Cannabis has been around as a medicine for centuries. Usually taken as an infusion, it has been used to treat a range of different problems. But it’s most common use is as a painkiller. This is not the same as the high created by the recreational form of the drug. The psychoactive chemicals come from a different part of the plant. In the West, cannabis arrived as a street drug and, once its qualities were recognized, illegal farms were set up to grow it. However, the strong Asian and African cultures for medicinal use was never completely ignored and, after some detailed research and a positive political campaign, sixteen US states have now legalized its use for medical purposes. This is controversial. The FDA warns the drug can be abused. Indeed, the recreational form is classified as a Schedule 1 drug. That’s the highest class, reflecting the perceived level of danger. So, even under medical supervision, the FDA does not permit the medical profession to use or recommend cannabis as a medicine. Nevertheless, seven states allow dispensaries to sell medical cannabis and collect sales tax. This generates several billion dollars in extra tax revenue at a time when the state deficits are growing.
At this point, we come to a grey area of policy and law. If you talk to the regulatory authorities and law enforcement agencies, cannabis remains a dangerous drug. Even though there are laws permitting its use by individual patients and caregivers, there’s considerable suspicion that morality and the law are being undermined. That said, states find their budgets under pressure and, when it comes to deciding priorities in enforcement, cannabis is low down on the list. The law enforcement agencies do not unnecessarily harass clinics and hospices where cannabis is routinely given to patients. We should also recognize an overall irony in all this.
If you look at all the major drugs developed by the manufacturing industry, all the patents are or were held privately. The assumption has been that effective drugs can be exploited for profit by the large corporations. But, when it comes to medical cannabis, the federal government holds the patent. This has not prevented the for-profit sector trying to produce individual drugs based on cannabis. Indeed, in some countries, synthetic cannabinoids are available on prescription. So far, there are no signs the FDA will approve any of these drugs for distribution in the US. In the UK, for example, there’s a new spray being made available for pain relief. There’s no high associated with its use. It works by numbing the muscles and it’s being prescribed for use in treating multiple sclerosis and will soon be available in hospitals for end-of-life treatment in cancer wards.
It’s fascinating to see a natural product slowly being accepted as medicinal despite the capacity to derive recreational versions. In a way, this is the same process Tramadol had to go through. No one wanted to create yet another addictive derivative from the poppy so, as a synthetic, Tramadol had to prove itself effective and not seriously addictive. Fortunately, prejudices were overcome and the drug is now the world’s top selling brand for pain relief. It will be interesting to see whether cannabis and its medicinal derivatives can also be accepted.