Cannabinol (CBN) (yes, medical marijuana)

Cannabinol (CBN) (yes, medical marijuana)

See: Tetrahydrocannabinol


Many may be unaware that marijuana (Cannabis sativa L., Cannabaceae) was once a widely accepted medical treatment for the prevention and relief of migraine headache, listed in the United States Pharmacopeia from 1860 to 1941. In this article, the author presents an overview of historical use, modern research, and safety data that supports the potential utility of Cannabis in migraine, a condition that affects an estimated 23 million Americans (Russo, 1998). Currently available migraine medications are not always reliable and may cause significant side effects.
Historical information shows that Cannabis was held in high regard for the treatment of migraine by American and British physicians for at least eight decades, from the latter half of the 19th century until the early 1940s. According to Russo, in 1915 "Sir William Osler, the acknowledged father of modern medicine, stated of migraine treatment, `Cannabis indica is probably the most satisfactory remedy.'" Despite vigorous protest by the American Medical Association, Cannabis was made illegal in the United States in 1937, and the plant was dropped from the United States Pharmacopeia in 1941. Nonetheless, the following year, the editor of the Journal of the American Medical Association (JAMA) continued to recommend Cannabis for the treatment of menstrual migraine.

Although no modern clinical studies have specifically investigated the use of Cannabis in migraine, a number of small pain-relief studies have reported positive results in chronic headache pain and improvement of pain tolerance. A study investigating the effects of oral doses of the Cannabis compound delta-9-tetrahydro-cannabinol (THC) in patients with cancer demonstrated a trend toward pain relief with escalating doses. The analgesic properties of Cannabis are believed to be unrelated to opioid mechanisms. Recent studies have pointed out some possible mechanisms of action for cannabinoids in migraine, including antinociceptive effects (interference with pain transmission) in an area of the brain that is considered a likely area for migraine generation.

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In 1988, after an extensive review of testimony, U.S. Drug Enforcement Agency administrative law judge Francis Young concluded, "By any measure of rational analysis marijuana can be safely used within a supervised routine of medical care." In a 1995 editorial, the editor of the British Medical Journal called for "moderation in the drug war," and a supportive commentary was published by JAMA during the same year. Based on the history of medical use of Cannabis and the positive evidence demonstrated in preliminary modern studies, the author of this review paper argues that "medical marijuana and its possible role in migraine treatment deserves proper scientific examination, both biochemically and clinically."

[Russo E. Cannabis for migraine treatment: the once and future prescription? An historical and scientific review. Pain. 1998;76:3-8.]
Article copyright American Botanical Council.
By Evelyn Leigh

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