Medicinal use of cannabis in the United States: Historical perspectives, current trends, and future directions

Authors

  • Sunil K. Aggarwal, PhD
  • Gregory T. Carter, MD, MS
  • Mark D. Sullivan, MD, PhD
  • Craig ZumBrunnen, PhD
  • Richard Morrill, PhD
  • Jonathan D. Mayer, PhD

DOI:

https://doi.org/10.5055/jom.2009.0016

Keywords:

cannabinoids, cannabis, marijuana, chronic pain, opioids, opiates, botanical medicine

Abstract

Cannabis (marijuana) has been used for medicinal purposes for millennia, said to be first noted by the Chinese in c. 2737 BCE. Medicinal cannabis arrived in the United States much later, burdened with a remarkably checkered, yet colorful, history. Despite early robust use, after the advent of opioids and aspirin, medicinal cannabis use faded. Cannabis was criminalized in the United States in 1937, against the advice of the American Medical Association submitted on record to Congress. The past few decades have seen renewed interest in medicinal cannabis, with the National Institutes of Health, the Institute of Medicine, and the American College of Physicians, all issuing statements of support for further research and development. The recently discovered endocannabinoid system has greatly increased our understanding of the actions of exogenous cannabis. Endocannabinoids appear to control pain, muscle tone, mood state, appetite, and inflammation, among other effects. Cannabis contains more than 100 different cannabinoids and has the capacity for analgesia through neuromodulation in ascending and descending pain pathways, neuroprotection, and anti-inflammatory mechanisms. This article reviews the current and emerging research on the physiological mechanisms of cannabinoids and their applications in managing chronic pain, muscle spasticity, cachexia, and other debilitating problems.

Author Biographies

Sunil K. Aggarwal, PhD

MD Candidate, Medical Scientist Training Program, University of Washington, Seattle, Washington.

Gregory T. Carter, MD, MS

Professor, Department of Rehabilitation Medicine, University of Washington, School of Medicine, Seattle, Washington.

Mark D. Sullivan, MD, PhD

Professor, Department of Psychiatry and Behavioral Sciences and Department of Bioethics and Humanities University of Washington School of Medicine, Seattle, Washington.

Craig ZumBrunnen, PhD

Professor, Department of Geography, University of Washington, Seattle, Washington.

Richard Morrill, PhD

Professor Emeritus, Department of Geography, University of Washington, Seattle, Washington.

Jonathan D. Mayer, PhD

Professor, Departments of Epidemiology, Geography, Global Health, Medicine, Family Medicine, and Health Services, University of Washington, Seattle, Washington.

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Published

01/29/2018

How to Cite

Aggarwal, PhD, S. K., G. T. Carter, MD, MS, M. D. Sullivan, MD, PhD, C. ZumBrunnen, PhD, R. Morrill, PhD, and J. D. Mayer, PhD. “Medicinal Use of Cannabis in the United States: Historical Perspectives, Current Trends, and Future Directions”. Journal of Opioid Management, vol. 5, no. 3, Jan. 2018, pp. 153-68, doi:10.5055/jom.2009.0016.

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