The doctor was frank with Hannah Deacon, mother of an epileptic boy. He told her that she would "never" get a prescription from the National Health Service (NHS) for tetrahydrocannabinol (THC) -based drugs, the psychoactive ingredient in cannabis. The British government was also useless, maintaining in February 2018 that marijuana had no medicinal value – a position it held for over 50 years, even when the country cultivated and exported marijuana for medicinal use. However, within a few months, he reversed, accepting that Cannabis sativa had medical use. Eight months after Deacon made his first public request, his son Alfie received THC-based medicine from the NHS.
Legislative assemblies across the planet are undergoing similar changes in the heart. This may portend broader legalization. History suggests that when medical cannabis is allowed, this is often the prelude to broader recreational access.
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People have been exploiting C. sativa for thousands of years and its medicinal use can be traced back to at least 400 AD. But like other recreational drugs, it began to face restrictions during the first half of the twentieth century. Meditation was common. A turning point occurred in 1900 when John Warnock, a British expatriate doctor in Egypt, suggested that marijuana was responsible for much of the country's insanity and crime. When the League of Nations met in 1924 to discuss narcotics like opium and heroin, its "evidence" of the dangers of cannabis was influential. But his methodology was doubtful. Data were collected only from patients of the Egyptian Madness Department. He did not speak Arabic, and an important way to determine if patients were users was to notice their "excited" denials when asked if they had tried the drug.
Then, in the 1930s, the United States was struck by moral panic as marijuana was accused of inciting violence among Mexican immigrants and of corrupting American children. When the international drug control system, the Single Convention on Narcotic Drugs, was established in 1961 at the United Nations, the use of marijuana in traditional medicine was ignored. It has been treated as having limited or non-existent therapeutic use and as being a dangerous drug, such as heroin, requiring tighter controls.
Inside the plant are chemicals called cannabinoids, similar to molecules produced by the human body, known as endocannabinoids. A wide network of receptors in the brain and human body respond to both plant and human versions of these molecules. The body's endocannabinoid system is involved in regulating everything from pain to mood, appetite, stress, sleep and memory. So far, 144 different cannabinoids have been found in C. sativa – most of them misunderstood – and new properties are being discovered all the time.
The best known are THC, the highest ingredient, and cannabidiol (CBD), which is not and is increasingly used as a food additive and supplement. Drug treaties severely prevented marijuana research. But over the years, evidence from clinical trials and elsewhere has shown its effectiveness in treating a variety of conditions, such as muscle pain in multiple sclerosis, chemotherapy-induced nausea, treatment-resistant epilepsy, and chronic pain in adults.
Useful for both pain relief and pleasure, marijuana has been popular in the decades since the Single Convention and the drug control treaties that followed it. It is the most widely cultivated and used illicit drug in the world. In 2017, it was produced in almost every country on earth. UN estimates of global drug use bring the number of drug users to 188 million (out of a total of 271 million in illegal drug use).
Cannabis is not completely free of dangers. An overdose is unlikely, perhaps impossible, but one in ten becomes addicted. And at high doses, with high resistance efforts or long term use, there is a risk of psychosis. In adolescents, there is a risk of impaired brain development. But given the amount of cannabis that is smoked for fun, it's remarkable how little damage is done. And more and more countries – more than 30 so far – have legalized medical marijuana (see map). In North and South America, medical use is often followed by acceptance of its recreational use. Some European countries have liberalized their laws for both purposes. But Germany, France and Britain first moved to the medicinal pot.
Allowing medicinal cannabis obliges governments to build regulatory structures to control legal provision to patients. When this happens, it seems easier for societies to accept the idea of recreational use. When grandma starts smoking weed for arthritis, the drug comes on the market.
Other arguments are also compelling in the push for full legalization, such as racial disparities in lawsuits, the social and judicial costs of criminalizing so many users, and the profits and taxes a legal sector can generate. But the fact that patients are suffering seems to have more political weight than the arguments of the liberalizers. Perhaps nervous politicians of a drug-raised generation will find wheelchairs with convenient cover.
In America, 33 states allow medical use and 11 have legalized recreational use. Nationally, the majority of the population favors federal legalization. By 2024, medical cannabis will be legal in all states, and recreational use will be found in nearly half, predict Arcview Market Research and BDS Analytics, companies that monitor cannabis businesses. Medical use is spreading like weeds throughout Latin America as opposition dwindles. Medical use is already found in Argentina, Colombia, Mexico, Chile, Peru, Jamaica and Uruguay.
Some governments and health insurers cover marijuana prescriptions. Almost 16,000 German patients receive medicinal cannabis – mostly for chronic pain and spasticity, and some, unlikely, for attention deficit disorder. In 2017, the leading insurer approved two-thirds of orders and spent $ 2.7 million on cannabis. This year, the European Parliament passed a (non-binding) vote to improve access to the medical vessel. Even the World Health Organization wants marijuana to be treated less restrictively, to recognize its medical utility, and to facilitate research. Most striking of all is the arrival of medical marijuana in countries that seem highly unlikely to relax drug laws, including South Korea, Thailand and Zimbabwe.
In countries that accept medical use, ease of access varies. International drug treaties technically allow medical cannabis. But the body that monitors international drug treaty compliance, the International Council on Narcotic Control (INCB), maintains an almost perpetual irritation tone in its reports, arguing that medical cannabis schemes are poorly regulated and allow leakage. drug use for recreational users.
Uruguay paved the way when it legalized marijuana in 2013. But it is the G7 member Canada reform that has done most to increase international tension over the legal status of marijuana. Last year, it completely legalized the drug. Part of their logic was that a regulated legal trade would restrict the black market and protect the young people who were buying it there. Canada's move caused strong fighting within the UN in Vienna, according to Martin Jelsma of the Transnational Institute, a think tank. The country is now accused of undermining the drug control system. Bill Blair, minister responsible for reducing organized crime, acknowledges that Canada is not compatible. "But," he says, "it's a very principled approach."
Attitudes toward the drug are waning around the world. But many important countries, notably Russia and China, remain relentlessly opposed to reform. Lack of global consensus prevents rewriting of drug treaties. Divisions are also found within the UN itself. The Human Rights Council and the Special Rapporteur on extrajudicial killings are critical of human rights violations that come with harsh national policies to suppress drug use, and WHO wants a change in the status quo. The INCB and the UN Office of Drug Control oppose the change.
It may be true that licensing medical marijuana tends to lead to broader liberalization. But those who resist it are swimming against the current. Mexico will probably legalize this year; Luxembourg is behind you and is likely to become the first EU country to legalize recreational cannabis; and New Zealand is planning a referendum on the subject. It is only a matter of time before international drug treaties are seen as fundamentally broken. Some fear that international law will be further damaged by all this rule breaking. Blair is reluctant to rely on how Canada can help solve the problem.
It could withdraw from the convention. But the Canadian government has already ruled that out. When Bolivia wanted to legalize the chewing of coca leaves, it withdrew from the convention and returned with a "reserve". One possibility that intrigues the winners of international politics is that Canada and other violators form an inter se agreement, allowing them to modify existing drug treaty provisions. For this to be an option, Canada will probably want to wait until the outlaw club is bigger.
In Britain, medical marijuana is legal, but still very difficult to obtain without an expensive private prescription. (Alfie was lucky.) The dilemma is that marijuana is in nobody's unusual medical land: neither licensed for most uses for which people want it, nor tested to the standards patients usually expect from drugs. Despite this, many countries are finding ways to move forward. France, for example, is moving forward with a large-scale clinical trial of the medical uses of cannabis.
The ambiguous legal status of the drug as a drug will persist for years. A long history of …