Archaeobotanical evidence of the use of medicinal cannabis in a secular context unearthed from south China.

ETHNOPHARMACOLOGICAL RELEVANCE: As one of the first plants used by ancient people, cannabis has been used for medicinal purposes for thousands of years. The long history of medicinal cannabis use contrasts with the paucity of archaeobotanical records. Moreover, physical evidence of medicinal cannabis use in a secular context is much rarer than evidence of medicinal cannabis use in religious or ritual activities, which impedes our understanding of the history of medicinal cannabis use. AIM OF THE STUDY: This study aims to provide archaeobotanical evidence of medicinal cannabis use and analyse the specific medicinal usage of cannabis in a secular context in ancient times. MATERIALS AND METHODS: Plant remains were collected from the Laoguanshan Cemetery of the Han Dynasty in Chengdu, South China, with the archaeological flotation process and were identified based on morphological and anatomical characteristics. The examination of the medicinal significance of the remains relied on the investigation of the documentation on unearthed medical bamboo slips, the diseases of the tomb occupants, the cemetery's cultural background and Chinese historical records. RESULTS: The botanical remains were accurately identified as cannabis. More than 120 thousand fruits were found, which represents the largest amount of cannabis fruit remains that have been statistically analysed from any cemetery in the world thus far. The cannabis fruits are suspected to have been used for medical purposes in a secular context and were most likely used to stop severe bleeding of the uterus and treat lumbago and/or arthralgia. CONCLUSIONS: The cannabis fruit remains reported here likely represent the first physical evidence of medicinal cannabis use for the treatment of metrorrhagia, severe lumbago, and/or arthralgia. This study emphasizes the importance of the evidence of the diseases suffered by the occupants of the tomb in determining the medicinal use of cannabis in a secular context and contributes to a comprehensive understanding of the ancient history of medicinal cannabis.

The Cannabis Spread throughout the Continents and its Therapeutic Use in History.

BACKGROUND: Cannabis sativa L. (C. sativa) is a plant whose use as a therapeutic agent shares its origins with the first Far East's human societies. Cannabis has been used not only for recreational purposes but as food to obtain textile fibers, to produce hemp paper, to treat many physical and mental disorders. AIM: This review aims to provide a complete assessment of the deep knowledge of the cannabis psychoactive effects and medicinal properties in the course of history covering i.) The empirical use of the seeds and the inflorescences to treat many physical ailments by the ancient Oriental physicians' ii.) The current use of cannabis as a therapeutic agent after the discovery of its key psychoactive constituent and the human endogenous endocannabinoid system. METHODS: This study was performed through a detailed analysis of the studies on the historical significance and medical applications of Cannabis sativa by using international scientific databases, historical and medical books, ancient Greek and Chinese manuscripts translations, library and statistical data from government reports and texts from the National Library of Greece (Stavros Niarchos Foundation), from the School of Health Sciences of the National and Kapodistrian University of Athens (Greece). We selected papers and texts focusing on a historical point of view about the medical importance of the plant and its applications for a therapeutic purpose in the past. RESULTS AND CONCLUSION: Through a detailed analysis of the available resources about the origins of C. sativa, we found that its use by ancient civilizations as a source of food and textile fibers dates back over 10,000 years, while its therapeutic applications have been improved over the centuries, from the ancient East medicine of the 2nd and 1st millennium B.C. to the more recent introduction in the Western world after the 1st century A.D. In the 20th and 21st centuries, Cannabis and its derivatives have been considered as a menace and banned throughout the world, but nowadays, they are still the most widely consumed illicit drugs all over the world. Its legalization in some jurisdictions has been accompanied by new lines of research to investigate its possible applications for medical and therapeutic purposes.

Cannabis and its constituents for cancer: History, biogenesis, chemistry and pharmacological activities.

Cannabis has long been used for healing and recreation in several regions of the world. Over 400 bioactive constituents, including more than 100 phytocannabinoids, have been isolated from this plant. The non-psychoactive cannabidiol (CBD) and the psychoactive Δ9-tetrahydrocannabinol (Δ9-THC) are the major and widely studied constituents from this plant. Cannabinoids exert their effects through the endocannabinoid system (ECS) that comprises cannabinoid receptors (CB1, CB2), endogenous ligands, and metabolizing enzymes. Several preclinical studies have demonstrated the potential of cannabinoids against leukemia, lymphoma, glioblastoma, and cancers of the breast, colorectum, pancreas, cervix and prostate. Cannabis and its constituents can modulate multiple cancer related pathways such as PKB, AMPK, CAMKK-ß, mTOR, PDHK, HIF-1α, and PPAR-γ. Cannabinoids can block cell growth, progression of cell cycle and induce apoptosis selectively in tumour cells. Cannabinoids can also enhance the efficacy of cancer therapeutics. These compounds have been used for the management of anorexia, queasiness, and pain in cancer patients. Cannabinoid based products such as dronabinol, nabilone, nabiximols, and epidyolex are now approved for medical use in cancer patients. Cannabinoids are reported to produce a favourable safety profile. However, psychoactive properties and poor bioavailability limit the use of some cannabinoids. The Academic Institutions across the globe are offering training courses on cannabis. How cannabis and its constituents exert anticancer activities is discussed in this article. We also discuss areas that require attention and more extensive research.

History of cannabis and the endocannabinoid system
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This article retraces the story of cannabis from the earliest contacts of humans with the plant to its subsequent global expansion, its medicinal uses, and the discovery of the endocannabinoid system in the 20th century. Cannabis was attested to around 12 000 years ago near the Altai Mountains in Central Asia, and since then, cannabis seeds have accompanied the migration of nomadic peoples. Records of the medicinal use of cannabis appear before the Common Era in China, Egypt, and Greece (Herodotus), and later in the Roman empire (Pliny the Elder, Dioscorides, Galen). In the 19th century, orientalists like Silvestre de Sacy, and Western physicians coming into contact with Muslim and Indian cultures, like O'Shaughnessy and Moreau de Tours, introduced the medicinal use of cannabis into Europe. The structure of the main psychoactive phytocannabinoid, tetrahydrocannabinol (THC), was determined in Israel by Mechoulam and Gaoni in 1964. This discovery opened the gate for many of the subsequent developments in the field of endocannabinoid system (ECS) research. The advances in the scientific knowledge of the ECS place the debate on cannabis liberalization in a new context.
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Este artículo describe la historia de la cannabis desde los primeros contactos de los humanos con la planta hasta su posterior expansión mundial, sus usos medicinales y el descubrimiento del sistema de endocannabinoides en el siglo XX. Hay testimonios de la cannabis desde hace unos 12,000 años, cerca de las montañas de Altai en Asia Central, y desde entonces las semillas de cannabis acompañaron la migración de los pueblos nómades. Los registros del uso medicinal de la cannabis aparecen antes de nuestra era en China, Egipto y Grecia (Herodoto), y más tarde en el imperio romano (Plinio el Viejo, Dioscórides, Galeno). En el siglo XIX, los orientalistas como Silvestre de Sacy y los médicos occidentales que entraron en contacto con las culturas musulmana e india, como O'Shaughnessy y Moreau de Tours, introdujeron el uso medicinal de la cannabis en Europa. La estructura del principal fitocannabinoide psicoactivo, el THC, fue identificada por Mechoulam y Gaoni en Israel en 1964. Este descubrimiento abrió la puerta para muchos de los desarrollos posteriores en el campo de la investigación del sistema de endocannabinoides (SEC). Los avances en el conocimiento científico del SEC colocan el debate acerca de la liberalización de la cannabis en un nuevo contexto.

Cet article décrit l'histoire du cannabis depuis les premiers contacts de l'espèce humaine avec la plante jusqu'à son expansion mondiale ultérieure, ses utilisations médicinales et la découverte du système endocannabinoïde au XXe siècle. La trace du cannabis a été retrouvée il y a environ 12 000 ans près des montagnes de l'Altaï en Asie centrale et depuis, les graines de cannabis ont suivi la migration des peuples nomades. Son usage médicinal apparaît avant notre ère en Chine, en Égypte et en Grèce (Hérodote), et plus tard dans l'empire romain (Pline l'Ancien, Dioscoride, Galien). Au XIXe siècle, des orientalistes comme Silvestre de Sacy et des médecins occidentaux en contact avec les cultures musulmanes et indiennes, comme O'Shaughnessy et Moreau de Tours, ont introduit son recours à des fins médicales en Europe. En 1964 en Israël, Mechoulam et Gaoni, en identifiant la structure du principal phytocannabinoïde psychoactif, le THC, ouvrent la voie à de nombreux développements dans le domaine de la recherche sur le système endocannabinoïde (SEC). Sur la base de ces progrès, le débat sur la libéralisation du cannabis se poursuit dans un nouveau contexte.

A North American History of Cannabis Use in the Treatment of Epilepsy.

Cannabis has been used for millennia in religious ceremonies, for recreation and for its medicinal qualities. There are multiple accounts detailing the specific ailments cannabis has been used to treat, many of which have included epilepsy. Racial discrimination and political stigmatization led to prohibition, which limited both patients' and researchers' access to the drug through the 20th century. Recently, academic interest has been renewed in cannabis, especially regarding the modulation of cortical excitability via the human endocannabinoid system. Modern research has produced several promising studies regarding the treatment of epileptic encephalopathies. Legalization of marijuana in Canada has potentially allowed for further trials, but it is by no means an end to the controversy surrounding the treatment of epilepsy with cannabinoids.

The Surprising Reach of FDA Regulation of Cannabis, Even After Descheduling.

As more states legalize cannabis, the push to "deschedule" it from the Controlled Substances Act is gaining momentum. At the same time, the Food and Drug Administration (FDA) recently approved the first conventional drug containing a cannabinoid derived from cannabis­cannabidiol (CBD) for two rare seizure disorders. This would all seem to bode well for proponents of full federal legalization of medical cannabis. But some traditional providers are wary of drug companies pulling medical cannabis into the regular small molecule drug development system. The FDA's focus on precise analytical characterization and on individual active and inactive ingredients may be fundamentally inconsistent with the "entourage effects" theory of medical cannabis. Traditional providers may believe that descheduling cannabis would free them to promote and distribute their products free of federal intervention, both locally and nationally. Other producers appear to assume that descheduling would facilitate a robust market in cannabis-based edibles and dietary supplements. In fact, neither of these things is true. If cannabis were descheduled, the FDA's complex and comprehensive regulatory framework governing foods, drugs, and dietary supplements would preclude much of this anticipated commerce. For example, any medical claims about cannabis would require the seller to complete the rigorous new drug approval process, the cost of which will be prohibitive for most current traditional providers. Likely also unexpected to some, there is no pathway forward for conventional foods containing cannabis constituents, with the (probably exclusive) exception of certain hemp seed ingredients, if those foods cross state lines. And it will certainly come as a shock to many that federal law already prohibits the sale of dietary supplements containing CBD--including those already on the market as well as those made from "hemp," which has recently been descheduled under the 2018 Farm Bill. This Article describes in detail the surprising reach of the FDA and then outlines three modest, but legal, pathways forward for cannabis-based products in a world where cannabis has been descheduled.

Medical Cannabis: A plurimillennial history of an evergreen.

The history of Cannabis goes along that of humankind, as speculated based on geographical and evolutionary models together with historic data collected to date. Its medical use is several thousand years old, as attested both by archeobotanical evidence of Cannabis remains and written records found in ancient texts from the sacred Vedic foundational texts of Ayurvedic medicine (about 800 before current era [BCE]) to the first known Pharmacopoea, the Chinese "Shen Nung Pen Ts'ao Ching" (1 century BCE). In this paper, we retrace the history of Cannabis traveling through the key stages of its diffusion among the most important ancient cultures up to our days, when we are facing a renaissance of its medical employment. We report through the centuries evidence of its use in numerous pathologic conditions especially for its anti-inflammatory, antiseptic, and anticonvulsing properties that support the requirement to direct our present research efforts into the definitive understanding of its efficacy.

Breve historia sobre la marihuana en Occidente / A brief history of marijuana in the western world

La marihuana es una sustancia con una extensa y controvertida historia. A lo largo del tiempo, esta planta, y desde hace más de 5.000 años, ha sido utilizada para diferentes fines, que van desde el uso lúdico y recreativo, pasando por un medio de relajación y meditación, hasta su uso en el tratamiento de varias enfermedades o el alivio de procesos vinculados a cierto tipo de malestares. Aunque se supuso que la marihuana tenía su origen en Mesoamérica, ahora se sabe que es sólo una leyenda urbana de poca credibilidad y que sus orígenes los podemos registrar en referencias médicas chinas datadas alrededor del año 2737 a. de C. Si bien esta planta no tiene un origen mesoamericano, sí ha generado interés en el mundo, y sobre todo en México. Es en este país donde el uso del cannabis ha ido desde intereses textiles y medicinales hasta el consumo lúdico, pasando por su venta libre, la prohibición por presiones políticas y sociales, su tolerancia y, recientemente, su despenalización para uso lúdico y medicinal. Desgraciadamente existen pocas referencias de la historia de esta planta en México, por lo que ha sido de nuestro interés presentar algunos datos sobre las generalidades de la marihuana, una breve historia en el mundo, el desarrollo de la despenalización en Norteamérica, sus usos medicinales y su paso por México hasta nuestros días

Marijuana is a substance with a long and controversial history. At different times in its history, which goes back over 5,000 years, this plant has been used for different purposes, ranging from recreational and leisure to its use in the treatment of several diseases or to offer relief in processes that entail a certain type of malaise, and including its consideration as a means of relaxation and meditation. Although it was supposed that the roots of marijuana lay in Central America, it is now known that this is but an urban legend with little credibility and that its origins can be found recorded in Chinese medical references dating back to the year 2737 BC. Although this plant was not originally from Central America, it has aroused interest around the world, and above all in Mexico. It is in this country where the use of cannabis has gone from applications in textiles and medicine to its free sale, the bans on its use due to political and social pressures, its tolerance and, recently, its decriminalisation for recreational and medicinal use. Unfortunately there are few references on the history of this plant in Mexico, and thus we have considered it interesting to present some data about the generalities of marijuana, a brief history in the world, the development of decriminalisation in North America, its medicinal uses and its course through Mexico to the present day

[A brief history of marijuana in the western world]. / Breve historia sobre la marihuana en Occidente.

Marijuana is a substance with a long and controversial history. At different times in its history, which goes back over 5,000 years, this plant has been used for different purposes, ranging from recreational and leisure to its use in the treatment of several diseases or to offer relief in processes that entail a certain type of malaise, and including its consideration as a means of relaxation and meditation. Although it was supposed that the roots of marijuana lay in Central America, it is now known that this is but an urban legend with little credibility and that its origins can be found recorded in Chinese medical references dating back to the year 2737 BC. Although this plant was not originally from Central America, it has aroused interest around the world, and above all in Mexico. It is in this country where the use of cannabis has gone from applications in textiles and medicine to its free sale, the bans on its use due to political and social pressures, its tolerance and, recently, its decriminalisation for recreational and medicinal use. Unfortunately there are few references on the history of this plant in Mexico, and thus we have considered it interesting to present some data about the generalities of marijuana, a brief history in the world, the development of decriminalisation in North America, its medicinal uses and its course through Mexico to the present day.

TITLE: Breve historia sobre la marihuana en Occidente.La marihuana es una sustancia con una extensa y controvertida historia. A lo largo del tiempo, esta planta, y desde hace mas de 5.000 años, ha sido utilizada para diferentes fines, que van desde el uso ludico y recreativo, pasando por un medio de relajacion y meditacion, hasta su uso en el tratamiento de varias enfermedades o el alivio de procesos vinculados a cierto tipo de malestares. Aunque se supuso que la marihuana tenia su origen en Mesoamerica, ahora se sabe que es solo una leyenda urbana de poca credibilidad y que sus origenes los podemos registrar en referencias medicas chinas datadas alrededor del año 2737 a. de C. Si bien esta planta no tiene un origen mesoamericano, si ha generado interes en el mundo, y sobre todo en Mexico. Es en este pais donde el uso del cannabis ha ido desde intereses textiles y medicinales hasta el consumo ludico, pasando por su venta libre, la prohibicion por presiones politicas y sociales, su tolerancia y, recientemente, su despenalizacion para uso ludico y medicinal. Desgraciadamente existen pocas referencias de la historia de esta planta en Mexico, por lo que ha sido de nuestro interes presentar algunos datos sobre las generalidades de la marihuana, una breve historia en el mundo, el desarrollo de la despenalizacion en Norteamerica, sus usos medicinales y su paso por Mexico hasta nuestros dias.

Cultivo y usos etnobotánicos del cáñamo (Cannabis Sativa L) en la ciencia árabe (siglos VIII-XVII) / Hemp cultivation and ethnobotanical uses in arabic science (8th-17th centuries)

El cáñamo es actualmente objeto de gran interés en el ámbito de la comunidad científica desde muy diferentes perspectivas, entre ellas, la etnobotánica. Este enfoque está interesado en estudiar la difusión cultural de la planta por la acción del género humano y su relación histórica y presente con este. En el marco de la etnobotánica histórica los estudios filológicos ofrecen información muy relevante para poder reconstruir la difusión cultural de la planta, sus usos y sus productos en diferentes tiempos y espacios geográficos. Hasta el momento no se ha publicado ningún trabajo sobre el cultivo y usos etnobotánicos del cáñamo en la civilización árabe-islámica clásica. A partir de los datos extraídos de casi una treintena de fuentes científicas redactadas entre los siglos VIII y XVII, analizamos en este artículo diferentes aspectos relativos al cultivo de la planta y sus usos etnobotánicos (alimentario-dietéticos, pienso y forraje, fabricación de hilos, tejidos y cuerdas, fabricación de papel, insecticida, repelente de animales, medicamento en veterinaria, abstergente, combustible, e incienso ceremonial). La información que encontramos en nuestras fuentes nos habla de la existencia de un proceso de transmisión y continuidad de formas de cultivo y usos del cáñamo desde la Antigüedad hasta la civilización árabe-islámica (AU)

Recent years have been witness to a vast outpouring of publications on hemp from many different scientific perspectives. Among them, Ethnobotany is interested in tracking how human action determined the cultural diffusion of this plant and how human beings have interacted with it throughout history. Within the theoretical frame of historical Ethnobotany, philological studies can provide us with a great deal of relevant information as they help us to reconstruct the cultural diffusion of hemp uses and products in the context of different ages and geographical spaces. So far, there is not available any publication on cannabis cultivation and its ethnobotanical uses in Arab-Islamic civilization. In this article we analyse several different aspects concerning this topic: cultivation, harvesting, retting and fiber separation techniques, human food and culinary uses, animal feed uses, raw material for threads, robes, cloth and paper fabrication uses, insecticide, animal repellent, medication in veterinary medicine, detergent, combustible and ritual incense uses. Our research is based on the information we find in nearly thirty Arabic scientific sources written between the 7th and the 18th centuries. This information enables us to claim that hemp techniques cultivation and uses were transferred from the pre-Islamic Ancient World civilizations to the Arab-Islamic civilization (AU)

[Argentina enacts first law on medical use of the cannabis plant. History and perspectives]. / Argentina tiene su primera ley sobre el uso medicinal de la planta de cannabis. Historia y perspectivas.

In the last few years, great expectations have risen in the society concerning the eventual therapeutic usefulness of compounds derived from the cannabis plant. It is well known that these compounds are being used in treating certain health conditions, either through medical prescription or self-administration. Extreme opinions range from believing that it is a harmful and dangerous drug to sustaining that it is a panacea. However, the sheer existence of an endocannabinoid system in the brain compels us to study its dimensions and derivations thoroughly. It is expected that controversies and knowledge gaps will be clarified within the framework of this new law. Prohibitionism should not be a category of analysis. Regardless of the therapeutic effects of cannabinoid compounds, demonstrated or to be demonstrated, there are already severe restrictions on their use, which mirror the still existing restrictions to the use of opioids (drugs of definite utility but on which a huge taboo persists). This review presents the first Argentine law on the medical use of cannabis. Milestones in the history of marijuana at the national level are pointed out, which are inextricably linked to world trends either in favor or against prohibition. The current status of the use of cannabis oil in the country and evidences for its therapeutic value are also analyzed. Evidences on its therapeutic value are also analyzed as well as the current status of the use of cannabis oil in our country.

Argentina tiene su primera ley sobre el uso medicinal de la planta de cannabis: Historia y perspectivas / Argentina enacts first law on medical use of the cannabis plant. History and perspectives

En los últimos años se ha generado en la sociedad una gran expectativa sobre la posible utilidad terapéutica de compuestos derivados de la planta de cannabis. Es muy bien sabido que están siendo utilizados en el tratamiento de diversas afecciones, ya sea por prescripción médica o por autoadministración. En un extremo de las opiniones están quienes consideran que es una droga dañina y peligrosa, mientras otros mantienen que es la panacea. No obstante, el simple hecho de que exista un sistema endocannabinoide en el cerebro obliga a estudiarlo en todas sus dimensiones y derivaciones. Se espera que, en el marco de la nueva ley, se puedan dilucidar las controversias y los vacíos del conocimiento. Las posiciones prohibicionistas no deberían ser una categoría de análisis. Independientemente de los efectos terapéuticos demostrados o por demostrar, ya se están vislumbrando severas restricciones al uso de compuestos cannabinoides, similares a las que aún hoy existen para acceder a los opioides (fármacos de utilidad definitivamente comprobada pero sobre los cuales persiste un enorme tabú). En esta revisión, se expone la primera ley sobre el uso medicinal del cannabis promulgada en Argentina. Se señalan los hitos de la historia sobre la marihuana en el país, indisolublemente relacionados con los argumentos prohibicionistas y los de flexibilización en el mundo. Se analiza la evidencia sobre su utilidad terapéutica y el estado actual del uso del aceite de cannabis en nuestro país.

In the last few years, great expectations have risen in the society concerning the eventual therapeutic usefulness of compounds derived from the cannabis plant. It is well known that these compounds are being used in treating certain health conditions, either through medical prescription or self-administration. Extreme opinions range from believing that it is a harmful and dangerous drug to sustaining that it is a panacea. However, the sheer existence of an endocannabinoid system in the brain compels us to study its dimensions and derivations thoroughly. It is expected that controversies and knowledge gaps will be clarified within the framework of this new law. Prohibitionism should not be a category of analysis. Regardless of the therapeutic effects of cannabinoid compounds, demonstrated or to be demonstrated, there are already severe restrictions on their use, which mirror the still existing restrictions to the use of opioids (drugs of definite utility but on which a huge taboo persists). This review presents the first Argentine law on the medical use of cannabis. Milestones in the history of marijuana at the national level are pointed out, which are inextricably linked to world trends either in favor or against prohibition. The current status of the use of cannabis oil in the country and evidences for its therapeutic value are also analyzed. Evidences on its therapeutic value are also analyzed as well as the current status of the use of cannabis oil in our country.

Cannabis: A Neurological Remedy or a Drug of Abuse in India.

BACKGROUND: Since ancient times, the use of cannabis as a medicine is well documented due to its potential therapeutic activity while subsequently its use as drug of abuse spread increasingly. OBJECTIVE: The present review sought to give an insight in the history of medical and recreational use of cannabis in India. CONCLUSION: Indian use of cannabis dates back to Vedic time, mostly for the ritualistic and religious purposes, as documented in the ancient literature. It was India that introduced the medical use of cannabis to neighboring countries. Nevertheless, in the same India, medical use did not propagate due to religious and social stigma related to the plant itself. The pharmacoactive constituents of cannabis and their therapeutic values in Ayurvetic medicine have been here described together with the adverse effects they can cause with special reference to neurological ones, including withdrawal symptoms. Finally, how cannabis made its route to the Indian society has also been discussed.

Evidence-based policy? The re-medicalization of cannabis and the role of expert committees in the UK, 1972-1982.

BACKGROUND: Cannabis was introduced to the UK as a medical product in the nineteenth century. However, with questions over its safety, efficacy, and possible harms its medical role diminished and by the 1950s it was viewed as a drug of misuse. Nonetheless, scientific and lay knowledge around cannabis expanded from the 1960s and cannabis re-appeared in different therapeutic forms. In re-medicalizing cannabis, science-policy transfer proved important and was enabled by the developing mechanism of expert committees, most notably the Advisory Council on the Misuse of Drugs (ACMD). METHODS: This article draws upon previously unknown archival material on the ACMD held at the National Archives and covers the period 1972-1982. It considers how expert groups were established, their membership, and the evolving discussion over therapeutic cannabis within the broader drug policy debate. RESULTS: Three distinct periods emerged: 1972-1976 with the creation of the Working Group on Cannabis; 1977-1979 when the Working Group focused on potential amendments to the Misuse of Drugs Act and recommended downgrading cannabis from Class B to Class C; 1980-1982 when the Expert Group on the Effects of Cannabis recommended downgrading cannabis and encouraged research into cannabis as a medicine. Sources reveal that driven by drug control imperatives the ACMD stimulated research on cannabis leading to increased research on medical applications. CONCLUSION: Expert advice was critical in the process of re-medicalization. Initially, discourse occurred in the closed expert committees of the ACMD. The drug problem had been framed under the criminal justice system but as the limitations of this were revealed, and there was continuing uncertainty over cannabis' impact, new approaches to cannabis were sought. It was this combination of more relaxed attitudes towards cannabis, research incentives, as well as a developing desire to draw medical needs away from discussion of drug control that was to allow re-medicalization to develop.

MEDICINAL CANNABIS LAW REFORM: LESSONS FROM CANADIAN LITIGATION.

This editorial reviews medicinal cannabis litigation in Canada's superior courts between 1998 and 2015. It reflects upon the outcomes of the decisions and the reasoning within them. It identifies the issues that have driven Canada's jurisprudence in relation to access to medicinal cannabis, particularly insofar as it has engaged patients' rights to liberty and security of the person. It argues that the sequence of medicinal schemes adopted and refined in Canada provides constructive guidance for countries such as Australia which are contemplating introduction of medicinal cannabis as a therapeutic option in compassionate circumstances for patients. In particular, it contends that Canada's experience suggests that strategies calculated to introduce such schemes in a gradualist way, enabling informed involvement by medical practitioners and pharmacists, and that provide for safe and inexpensive accessibility to forms of medicinal cannabis that are clearly distinguished from recreational use and unlikely to be diverted criminally maximise the chances of such schemes being accepted by key stakeholders.

Medical marijuana in the workplace: challenges and management options for occupational physicians.

Although possession and use of marijuana is prohibited by federal law, legalization in four states (Alaska, Colorado, Oregon, and Washington) and allowance for palliation and therapy in 19 others may reposition the drug away from the fringes of society. This evolving legal environment, and growing scientific evidence of its effectiveness for select health conditions, requires assessment of the safety and appropriateness of marijuana within the American workforce. Although studies have suggested that marijuana may be used with reasonable safety in some controlled environments, there are potential consequences to its use that necessitate employer scrutiny and concern. Several drug characteristics must be considered, including Δ-tetrahydrocannabinol (Δ-THC, or THC) concentration, route of administration, dose and frequency, and pharmacokinetics, as well as the risks inherent to particular workplace environments.