Cannabis, or marijuana, is obtained from the hemp plant, which is one of the oldest useful plants on Earth. Hemp can be used to make various products, including rope and clothing from the stem fibres, cooking oil from the seeds, and essential oil from the distilled leaves and flowers. Hashish is obtained from the resin of the female hemp plant, and cannabis from the dried leaves, flowers and inflorescences (flower heads).
In the 13th century, hemp fibre found its way to Europe via Spain. The reason for this was papermaking, because back then nobody had mastered making paper from wood. A little anecdote: in 1455 Johannes Gutenberg printed his famous Gutenberg Bible on hemp paper. The American Declaration of Independence of 1776 was also printed on hemp paper. The first American President, George Washington, grew hemp on a large scale.
A rethink is underway
After decades of criminalising cannabis, a rethink has now begun. This is because we now know that cannabis promises great medical advances. We could have worked this out sooner. In a medical text written in China written between 300 BC and 200 AD, the author describes how hemp can be used as a cure for malaria, rheumatism and many other diseases and ailments.
And from the Middle Ages until modern times, hemp was used to relieve labour cramps and postpartum pain. Pliny the Elder, a Roman scholar, officer and administrator, wrote that hemp relieved pain, and Pedanios Dioscurides, a Greek doctor who lived in the 1st century during the epoch of Emperor Nero (54–68 AD), reported the effectiveness of hemp seed juice in treating earache.
From the 11th century onwards, cannabis found its way into monastery medicine and was used to treat various ailments and as a substitute for opium. The abbess Hildegard von Bingen (1098–1179) recommended hemp as a remedy for nausea and stomach pain. Cannabis found its way into modern medicine through a report published in 1839 by the Irish doctor William Brooke O’Shaughnessy (1809-1889), who discovered an analgesic, antispasmodic and muscle-relaxing effect after the use of cannabis.
The road to legalisation
Authorities in Canada and the US have recognised the importance of the medical marijuana sector and have started legalising it. The House of Representatives Legal Committee passed a bill to legalise cannabis at the federal level in November 2019. Meanwhile 37 of the 50 American states, as well as the federal district and seat of government Washington, DC, have legalised cannabis as a medicinal product (as of May 2021).
In 16 states, cannabis has even been approved as a legal smoking substance for people aged 21 and over, and other states are following suit. Israel’s Justice Minister, Avi Nissenkorn, stated in late 2020 that Israel plans to legalise cannabis for adult use “within 9 months
Changes are also afoot in Europe
In 2017, Greece became the sixth EU country to legalise the use of cannabis for medicinal purposes. Prime Minister Alexis Tsipras commented: “From now on things will change in Greece, as it is now one of the countries where supplying medical cannabis to patients in need is legal.” The cultivation of medical cannabis is also now permitted in Greece, a fact of great importance to patients in need of medical treatment.
The Netherlands has always gone its own way. It granted permission for the medical use of cannabis 22 years ago. In the Netherlands, cannabinoids are now sold in drugstores. Over the next 5 years it can be assumed that cannabis will be further legalised around the world, and that many European countries will be involved.
Cannabis in medicine
Since 2017, doctors in Germany have been able to prescribe cannabis as a drug. The costs for this are covered by health insurance companies. In the future, drugs containing hemp will be available to help with conditions such as cancer, multiple sclerosis and chronic pain. In France, cannabis has been outlawed in the medical and private sectors since 1970, but there are now plans to investigate the plant’s medicinal benefits more closely.
Since cannabis has often been classified as illegal in countries around the world, we have lost out on important research results and scientific studies for more than 50 years. If research into cannabis had been allowed earlier, today we could be much further on in the development of pain medication for cancer and tumours. Today, there is still a lack of important, scientifically unambiguous and qualitatively verifiable studies.
There are still too few conclusive studies that have investigated and proven the effects of cannabis, according to experts. How did this situation arise? In 1925, at the second international opium conference of the League of Nations in Geneva, it was decided to restrict cannabis worldwide. The legal restrictions on cannabis prevented its medicinal use.
As a medicinal product, cannabis is mostly grown under state supervision. In Germany it takes place under the supervision of the Cannabis Agency and in Austria under the supervision of the Agency for Health and Food Safety (AGES).
However, research into the medicinal effects of cannabis is still in its infancy. So far, a total of 113 different cannabinoids have been identified, and little is known about their effects. Currently the most widely discussed cannabinoid is cannabidiol, or CBD for short. It is thought to be mainly responsible for cannabis’ therapeutic effects. It was discovered back in 1940, but has only recently received widespread attention, as the pharmacological effects of cannabis have only recently become the focus of medical research.
According to the principles of evidence-based medicine, it has been proven that cannabis is effective in the treatment of chronic neuropathic pain. So far, its effectiveness on tumour cells has been less well documented, which is not surprising given the fact that there are 113 different cannabinoids, not all of which have yet been researched. The research process will take many years to complete.
This brings us to CBD – cannabidiol
According to the European Court of Justice, CBD is not a drug. CBD oils mainly contain the cannabinoid CBD, which is said to counteract pain and inflammation. In addition, CBD has no intoxicating effects. Furthermore, CBD is said to have an anxiolytic, calming, antispasmodic effect and to inhibit feelings of hunger. But here, too, we should bear in mind that the research in this area is far from comprehensive. We do not yet know which long-term medical effect mechanisms are activated by CBD. The only thing that is certain is that CBD oil has a positive effect on health.
RTL has summarised the conditions CBD helps to fight:
Epilepsy: According to initial results, CBD can help treat epilepsy and make epileptic seizures less frequent, especially in children.
Pain: Cannabinoids have an analgesic effect. This means that CBD can have a positive effect on joint pain, but also on headaches (migraines) and menstrual pain. CBD has also been used effectively to treat fibromyalgia and arthritis.
Skin problems: CBD can also have a soothing effect on neurodermatitis, acne and other skin problems, according to a study published in the Journal of Clinical Investigation.
Anxiety: Studies have shown that cannabidiol can slow down the production of anxiety hormones. CBD not only has a positive effect on everyday anxiety, it also apparently helps with anxiety disorders and post-traumatic stress disorders.
Sleep disorders and stress: CBD has a relaxing effect, which improves the quality of sleep. CBD can also help to reduce stress-related problems such as nervousness and irritability.
Cancer therapy: Research has also shown that CBD oil accelerates the death of cancer cells, slows tumour growth and inhibits metastasis. CBD oil can also help to alleviate the side effects of chemotherapy.
This short summary has also been confirmed by praktischarzt.de/ratgeber/cbd-oel.
The hype around CBD
There is currently a lot of hype around CBD oil. CBD products are trendy. The Internet is full of them, offering teas, cosmetics, dietary supplements, chewing gum and drops. CBD products are also sold in drugstores and some pharmacies, although not as medicinal products. Even W&V has written: “Hemp is one of the most exciting healthcare trends with real growth potential”.
E.B. Russo: History of cannabis as medicine. In: G.W. Guy, B.A. Whittle, P. Robson (editors.): Medicinal uses of cannabis and cannabinoids. Pharmaceutical Press, London 2004
W. B. O’Shaughnessy (1839) Case of Tetanus, Cured by a Preparation of Hemp (the Cannabis indica.), Transactions of the Medical and Physical Society of Bengal (memento from July 21, 2011 in the Internet archive) 8, 1838–1840, pp. 462–469.
S. Pisanti, M. Bifulco: Modern history of medical cannabis: from wide-spread use to prohibitionism and back. In: Trends in Pharmacological Sciences 38 (3). 2017, pp. 195–198