“For the relief of certain kinds of pain, I believe, there is no more useful medicine than Cannabis within our reach,” wrote Sir John Russell Reynolds, neurologist, epilepsy research pioneer, and physician to Queen Victoria back in 1859. In fact, cannabis was used for pain relief in all of the major ancient civilizations from Asia through the Middle East and into Europe and the Americas. The scientific inquiry into cannabis over the past several decades has confirmed that it is an effective and safe analgesic for many kinds of pain.

Cannabis use originated thousands of years ago in Asia, and has since found its way around the world.  The history of cannabis use goes back as far as 12,000 years, which places the plant among humanity’s oldest cultivated crops.  Cannabis plants are believed to have evolved on the steppes of Central Asia, specifically in the regions that are now Mongolia and southern Siberia.  In ancient China, hemp was grown for food and hundreds of other uses, so it was natural for people to realize that Cannabis plants could be used medicinally. Ancient and medieval physicians mixed the plant into teas that were used as medicine to treat pain and other ailments; In the ancient world, hemp was a common agricultural crop, harvested for its high-protein seeds, oil, and fiber.  Both hemp and psychoactive marijuana were used widely in ancient China.  Medicinal cannabis started in China then spread throughout Asia into the Middle East and Africa.  According to Chinese legend, Emperor Shen Neng was one of the first major leaders in the ancient world (2737 B.C.) to officially prescribe marijuana tea to treat various illnesses.  The first record of the drug’s medicinal use dates to 4000 B.C.

Cannabis came to the South Asian subcontinent between 2000 B.C. and 1000 B.C., when the region was invaded by the Aryans.  From China, coastal farmers brought cannabis to Korea about 2000 B.C. or earlier.  The drug became widely used in India, where it was celebrated as one of “five kingdoms of herbs … which release us from anxiety” in one of the ancient Sanskrit Vedic poems whose name translate into “Science of Charms.”  Compared to the Western world, and even other parts of Asia like China and Japan, India has always remained closely tied to cannabis use — medicinally, religiously, recreationally, and spiritually.  The Indian Hemp Drugs Commission described the history and culture of cannabis in India as follows: “To the Hindu the hemp plant is holy. A guardian lives in the bhang leaf… To see in a dream the leaves, plant, or water of bhang is lucky… No good thing can come to the man who treads underfoot the holy bhang leaf. A longing for bhang foretells happiness.”

Cannabis came to the Middle East between 2000 B.C. and 1400 B.C., and it was probably used there by the Scythians, a nomadic Indo-European group. The Scythians also likely carried the drug into southeast Russia and Ukraine. Germanic tribes brought the drug into Germany, and marijuana went from there to Britain during the 5th century with the Anglo-Saxon invasions.  Cannabis was allegedly introduced to Iraq in 1230 C.E., and traveled to Egypt with “mystic Islamic travelers” from Syria sometime during the Ayyubid dynasty in the 12th century C.E.  The earliest restrictions on cannabis were reported in the Islamic world by the 14th century.  Throughout the Middle Ages, cannabis was a widely popular drug in the Middle East. Because wine was forbidden in Islam, many Muslims turned to smoke hashish (cannabis resin).  The use of hashish began to spill over from the Persian world into the Arab world, and cannabis is thought to have been introduced to Africa by early Arab or Indian Hindu travelers.

During the Middle Ages in Europe, cannabis may not have been a religious or spiritual hallucinogen like it was in India, but it was definitely integrated in folk medicine and used to treat tumors, cough, and jaundice.  The Spanish brought industrial hemp to the western hemisphere and began cultivating it in Chile starting about 1545.  In 1607, “hempe” was among the crops Gabriel Archer observed being cultivated by the natives at the main Powhatan village, where Richmond, Virginia is now, and in 1613, Samuel Argall reported wild hemp “better than that in England” growing along the shores of the upper Potomac. As early as 1619, the first Virginia House of Burgesses passed an Act requiring all planters in Virginia to sow both English and Indian hemp on their plantations.

Cannabis was introduced to Brazil either by Portuguese colonists or by African slaves in the early 1800s. The intent may have been to cultivate hemp fiber, but the slaves from Africa used it psycho-actively, leading the Municipal Council of Rio de Janeiro, in 1830, to prohibit bringing cannabis into the city and punishing its use by slaves.  Similarly, the British practice of transporting Indian indentured workers throughout the empire had the result of spreading longstanding cannabis practices.  Attempts at criminalizing cannabis in British India were made, and mooted, in 1838, 1871, and 1877.

In the U.S., the Food and Drug Administration (FDA) was created in 1906 in response to an addiction crisis, as many people were becoming addicted to heroin, opium, and morphine.  Opium became very popular after the American Civil War.  Cocaine followed in the 1880’s.  Coca was popularly used in health drinks and remedies.  Morphine was discovered in 1906 and used for medicinal purposes.  Heroin was used to treat respiratory illness, cocaine was used in Coca-Cola, and morphine was regularly prescribed by doctors as a pain reliever.  The abuse of opium and cocaine at the end of the 19th century reached epidemic proportions.  Local governments began prohibiting opium dens and opium importation.  In 1906 the Pure Food and Drug Act required all physicians to accurately label their medicines.  Drugs were no longer seen as harmless remedies for aches and pains.  The FDA mainly controlled opium and morphine during this time, rather than marijuana, but the creation of the FDA signaled a major shift in drug policy in America.  Many Americans began to see those who smoked marijuana as troublesome, associating cannabis with “lower class criminality.”

Drug use was officially declared a crime under the Harrison Narcotics Act in 1914, the United States’ first federal drug policy.  The act restricted the manufacture and sale of marijuana, cocaine, heroin, and morphine, and was aggressively enforced.  Physicians, who were prescribing drugs to addicts on “maintenance” programs were harshly punished.  Between 1915 and 1938, more than 5,000 physicians were convicted and fined or jailed (Trebach, 1982, p. 125.)  In 1919, The Supreme Court ruled against the maintenance of addicts as a legitimate form of treatment in Webb et al. v. United States.  America’s first federal drug policy targeted physicians and pharmacists.  By 1937, the federal government passed the Marihuana Tax Act, making the use of non-medical cannabis illegal. At that time, cannabis was still used in various medical treatments, albeit in controlled forms.

The social movements of the 1960’s gave birth to a rebellious national attitude that popularized drug use.  The counterculture made marijuana fashionable on college campuses.  Many soldiers returned from the Vietnam War with marijuana and heroin habits.  In short, the demand for drugs in America skyrocketed in the 1960’s.

In the mid-20th century, cannabis began to expand to new populations, first at the margins of Western societies, but then increasingly into the mainstream. Cannabis made further inroads with white Americans in the 1950s with the appearance of the beatnik subculture.  In the 1960s, the United States saw a dramatic increase in cannabis usage, particularly among young people and college students, bringing cannabis into the middle-class mainstream.  Cannabis began to attract renewed interest as medicine in the 1970s and 1980s, due to its use by cancer and AIDS patients who reported relief from the effects of chemotherapy and wasting syndrome.  In 1996, in defiance of federal law, California became the first state to legalize medical cannabis. In 2001, Canada became the first country to adopt a system regulating the medical use of cannabis.  Entering the 21st century, nations began to change their attitudes about cannabis, and some initiated measures to decriminalize it; in 2001 Canada became the first nation to legalize medical cannabis.  In 2015 Uruguay became the first to legalize recreational cannabis, with Canada following in 2018.

As of April 2015, 23 states in the U.S. had legalized medical cannabis for people with certain specific medical qualifications, usually including children with epileptic conditions and some cancer patients who use cannabis to ease the side effects of chemotherapy and/or radiation. Some states allow patients with HIV/AIDs, Parkinson’s disease, multiple sclerosis, or even Crohn’s disease to obtain medical cannabis.  While research into medical cannabis is still limited due to restrictions preventing scientists from access to the drug, even for research purposes, recent studies have begun to explore some therapeutic aspects of medical marijuana. For example, one 2014 study suggested that cannabis might be effective in targeting brain tumors.  A 2015 study found that cannabis could be effective in treating schizophrenia. Research has also shown that it can help heal broken bones, halt and prevent severe seizures, and even cure migraines. In states where medical marijuana is legal, anecdotal evidence certainly seems to acknowledge that it’s helpful in treating a variety of medical conditions.  Supporting this general idea, a 2014 study found that over 90 percent of people in California who were prescribed cannabis reported that it helped them treat a serious medical condition.