INTRODUCTION: Evolution of medical cannabis

Cannabis is a controversial plant with a lengthy and intriguing past. Due to its numerous applications, the plant has spread to several businesses and consumer goods, most notably in the medical industry (Grinspoon, 2022). The history and evolution of medicinal Cannabis can be traced back to ancient times when ancient physicians in different countries combined Cannabis with other medicines to treat pain and other ailments. Historically, the use of Cannabis is likely to have originated in either western China or central Asia (Bridgeman & Abazia, 2017). Many people have resorted to Cannabis, believing that the drug has multiple medical properties and functions, such as treating inflammation, amenorrhea, depression, asthma, and loss of appetite, among other ailments. In recent years, medicinal Cannabis has attracted substantial attention in the United States. Included among the complexities of this treatment are the discussions surrounding its ethical, legal, and societal ramifications (Pisanti & Bifulco, 2019). In addition, complications have arisen regarding the drug’s packaging, safe administration, and distribution. Despite these complexities, medicinal Cannabis currently serves vital roles in health as it is used to lower blood pressure, fight cancer, treat anxiety disorder, reduce inflammation and prevent seizures, among other health conditions.
Research question and aim
• How did medicinal Cannabis evolve to become a critical substance used, and what are its impacts on treatment?
• This study aims to identify the history and evolution of medicinal Cannabis and further understand its effectiveness in treating different forms of ailment.
This study’s main objective is to understand how medicinal Cannabis evolved and became a vital substance with multiple clinical impacts and effectiveness. Besides, the study aims at identifying the medically necessary compounds of medicinal Cannabis, as well as its uses and impacts on health.


This literature review plays a vital role in this research paper as it provides a clear and elaborate context of the evolution of medicinal Cannabis from ancient times to date. Besides, the literature review enhances innovation, ensures professional standards, and helps avoid duplicative research on the evolution and benefits of medicinal Cannabis. The evolution of medicinal Cannabis is one of the significant themes addressed in this literature review. This will provide a broad description of how medicinal Cannabis evolved over time and became a significant substance used in treating different types of diseases. The second vital theme addressed in this review is the uses and impacts of medicinal Cannabis. Multiple studies have revealed that medicinal Cannabis performs significant roles in health, particularly in treating cancer, among other ailments.
Cannabis is a natural substance obtained from a plant that has existed since ancient times. Extensive evidence indicates that Cannabis was used in Romania more than five thousand years ago. In their research on the history and pharmacology of medicinal Cannabis, Bridgeman and Abazia (2017) date the earliest usage of Cannabis for medical purposes to approximately 400 AD. Cannabis was initially described in the United States Pharmacopoeia in 1850 and was widely used as a patent medicine in the United States throughout the 19th and early 20th centuries (Arboleda et al., 2020). The Marihuana Tax Act of 1937 was the first federal law to outlaw the cultivation, distribution, and use of cannabis. Following the passing of this act in 1937, Cannabis was removed from the U.S. Pharmacopoeia in 1942. (Takakuwa, & Schears, 2019). In 1951 and 1956, the Boggs and Narcotic Control Acts tightened the penalties for possession, and in 1970, the Controlled Substances Act brought about federal ban (Grinspoon, 2022). These legal measures contributed to the development of research restrictions by regulating the acquisition of cannabis for academic reasons, which goes beyond the simple prohibition of the drug. With the passage of the Compassionate Use Act in 1996, California became the first state to enable the legal, medical use of cannabis (Grinspoon, 2022). By January 1, 2017, 28 states, the District of Columbia, Guam, and Puerto Rico will have passed legislation regulating the sale and distribution of Medical Cannabis; 21 states and the District of Columbia will have decriminalized marijuana and eliminated prohibition for small-scale possession; and 8 states, including the District of Columbia, will have passed legislation regulating the sale and distribution of medicinal Cannabis (Johal et al., 2020).

The medicinal properties of the cannabis

The medicinal properties of the cannabis plant have been acknowledged for ages. Cannabis was listed in the pharmacopeia of Emperor Shen Nung, dating back to 2800 B.C., when it was utilized to treat a wide range of medicinal ailments. The cannabis plant has a long and exciting history. Cannabis was first utilized in either central Asia or western China. People have utilized Cannabis for its alleged medical advantages for generations. It was first attested in literature in 2800 BC when it was included in Emperor Shen Nung’s pharmacopeia (Grinspoon, 2022). In ancient writings from India, Greece, Assyria, and Rome, the medicinal benefits of Cannabis are mentioned. Arthritis, amenorrhea, depression, inflammation, loss of appetite, pain, and asthma are among the ailments that can be treated with Cannabis. Ancient Hindus attributed the medicinal qualities of Cannabis to its capacity to please deities such as Shiva. According to ancient Hindu texts, a person with a fever has offended the gods, who then exhale their “hot breath” on them. It was believed that using Cannabis in rituals would appease the gods and lower the temperature. New scientific evidence suggests an alternative perspective. By suppressing thermogenesis in the hypothalamus, THC decreases core body temperature.
The public perception of medicinal cannabis use suggests that this plant-based therapy is considered similarly to a botanical medication product or supplement used for health or symptom relief when a disease continues, which many believe is a result of the opioid overuse epidemic (Grinspoon, 2022). Clinical trials have not yet shed light on all of the unknowns surrounding medicinal Cannabis, including the likelihood that it has intoxicating, psychotropic, and debilitating effects similar to those of other herbal medicines and supplements (Grinspoon, 2022). Proponents of medical marijuana argue that the drug has numerous medical applications, especially when conventional treatments have failed to alleviate patients’ symptoms; that beneficial cannabinoids exist, as demonstrated by single-entity agents derived from Cannabis containing the compounds THC and cannabidiol (CBD); that Cannabis is relatively safe, with few deaths associated with use; that patients can self-titrate dosages; and that the drug has no psychoactive effects (Johal et al., 2020).
Even though Cannabis has been used in alternative medicine for thousands of years, it was not brought into western medicine until the nineteenth century. Some of the first written references to Cannabis as a medicine can be found in the Pen-ts’ao ching (Grinspoon, 2022). This is the earliest pharmacopeia, made in China around 100 A.D., based on oral traditions dating back to 2700 B.C. Around 1000 BCE, Cannabis is thought to have made its way to India, where it quickly became popular as a medicine. In Persian medicine, Cannabis was used to treat gout and wounds that were getting worse. In Arabic medicine, it was used to treat epilepsy. As early as the 15th century, it was used all over Africa to make work easier and treat things like malaria and dysentery. Most people agree that Cannabis came to the Americas in the 1600s. Since then, advances have been made in cannabis science and the rules surrounding its use (Johal et al., 2020). The District of Columbia and eleven states have legalized Cannabis for recreational use as of 2020. Alternatively, Cannabis has been decriminalized in several states, meaning that it is still illegal at the federal level, but possession by minors is no longer penalized by law. To date, 26 states have decreased penalties for personal possession of small amounts of marijuana. Anecdotal evidence has supported the medicinal use of Cannabis for millennia, whereas scientific evidence has only lately caught up. The results of ongoing clinical trials will likely impact the future of cannabis cultivation, medicinal research, legalization, and patient care.
Although cannabis and cannabinoid medicines are commonly used for symptom relief and disease treatment, the data supporting their efficacy in various applications is inconsistent (MacCallum & Russo, 2018). The analgesic efficacy for prolonged pain remains debatable (Schlag, 2020). Therapeutic medicines based on THC, such as dronabinol, have been approved for antiemetics in the United States for multiple years. However, there is insufficient evidence to recommend the routine use of medicinal Cannabis for reducing chemotherapy-related nausea and vomiting. Recent research has examined the possibility of cannabis-derived medicines to alleviate chemotherapy-induced nausea and vomiting (MacCallum & Russo, 2018). According to a meta-analysis of 23 randomized, controlled trials, patients who received cannabis-based medications experienced fewer episodes of nausea and vomiting than those who received a placebo. Those who utilized cannabis-based medications to alleviate their nausea and vomiting were treated at a similar rate as those who used conventional antiemetics (MacCallum & Russo, 2018).
Compared to those given a placebo or conventional antiemetics, patients who received cannabis-based treatments were more likely to drop out of studies due to adverse effects such as “feeling high,” dizziness, drowsiness, and dysphoria. Patients who participated in a crossover trial were given both cannabis-based drugs, and traditional antiemetics strongly preferred the cannabis-based therapy (Takakuwa & Schears, 2019). Cannabinoid-based medicines may be helpful when conventional antiemetics are ineffective against chemotherapy-induced nausea and vomiting. Unfortunately, the studies only produced evidence of mediocre quality and were restricted to chemotherapy medications and antiemetics developed in the 1980s and 1990s.



Despite insufficient clinical evidence, state legislators have accepted a range of disorders and accompanying symptoms as qualifying conditions for medical cannabis usage. Cancer, human immunodeficiency virus/acquired immunodeficiency syndrome, glaucoma, and multiple sclerosis are the most prevalent illnesses acknowledged by states that permit medicinal Cannabis (Yu et al., 2020). Patients in the United States often utilize medical Cannabis to relieve chronic pain. Cannabis is not potent enough to treat acute pain such as that felt after surgery or a broken bone. However, it can help alleviate the chronic pain that plagues millions of Americans, particularly the elderly. It is tempting that it is safer than opiates since one cannot overdose on it, and it is not addicted and may be substituted for NSAIDs such as Advil and Aleve (Bridgeman & Abazia, 2017). Cannabis has been demonstrated to alleviate multiple sclerosis symptoms and nerve pain. The few options, such as Lyrica, Neurontin, and opiates, are exceedingly sleepy. Those who have used Cannabis for medical purposes report that it helps them return to normal activities without feeling completely bewildered.
According to Grinspeen (2020), patients with Parkinson’s disease frequently report a dramatic reduction in tremors after using medicinal Cannabis, a well-known muscle relaxant. It has also been observed that fibromyalgia, endometriosis, interstitial cystitis, and other chronic pain-causing conditions benefit from its use. The therapeutic qualities of marijuana extend beyond its use as an anti-nausea drug and a weight-maintenance aid to include glaucoma treatment (Blake & Nahtigal,2019). The treatment of posttraumatic stress disorder among returning military troops is a fascinating area of research. Veterans and their therapists have reported substantial progress, prompting many to demand additional research and a loosening of legislative restrictions on the subject. Reportedly, patients suffering from HIV-related symptoms, such as pain and wasting syndrome, IBS, and Crohn’s disease, have benefited from medicinal marijuana treatment.

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The history and development of medicinal Cannabis may be traced back to antiquity when ancient physicians in various countries used Cannabis with other medications to treat pain and other ailments. Historiographically, cannabis use most likely originated in either western China or central Asia. However, this substance has continued to face multiple forms of stigmatization in many countries despite its significant impacts on health. After decades of stigmatization, Cannabis is currently undergoing a legal and cultural re-evaluation. According to current polling data, most of the United States population supports legalizing Cannabis for medical or recreational use.
Consequently, Cannabis has been authorized in many states for medical or recreational usage. Nevertheless, some scientists and legislators demand more extraordinary evidence of the benefits of marijuana in particular conditions. Some individuals are concerned that the risks connected with marijuana use could outweigh its advantages; therefore, additional research is required. Two synthetic cannabinoids are now available. They are used to treat the severe deleterious effects of epilepsy and chemotherapy. Pain relief is a typical indication and benefit of medical cannabis use. Cannabinoids in Cannabis can alleviate pain by altering how the brain processes feelings of discomfort. This could benefit chronic pain illnesses such as arthritis, endometriosis, fibromyalgia, and migraine. It has the potential to minimize the severity of unpleasant effects caused by cancer treatment, such as nausea and lack of appetite. One of the many benefits of medical Cannabis is its ability to reduce inflammation. There is speculation that Cannabis helps reduce edema. This could potentially reduce the symptoms of inflammatory disorders such as IBS, Crohn’s, and R.A. A decrease in systemic inflammation has been associated with favorable health consequences.

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