Since the first scientific reports on medical cannabis in the mid-19th-century, research of medicinal cannabis has exponentially expanded. Over 35,000 cannabis studies or research pieces have been published under Pubmed, with more than 19,000 in the past 10 years.
The history of medical cannabis has been entwined with human evolution for at least ten thousand years. Translating its historical use into modern scientific paradigms is an ever-evolving challenge for researchers.
Being a botanical-based medicine with extensive and variable medicinal constituents can make it difficult to study under the controlled conditions by which most medicines are evaluated. Prohibition and stigmatisation in modern history have further stymied progress in research.
However, as we come to understand more about specific cannabinoids’ actions, and as the cloak of stigma and illegality is finally being lifted around the world, well-designed clinical research initiatives, like those at Entoura, have the power to evaluate the benefits of medical cannabis with increasing confidence.
Ancient uses for medical cannabis
The first recorded use of cannabis as a medicine stems from ancient Chinese medicine. Chinese medical texts record cannabis being used in cases of gout, digestive complaints and rheumatism.
Vedic texts derived from India note its benefits in cases of sleep disturbances, anxiety, epilepsy and fevers. Ancient Egyptians recorded using medicinal cannabis preparations for gastrointestinal symptoms, tumours and a range of pain presentations – which in modern-day context may be interpreted as glaucoma, menstrual pain and earaches.
Many of these conditions where cannabis has been applied for hundreds if not thousands of years are now being investigated and validated by modern research.
Cannabis through the ages
Greeks and Romans used cannabis preparations for inflammatory conditions and pain, and in the Americas cannabis was used as pain relief in numerous circumstances, for convulsive disorders and opiate addiction, amongst other things.
In Britain, the famous 17th-century English herbalist Nicholas Culpepper recorded using medical cannabis for joint pain, inflammatory presentations, appetite, menstrual and digestive concerns.
The beginnings of scientific medical cannabis research
The first record of medical cannabis from a scientific lens came in the mid-1800s. Irish physician Dr William O’Shaughnessy is credited with some of the first scientific research conducted on cannabis.
His research encompassed animal and human observations, in the areas of epilepsy, rheumatic joint pain, palliative care and in the alleviation of vomiting from cholera.
Other research followed on from O’Shaughnessy highlighting the use of medicinal cannabis as a sedative, for pain relief, sleep disturbances and found it to be useful in certain psychological presentations.
Medical cannabis research meets a roadblock
Far from facilitating a leap into scientific enlightenment on the therapeutic potential of medicinal cannabis, the 20th-century resulted in a downturn of research in this space in view of international drug conventions and a racially fuelled political maelstrom surrounding the plant, largely stemming from the USA.
And yet, there were some notable breakthroughs. Although the cannabinoid CBD was identified in 1940, the discovery of THC, by Israeli researchers Raphael Mechoulam and Yeheil Gaoni in 1964 proved to be a launching pad for modern medical cannabis research.
The now famous ‘grandfather of cannabis’ Prof. Mechoulam, spearheaded research into the Endocannabinoid System – our bodies’ innate cannabinoid system that has influence over the immune system, hormonal and sleep patterns, appetite, mood and more.
This discovery has advanced our understanding of this previously unknown regulatory system’s diverse actions within the body, as well as how medical cannabis exerts its therapeutic actions.
However, these initial advancements were very much stifled by the prohibition era, starting as early as 1906 when many US states labeled cannabis as a poison. During the time of cannabis prohibition in the 20th-century, the foundations for modern clinical research, including randomised controlled trials and other scientific methodologies evaluating safety and efficacy, were established. But medical cannabis was left by the wayside, inhibited by local and international regulations from entering the modern medical research structure during such a crucial time of scientific progress.
Over the last 25 years or so, landmark discoveries in the field of cannabinoids and a slow unravelling of prohibition-era restrictions around the world has led to medical cannabis research has become progressively more specific. From trials involving cannabis preparations with little knowledge of the cannabinoid or phytochemical content, to nowadays where clinical trials are conducted for specific conditions with assayed cannabis medicines.
The 1990s and early 2000s bred extensive studies into how medical cannabis might be of use in palliative care, multiple sclerosis, epilepsy and chemotherapy-induced nausea and vomiting.
Research in animal models, human cell lines and clinical trials continue to uncover how cannabinoids may have applications in areas such as tumours, anxiety, PTSD, skin conditions, chemotherapy-induced cachexia/anorexia and a range of autoimmune disorders.
IP challenges in medical cannabis research
One challenge faced in medical cannabis research and product development that can’t be overlooked is that of intellectual property. Being a plant with a long history of use in relatively simple dosage forms (tincture or dried flower), for the majority of current final formulations of medicinal cannabis, it is difficult to generate IP. This has interrupted the traditional pathways for researching products whereby IP leads to research opportunities and funding which progresses a medicine through clinical trials towards products on the shelves.
While it is difficult to generate the IP, nonetheless in Australia, cannabis plants and products are eligible for some IP protections such as patents and plant breeder’s rights when certain criteria are met. And no doubt, as more cannabis licenses are granted and cultivation research expands we are likely to see a further increase in clinical research utilising the plant IP.
Australian medical cannabis research
Entoura is committed to the growth of medical cannabis research and expansion of accessibility for patients. To accomplish this, we engage in collaborations with other eminent medical cannabis companies and instigate our own clinical trials to grow the global understanding of this medicine.
Entoura research into medicinal cannabis and sleep
Entoura has recently been actively taking part in two key Australian medical cannabis studies:
Sleep can be a dream for some, and a nightmare for others. Medical cannabis preparations have been shown to have therapeutic effects for some people suffering insomnia. Our sleep study aims to evaluate the safety and effectiveness of medical cannabis on those who have difficulty getting to sleep or staying asleep.
Entoura anxiety and PTSD study
Together with Applied Cannabis Research, Entoura is currently recruiting for a research study investigating the effects and safety of medical cannabis on anxiety and PTSD as part of CACOS, the CA Clinics Observational Study.
This study collects and analyses data on medicinal cannabis for a range of hard-to-treat conditions through a series of surveys which record a patient’s treatment progress throughout a 12 month period, reporting on side effects, dosage and treatment satisfaction. Anecdotal and some clinical research support the use of cannabis medicines in mental health presentations, and Entoura’s study hopes to reveal further details on how effective medical cannabis is at reducing symptoms and improving quality of life.
Our friends at CA Clinics and Applied Cannabis Research are conducting a number of other studies that complement our initiatives at Entoura. By examining patient-reported outcomes for conditions related to pain, inflammation, sleep, palliative care as well as neurological, psychiatric, gastrointestinal and musculoskeletal disorder, the global medical cannabis community can learn from high-quality Australian research.
For more information, please contact us.