then in Italy.
Cannabis descriptions are found in many books about plants
written in this period, which clearly state, since the mid 18
century, the distinction between male and female plants
(previously described in a Chinese ideogram in the beginning
of the Christian Era).
References to the medical use of
cannabis are scarce. Europeans may have known about the
plant’s medical use in the Middle East and Africa, but they
confused it with opium.
Western medicine in the 19
and 20
There are some reports, from the early 19
century, about
the use of cannabis by European physicians, especially
regarding the use of the seeds or homeopathic medications.
However, the effective introduction of cannabis in Western
medicine occurred in the midst 19
century through the works
of Willian B. O’Shaughnessy, an Irish physician, and by the
book by Jacques-Joseph Moreau, a French psychiatrist.
O’Shaughnessy served in India with the British for several
years and made his first contact with cannabis use in that
country. He studied the literature on the plant, described many
popular preparations, evaluated its toxicity in animals, and,
later, he tested its effect on patients with different pathologies.
In 1839, he published the work: ‘On the preparations of the
Indian hemp, or gunjah’, which, in the first paragraph,
establishes a panorama of plant use:
‘The narcotic effects of Hemp are popularly known in the
south of Africa, South America, Turkey, Egypt, Middle East
Asia, India, and the adjacent territories of the Malays, Burmese,
and Siamese. In all these countries, Hemp is used in various
forms, by the dissipated and depraved, as the ready agent of a
pleasing intoxication. In the popular medicine of these nations,
we find it extensively employed for a multitude of affections.
But in Western Europe, its use either as a stimulant or as a
remedy is equally unknown’.
In his book, O’Shaughnessy describes various successful
human experiments using cannabis preparations for
rheumatism, convulsions, and mainly for muscular spasms of
tetanus and rabies.
Moreau used cannabis with a different purpose. He was an
assistant physician at the Charenton Asylum, near Paris, and
a common therapeutic practice at the time was to accompany
psychiatric patients in long trips to exotic and distant countries.
During those trips he observed that the use of hashish
(cannabis resin) was very common among Arabs, and he was
impressed with the substance’s surprising effects. In Paris,
around 1840, Moreau decided to experiment, systematically,
different cannabis preparations; first on himself and later on
his students. As an outcome, in 1845 he published the book
Du Hachisch et de l’Alienation Mentale: Etudes
Psychologiques’, with one of the most complete descriptions
of the acute effects of cannabis.
Moreau clearly states his
purpose: ‘...I saw in hashish, more specifically in its effects
on mental abilities, a powerful and unique method to
investigate the genesis of mental illness’.
These two types of medical interest for cannabis, concerning
its psychoactive effects (as an experimental psychotomimetic)
as well as its therapeutic use, persisted through the years.
O’Shaughnessy and Moreau’s contributions had a great impact
on Western medicine, especially due to the scarcity of
therapeutic options for infectious diseases such as rabies, cholera,
and tetanus. The medical use of the drug spread from England
and France reaching all Europe and then North America. In
1860, the first clinical conference about cannabis took place
in America, organized by the Ohio State Medical Society.
In the second half of the 19
century, over 100 scientific
articles were published in Europe and the United States about
the therapeutic value of cannabis.
The climax of the medical
use of cannabis by Western medicine occurred in the late 19
and early 20
century. Various laboratories marketed cannabis
extracts or tinctures, such as Merck (Germany), Burroughs-
Wellcome (England), Bristol-Meyers Squibb (United States),
Parke-Davis (United States), and Eli Lilly (United States).
The medical indications of cannabis, in the beginning of
the 20
century, were summarized in Sajous’s Analytic
Cyclopedia of Practical Medicine (1924) in three areas:
1) Sedative or Hypnotic: in insomnia, senile insomnia,
melancholia, mania, delirium tremens, chorea, tetanus,
rabies, hay fever, bronchitis, pulmonary tuberculosis, coughs,
paralysis agitans, exophtalmic goiter, spasm of the bladder,
and gonorrhea.
2) Analgesic: in headaches, migraine, eye-strain,
menopause, brain tumors, tic douloureux, neuralgia, gastric
ulcer, gastralgia (indigestion), tabes, multiple neuritis, pain
not due to lesions, uterine disturbances, dysmenorrhea,
chronic inflammation, menorrhagia, impending abortion,
postpartum hemorrhage, acute rheumatism, eczema, senile
pruritus, tingling, formication and numbness of gout, and for
relief of dental pain.
Rev Bras Psiquiatr. 2006;28(2):153-7
History of cannabis as a medicine 156
3) Other uses: to improve appetite and digestion, for the
‘pronounced anorexia following exhausting diseases’, gastric
neuroses, dyspepsia, diarrhea, dysentery, cholera, nephritis,
hematuria, diabetes mellitus, cardiac palpitation, vertigo, se-
xual atony in the female, and impotence in the male.
Figure 1 shows an illustration of the periods in which the
medical uses of cannabis began in different regions.
In the second half of the 20
century, cannabis reached
great social importance due to the explosion of its consumption
for hedonistic purposes. Until that time, in the West, the
hedonistic use of the plant was limited to small groups. In
Europe, groups of intellectuals gathered to use the drug.
Descriptions of this use may be found in novels by 20
French writers, such as Gautier and Boudelaire. In the
Americas, this practice was relatively common among the Black
in the rural area of Northeastern Brazil since the 16
who would meet on weekends to use the drug in groups. This
use was later passed on to fishermen of the San Francisco
River and by sea to the coastal cities. In the early 20
the use of cannabis in Brazil remained restricted to small
low-socioeconomic groups, and was known as the ‘opium of
the poor’.
In Mexico, cannabis was also used by the most
underprivileged population and it was through Mexican
immigrants that its use, for recreation, reached the United
States in the first decades of the 20
century. Until the 1950’s,
in the United States, cannabis use was restricted to the
neighborhoods of Blacks and Hispanic immigrants.
Since the 1960’s, the recreational use of cannabis rapidly
spread among the younger ranges of the population throughout
the Western world. In the United States, the percentage of
young adults that had used cannabis, at least once, went
from 5%, in 1967, to 44%, 49%, 68%, and 64%, in 1971,
1975, 1980, and 1982, respectively.
This use remains
high until today.
In 1964, the chemical structure of Δ
THC was identified by Gaoni and Mechoulam,
contributed to a proliferation of studies about the active
constituents of cannabis.
The startling boost in cannabis consumption, which intensified
its social importance, along with the better knowledge of its
chemical composition (which made it possible to obtain its pure
constituents) contributed to a significant increase in scientific
interest for cannabis, as of 1965. The number of publications
about cannabis reached their peak in the early 1970’s. In this
period, a Brazilian research group, led by Carlini, had a great
contribution, especially about the interactions of Δ
-THC with
other cannabinoids.
Since then, Carlini has been developing
efforts for the realignment of public policies concerning cannabis
After the middle of 1970’s, the number of publications
started to slowly decline during the following two decades. The
interest in studies about cannabis was renewed in the early
1990’s, with the description and cloning of specific receptors for
the cannabinoids in the nervous system and the subsequent
isolation of anandamide, an endogenous cannabinoid.
Afterwards, the number of publications about cannabis has been
continuously growing, attesting the great interest in research
involving the herb. Figure 2 shows the evolution of the number
of publications about cannabis in the last 50 years.
With the growth of scientific interest for cannabis, its
therapeutic effects are being once again studied, this time
using more accurate scientific methods. There are studies, in
different phases, about the therapeutic effects of Δ
-THC in
conditions such as: epilepsy, insomnia, vomits, spasms, pain,
glaucoma, asthma, inappetence, Tourette syndrome, and
others. Among the therapeutic indications of Δ
-THC the
following are considered close to being proven: anti-emetic,
stimulant of appetite, analgesic, and in symptoms of Multiple
Other cannabinoids are also under investigation,
such as Canabidiol (CBD), which has evidence for therapeutic
effects in epilepsy, insomnia, anxiety, inflammations, brain
damage (as a neuroprotector), psychoses, and others.
Decline and rediscovery
In the first decades of the 20
century, the Western medical
use of cannabis significantly decreased. This may have
occurred, among other factors, because of the difficulty to
obtain replicable effects, due to the extreme varying efficacy
of different samples of the plant. At that time, the active
principle of cannabis had not yet been isolated and the drug
was used in the form of tinctures or extracts whose power
was dependent on different factors, such as origin, age, and
mode of preparation.
In addition, various medications appeared
at the end of the 19
century, with known efficacy for the
treatment of the main indications of cannabis. Vaccines were
developed for various infectious diseases, such as tetanus;
effective analgesics such as aspirin appeared , and hypodermic
syringes allowed the injectable use of morphine; and, as a
narcotic and sedative, cannabis was rivaled by substances
such as chloral hydrate, paraldehyde, and barbiturates.
Finally, many legal restrictions limited the medical use and
experimentation of cannabis. In the United States, as the result
of a campaign of the Federal Bureau of Narcotics, the
Marihuana Tax Act law was passed in 1937. Under this Act,
anyone using the plant was required to register and pay a tax
of a dollar an ounce (28.35 g), for medical purposes, and
100 dollars an ounce for any other use. Despite the low value
for medical use, the non-payment of this tax, however, resulted
in a 2.000 dollar fine and/or 5 years imprisonment. This law
brought difficulties for the use of the plant due to the excessive
paperwork and the risk of severe punishment. When cannabis
transaction regulations, including prescriptions, were
transferred to the tribute area, this law circumvented a decision
of the Supreme Court which gave the States the right to control
commercial transactions and, in practice, meant banning the
use of cannabis in the whole American territory. Cannabis
was removed from the American pharmacopoeia in 1941.
Figure 1 - Age of the beginning of cannabis use as a
157 Zuardi AW
Rev Bras Psiquiatr. 2006;28(2):153-7
However, cannabis products must be used cautiously since
some studies suggest that early-onset cannabis use can induce
cognitive deficits and apparently acts as a risk factor for the
onset of psychosis among vulnerable youths.
At the beginning of 2005, a multinational pharmaceutical
laboratory received the approval in Canada, and is pleading
authorization in the United Kingdom and the European Union,
to market a medication containing Δ
-THC and CBD for the
relief of neuropathic pain in patients with multiple sclerosis.
Thus, a new cycle begins for the use of cannabis derivatives
as medication, this time more consistently than in the past.
The structures of chemical compounds derived from cannabis
are now known, the mechanisms of their action in the nervous
system are being elucidated with the discovery of an
endogenous cannabinoid system, and treatment effectiveness
and safety are being scientifically proven.
Antonio Waldo Zuardi is recipient of National Conselho Nacional de
Desenvolvimento Científico e Tecnológico (CNPq) and was supported
in part by the Fundação de Amparo à Pesquisa do Estado de São Paulo
Figure 2 - Number of cannabis-related publications in the
last 50 years. The source used was the ‘ISI Web of Knowledge’
with the keywords: cannabis or marijuana or marihuana.
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3. Leson G, Pless P. Hemp seed and hemp oil. In: Grotenhermen F,
Russo E, eds. Cannabis and cannabinoids. New York: The Haworth
Integrative Healing Press; 2002. Chapter 38. p. 411-25.
4. Li HL. Hallucinogenic plants in Chinese herbals. J Psychodelic
Drugs. 1978;10(1):17-26.
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GG, editor. Marihuana in science and medicine. New York: Raven
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Psychologiques. Paris: Librarie de Fortin Mason; 1845 (English
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J Psychiatry. 2004;184:110-7.
... Cannabis sativa is one of the oldest cultivated plants utilized by humans, being used as a food, textile and as a medicine for millennia [34][35][36]. The Ebers Papyrus (1550 BCE) from ancient Egypt describes the use of cannabis to aid childbirth [37]. ...
... The Ebers Papyrus (1550 BCE) from ancient Egypt describes the use of cannabis to aid childbirth [37]. In ancient China, the use of cannabis for female reproductive symptoms was reported in the Pen-Tsao Ching, based on the oral traditions passed down from the Emperor Shen-Nung, who lived circa 2700 BCE [36,38]. The ageold Indian Atharva Veda of 1000 BCE described cannabis as a sacred plant, used as an analgesic, anesthetic, antiinflammatory, anti-spasmodic, and hypnotic medicine [36]. ...
... In ancient China, the use of cannabis for female reproductive symptoms was reported in the Pen-Tsao Ching, based on the oral traditions passed down from the Emperor Shen-Nung, who lived circa 2700 BCE [36,38]. The ageold Indian Atharva Veda of 1000 BCE described cannabis as a sacred plant, used as an analgesic, anesthetic, antiinflammatory, anti-spasmodic, and hypnotic medicine [36]. ...
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Cannabis sativa (L), a plant with an extensive history of medicinal usage across numerous cultures, has received increased attention over recent years for its therapeutic potential for gynecological disorders such as endometriosis, chronic pelvic pain, and primary dysmenorrhea, due at least in part to shortcomings with current management options. Despite this growing interest, cannabis inhabits an unusual position in the modern medical pharmacopoeia, being a legal medicine, legal recreational drug, and an illicit drug, depending on jurisdiction. To date, the majority of studies investigating cannabis use have found that most people are using illicit cannabis, with numerous obstacles to medical cannabis adoption having been identified, including outdated drug-driving laws, workplace drug testing policies, the cost of quality-assured medical cannabis products, a lack of cannabis education for healthcare professionals, and significant and persistent stigma. Although currently lacking robust clinical trial data, a growing evidence base of retrospective data, cohort studies, and surveys does support potential use in gynecological pain conditions, with most evidence focusing on endometriosis. Cannabis consumers report substantial reductions in pelvic pain, as well as common comorbid symptoms such as gastrointestinal disturbances, mood disorders such as anxiety and depression, and poor sleep. Substitution effects were reported, with >50% reduction or cessation in opioid and/or non-opioid analgesics being the most common. However, a substantial minority report not disclosing cannabis consumption to their health professional. Therefore, while such deprescribing trends are potentially beneficial, the importance of medical supervision during this process is paramount given the possibility for withdrawal symptoms.
... To exemplify the long co-existence with hemp, ancestral archaeological relics date the use of this plant fiber as a fabric to approximately 8000 years before the common era (BCE) as a material in ancient Mesopotamia (present-day Iran and Iraq), and to 4000 years BCE and 3000 years BCE as a material for ropes in China and Kazakhstan, respectively. Impressively, until the beginning of the nineteenth century, it was estimated that around 80% of fabrics, candles, ropes, among other items, were produced from hemp [9,[14][15][16]. ...
... The Pen Ts'ao Ching (the oldest pharmacopoeia in the world of Chinese origin and oral traditions, compiled around the 1 st century but related to periods dating back to 2700 BCE) quotes that 'The Ma-fen ('fruit' of Cannabis)' if ingested in excess, it can cause the user to see demons.'. Associated with the shamanistic culture of Central Asian natives, Cannabis, along with ginseng, was believed to help necromancers achieve premonitory powers and enlightenment of being [9,14]. ...
... The two purposes were often linked. Described in the Vedas as one of the five sacred plants, it was believed to have arisen from a drop of amrita (sacred nectar) that fell from heaven onto the earth and was able to bring joy and freedom to those who used it [9,14]. ...
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From the Himalayan mountains to the South American coast, Cannabis, a general term for plants of the genus Cannabis, with thousands of years of contact with humankind, shows its versatility as food tools such as hemp, religious and hedonistic input, and other purposes through the millennia, according to the populations in question. In this paper, a review of the context of the use of Cannabis and its place in world history is presented, from ancient Mesopotamian relics, traditional Chinese and Ayurvedic medicines, to the reasoning behind the isolation and structural elucidation of three phytocannabinoids and the spread of Cannabis throughout the world.
... At the same time, its use as a recreational drug increased. Thus, legal restrictions on the use of cannabis were imposed that delayed exploring its medical potential for more than 50 years (4)(5)(6). Only after the discovery of cannabinoid (CB) receptors in the early 1990s, attention was payed to this new field of research leading to the introduction of the endocannabinoid system (ECS). ...
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Numerous studies in various cancer models have demonstrated that ingredients of cannabis can influence tumor growth through the endocannabinoid system (ECS), a network of molecules (mediators, receptors, transporters, enzymes) that maintains homeostasis and protection in many tissues. The main constituents of the ECS are the classical cannabinoid (CB) receptors, such as CB 1 and CB 2 , their endogenous ligands (endocannabinoids), and the endocannabinoids’ synthesizing and degrading enzymes. The role of the ECS in cancer is still unclear and its effects often depend on the tumor entity and the expression levels of CB receptors. Many studies have highlighted the tumor cell-killing potential of CB 1 agonists. However, cannabis is also known as an immunosuppressant and some data suggest that the use of cannabis during immunotherapy worsens treatment outcomes in cancer patients. CB receptors are widely present in immune cells, and together with monoacylglycerol lipase, the 2-arachidonoylglycerol degrading enzyme, they could be critically involved in the regulation of the immune cell profile of the tumor microenvironment (TME), and hence in tumor progression. So far, data on the impact of the ECS in the immune-TME are still vague. In this review, we discuss the current understanding of the ECS on immunoregulation during tumor growth, and how it might affect the outcome of cancer immunotherapy.
... Prohibition on the growth and use of C. sativa throughout human history has inhibited our understanding of this economically valuable species [24][25][26][27][28]. Modern research has often focused on female plants [29][30][31][32][33], leaving a gap in our understanding of male plants, cosexual plants, male-male competition, and factors that impact male reproductive dynamics. ...
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Cannabis sativa L. is cultivated globally for its cannabinoid-dense inflorescences. Commercial preference for sinsemilla has led to the development of methods for producing feminized seeds through cross-pollination of cosexual (masculinized) female plants. Although the induction of cosexuality in Cannabis plants is common, to date, no work has empirically tested how masculinization of female Cannabis plants impacts male flowering, pollen production, pollen fitness, and related life-history trade-offs. Here, we cultivated a population of Cannabis plants (CFX-2) and explored how the route to cosexuality (drought vs. chemical induction) impacted flowering phenology, pollen production, and pollen fitness, relative to unsexual male plants. Unisexual males flowered earlier and longer than cosexual plants and produced 223% more total pollen (F2,28 = 74.41, p < 0.001), but per-flower pollen production did not differ across reproductive phenotypes (F2,21 = 0.887, p = 0.427). Pollen viability was 200% higher in unisexual males and drought-induced cosexuals (F2,36 = 189.70, p < 0.001). Pollen non-abortion rates only differed in a marginally significant way across reproductive phenotypes (F2,36 = 3.00, p = 0.06). Here, we demonstrate that masculinization of female plants impacts whole-plant pollen production and pollen fitness in Cannabis sativa.
... Soon after the discovery of its chemical structure and ability to obtain various compounds from the plant in the late 1900s, as well as the description of the cannabinoid receptors and the endocannabinoid system in the 1990s, cannabis use for medical purposes has increased significantly with a steep rise in the last few years [31,144]. It is evident that the majority of this use results from illegal access, however, this has been recognised and laws are in a fast-changing phase with several products approved and several others on a registered unapproved list. ...
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The side effects of cancer therapy continue to cause significant health and cost burden to the patient, their friends and family, and governments. A major barrier in the way in which these side effects are managed is the highly siloed mentality that results in a fragmented approach to symptom control. Increasingly, it is appreciated that many symptoms are manifestations of common underlying pathobiology, with changes in the gastrointestinal environment a key driver for many symptom sequelae. Breakdown of the mucosal barrier (mucositis) is a common and early side effect of many anti-cancer agents, known to contribute (in part) to a range of highly burdensome symptoms such as diarrhoea, nausea, vomiting, infection, malnutrition, fatigue, depression, and insomnia. Here, we outline a rationale for how, based on its already documented effects on the gastrointestinal microenvironment, medicinal cannabis could be used to control mucositis and prevent the constellation of symptoms with which it is associated. We will provide a brief update on the current state of evidence on medicinal cannabis in cancer care and outline the potential benefits (and challenges) of using medicinal cannabis during active cancer therapy.
... Słowa kluczowe: kannabidiol, konie, test lękliwości, suplementacja WSTĘP Kannabidiol (CBD) jest organicznym związkiem chemicznym, jednym z kannabinoidów występujących w konopiach -roślinach gatunku Cannabis sativa, posiadającym właściwości lecznicze oraz profilaktyczne [Zuardi 2006]. Związek ten wpływa na układ endokannabinoidowy (ECS), który występuje u prawie wszystkich organizmów żywych, od prymitywnych parzydełkowców po ssaki [Pagotto i in. ...
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Celem pracy była ocena wpływu kannabidiolu (CBD) na rytm serca, stężenie kortyzolu w ślinie oraz czas podejścia do przedmiotu u koni poddanych testom lękliwości. W badaniu uwzględniono 20 koni rasy polski koń sportowy, podzielonych na grupę badawczą oraz kontrolną. Koniom z grupy badawczej podawano codziennie przez 21 dni CBD w ilości 100 mg. Obie grupy były poddane dwóm testom lękliwości: przed rozpoczęciem suplementacji, w 10 i 11 oraz 20 i 21 dniu suplementacji. Pomiar rytmu serca oraz pobranie śliny w celu wyznaczenia stężenia kortyzolu w ślinie, wykonano przed i zaraz po zakończeniu każdego testu dla obu grup. Dodatkowo zmierzono czas podejścia do przedmiotu w obu testach lękliwości. W badaniach nie wykazano istotnej statystycznie różnicy w stężeniu kortyzolu i rytmie serca pomiędzy grupą badawczą a kontrolną. Wykazano znaczące statystycznie różnice pomiędzy grupami w czasie podejścia do przedmiotu w trzech badaniach. Uzyskane wyniki nie świadczą w sposób jednoznaczny o przeciwlękowym działaniu CBD na organizm konia, ale skrócenie czasu podejścia do przedmiotu daje podstawy do dalszych badań nad przeciwlękowym działaniem CBD u koni.
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BACKGROUND AND OBJECTIVES Cannabis Sativa has been part of human evolution and has been used by different populations for different purposes. By reviewing the history and main advances in cannabinoid medicine, the aim of this study was to identify the major discoveries in recent years, which have prompted the publication of articles. CONTENTS The following topics were searched: “history of cannabis”, “history of hashish”, “history of marijuana” and “main advances in endocannabinoid medicine”; in SCIELO, Pubmed, Google Scholar, Brazilian Digital Library of Theses and Dissertations (BDTD), Latin American and Caribbean Literature in Health Sciences (LILACS) and Medline (Capes platform) databases. CONCLUSION There has been an increase in the number of publications following major discoveries about the endocannabinoid system, including receptors and endocannabinoids, but prejudice and the difficulty of accessing this therapeutic tool prevent further development. Keywords: Cannabis; Cannabinoids; History; Tetrahydrocannabinol; Therapeutic use
Background Controversy remains as to whether cannabis acts as a causal risk factor for schizophrenia or other functional psychotic illnesses. Aims To examine critically the evidence that cannabis causes psychosis using established criteria of causality. Method We identified five studies that included a well-defined sample drawn from population-based registers or cohorts and used prospective measures of cannabis use and adult psychosis. Results On an individual level, cannabis use confers an overall twofold increase in the relative risk for later schizophrenia. At the population level, elimination of cannabis use would reduce the incidence of schizophrenia by approximately 8%, assuming a causal relationship. Cannabis use appears to be neither a sufficient nor a necessary cause for psychosis. It is a component cause, part of a complex constellation of factors leading to psychosis. Conclusions Cases of psychotic disorder could be prevented by discouraging cannabis use among vulnerable youths. Research is needed to understand the mechanisms by which cannabis causes psychosis.
Hallucinogenic plants from Chinese works are given in the order of their relative importance. The Chinese herbals and other related works cited here are given with the author's name first and arranged chronologically to give a historical perspective to this record. A bibliography to modern works is given at the end of the paper. It has to be noted that most of the earlier herbals have been lost and existed only as quotations in subsequent works. A number of these items have been reconstituted by later workers. The illustrations given here are from Chang Ts'un-hui, the 1249 A.D. edition of T'ang Shen-wei's Cheng-lei pen-ts'ao of 1108 A.D., which is one of the earliest illustrated pen-ts'ao extant.
The anti-marihuana law of 1937 was largely the federal government's response to political pressure from enforcement agencies and other alarmed groups who feared the use and spread of marihuana by “Mexicans”. Recent evidence also suggests that the Federal Bureau of Narcotics resisted the enforcement burden of the antimarihuana law until mounting pressure on the Treasury Department led to a departmental decision, probably in 1935, to appease this fear, mostly in the Southwest and West, by federal legislation. Previously unpublished documents clarify the role of medical research in the campaign for a federal anti-marihuana law and in the Treasury Department's preparation for congressional hearings.