Medical History of Cannabis Dr. David Hepburn

Thursday, 21 June 2018

Traditional Cannabis has been known in North America as the stoner-hippie drug known for psychedelic properties, however the history and usage of medical Cannabis dates back much further.

Historical use and significance of the Cannabis plant has been noted in a wide variety of written works, with origins tracing back to the ancient world. The first record of Cannabis’ use in medicine comes from the Pen’ts’aoching, the world’s first pharmacopeia, compiled by oral traditions during the time of China’s Emperor Shen-Nung in 2700 BC. Uses for medical Cannabis in this time included rheumatic pain, gout and malaria.

The use of medical Cannabis then began its’ long history in India, becoming a strong part of both Indian legend and religion. Mentioned in The Vedas, sacred Hindu text, Cannabis was referred to as a source of happiness, joy-giver, liberator that was compassionately given to humans to help us attain delight and lose fear[1]. A large-scale study was commissioned by the British in the late 1890s over concern of the widespread use of Cannabis in Colonial India[2]. They were particularly concerned about the potential psychoses of the drug, and the risk it posed to the health of the natives. In the end, it was decided that its use was ancient, had religious sanction among Hindus, and was ultimately harmless in moderation. Cannabis was generally used in India as an anticonvulsant, analgesic, anesthetic, antibiotic and anti-inflammatory.[3]

Therapeutic uses of Cannabis were first introduced to Western medicine in 1839 by Irish physician William O’Shaughnessy when he published ‘On the preparations of Indian hemp or gunjah’3. O’Shaughnessy tested the toxicity of Cannabis on animals, and once determined the product was safe, provided extracts to patients, discovering it’s analgesic and sedative properties. In the end, he came to realize the efficacy of Cannabis in treating muscle spasms caused by tetanus and rabies.[4] Upon the results of O’Shaughnessy’s trials, as with those of other physicians at the time, the use of Cannabis began to spread rapidly through the world of Western medicine in both Europe and North America.

The rise of vaccines for diseases previously treated by cannabis ultimately resulted in a decline of cannabis use during the 1900’s compounded by the development of many synthetic analgesics that rendered cannabis use at the time obsolete3. The American Medical Assocation advised that Cannabis remained a medical agent, however ultimately in 1941 Cannabis was removed entirely from the American Pharmacopeia.


After the removal of Cannabis from the American Pharmacopeia, the use of Cannabis for medical purposes was nearly non-existent, until it’s revival for recreational purposes in the 1970’s. Studies began to advance, identifying the cannabinoid receptors in the nervous system, alluding to the possible source of Cannabis’ analgesic, sedative and immunoregulatory properties.[5]

Fast-forwarding to today, research into the potential uses of Cannabis for medical purposes are continuously expanding into areas not explored previously. This includes isolation of specific compounds for treatment diseases such as Epilepsy, Cancer, Multiple Sclerosis and Alzheimer’s, as well as the potential to use it in place of common every day drugs for sleep aid and chronic pain. As we go forward, it is becoming abundantly clear that the possibilities for medical Cannabis are endless.

References:

[1]Abel, E.L. (1980). The First Twelve Thousand Years. New York: McGraw Hill.
[2]Iverson, L.L. (2008). The Science of Marijuana. New York: Oxford University Press.
[3]Zuardi AW. History of cannabis as a medicine: a review. Rev Bras Psiquiatr 2006;28:153-7. 
[4]Mikuriya TH. Marijuana in medicine: past, present and future. Calif Med 1969;110:34-40. 
[5]Lee MA. The discovery of the endocannabinoid system. The Prop 215 Era 2012.
  URL: http://www.beyondthc .com/wp-content/uploads/2012/07/eCBSystemLee.pdf

Conditions Cannabis is prescribed for - By Dr. David Hepburn

Tuesday, 5 June 2018

In listing ten common conditions that doctors use cannabis to treat, it is important to appreciate that some conditions respond better to different types or different combinations of cannabinoids. For example, migraines, will respond to THC dominant medications. Joint inflammation conditions prefer CBD dominant strains while others still, like chronic pain, usually settle on a 1:1 CBD:THC combination. Not only are the type and ratio of cannabinoids used important, but so is the dose. For example, a low dose of THC (micro-dosing) can help with anxiety and some types of pain. A higher dose of THC can do the exact opposite and actually exacerbate anxiety and worsen pain. While cannabis is being used for treatment in dozens of conditions ranging from Acne to Tourette’s to Asthma (yes that asthma), here are some of the more common conditions where cannabinoid medicine plays a role. 

Arthritis.


For those with either osteoarthritis or rheumatoid arthritis, their joints are just smoking, which is why many turn to smoking joints. However the ingested route of medical oils are more effective for longer periods of time compared to the relatively quick but short acting relief of an inhalation method such as a vaporizing (always preferred over smoking). Much safer than most medications used to treat arthritis, cannabis has no risk of causing stomach bleeds, constipation and even death that opiates or anti-inflammatory medications (NSAIDS) could cause. In fact, NOBODY dies of cannabis.....ever. This is because, unlike opiates that claim numerous lives every day, there are no cannabinoid receptors in the brainstem, that vital part of the brain that controls our respiratory and cardiovascular systems. 
Cannabis acts to harness our own endocannabinoid system (ECS), which includes our naturally produced cannabinoids, anandamide and 2AG. These endocannabinoids are made throughout our body and are made in response to imbalances in multiple systems, usually involving hormones and neurotransmitters. When we make too much cortisol, the stress hormone, our ECS kicks in and we make anandamide that works to shut down cortisol production. When our own natural cannabinoids aren’t enough, then the addition of plant cannabinoids can be very helpful.
It has become headline news, of late, that CBD dominant cannabis can significantly reduce seizures in many children (and adults) in some of the more difficult type of seizure disorders. Noting the powerful effect cannabinoids have on children with terrible seizures, many key opinion leaders in the worlds of medicine and government have changed their minds about cannabis. Some families will even relocate to places where there is a more compassionate government that allows children to be treated for seizures with cannabis oil.


William Osler, the founder of modern medicine, stated that “cannabis is the single best treatment for migraines.” This is one of the few conditions where vaporized cannabis is more effective than ingested, as those who get struck by a migraine (often with nausea) don’t want to wait an hour before the ingested oils kick in.
Twitchiness involving nerves and spasm are areas where cannabinoids tend to excel in. This also defines the cause of IBS, a very common condition that may be fraught with constipation, diarrhea or both. The bowel has many cannabinoid receptors (CB2R) that, when activated by cannabis medicine, can reduce gut spasm and cramping.

In the next post we will see another five conditionswhich cannabis can help

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