Cannabis Roots: How North American Healthcare Led to Sickcare and the Current Cannabis Quagmire
Parts of this article were created in partnership with the Association for Cannabis Health Equity in Medicine. For more information about ACHEM, please visit the ACHEM website at www.achemed.org
Whether it is called weed, ganja, hemp, or marihuana, and whether we realize it or not, they are all genetically the same plant. For the intents and purposes of this publication, we will refer to the plant at large as cannabis.
The cannabis plant has been utilized as medicine for thousands of years. Yet, under current federal United States law, cannabis still remains an illegal substance today (federally illegal, no matter what we may hear people, investors, and companies claiming). However, the cannabis industry does reserve varying levels of legality across the United States and its territories, whose often-named “marijuana” programs are able to operate via statements made through the Department of Justice and their specific instructions to not prosecute states that have such laws – creating an unstable and complicated ground for the industry and its advocates on multiple counts, to say the least.
The million-dollar question: How did a globally-utilized therapeutic plant traverse from being used as mainstream, first-line therapy and medical treatment for a myriad of ailments to a being a substance with not only ‘no approved medical use’, but one that developed such bloated social stigma and vitriol – all without a single death or disease documented from its application?
With this primer, we attempt to answer this question by outlining the following:
A brief history of cannabis as a wellness tool and as a therapeutic medicine
Why cannabis has been wrongly slandered and outlawed in the U.S.
Monumental, parallel events which contributed to – and still contribute to – the mainstream dismissal of cannabis and other integrative practices as first-line therapy by the majority of allopathic and western medical professionals
It wasn’t the properties of the plant that have led to cannabis’ mainstream stigmatization, but rather a country ripe with fear and, most importantly, bureaucratic self-interest looking to benefit from such stigmatized branding.
First Thing’s First | Prehistoric Plant Medicine
The plant’s pharmacological chronology begins as early as 2700 BCE when Shen Nong Ben Cao Jing noted the plant as having “hallucinatory, appetite stimulation, tonic, and anti-senility effects”. Citations of its use since include, but are not limited to, treatment for:
Ancient Sumeria and Akkadia, ~1800 BCE
Epilepsy
Grief
Neuralgia
pediculicide (treatment of body mites/lice)
Egyptian texts, ~1500 BCE
Vaginal contractions
Eye conditions
13th-century Codex Vindobonensis
Breast swelling and pain
Shaping the Future | Turn-of-the-Century North American Healthcare
In the United States, cannabis was widely prescribed during the 19th and 20th centuries. In fact, it was listed as a medicine in the United States Pharmacopeia-National Formulary (USP-NF) until as recently as 1942. The USP-NF is an official medical publication that sets standards for all over-the-counter and prescription medications. It is published by the United States Pharmacopoeia (USP), a public policy organization “dedicated to helping improve global health through standards setting in compounding, biologics, pharmaceutical manufacturing, and other fields.”
The first USP monograph concerning cannabis was published in 1850, and two additional monographs were created in 1916 and 1936. “Extractum Cannabis” was listed as a treatment for over 100 different conditions including alcoholism, cholera, convulsive disorders, gout, insanity, leprosy, menstrual cramps, opiate addiction, rabies, tetanus, and typhus, to name a few. Recommendations for its use continued until its forced removal (after the passage of the Marijuana Tax Act.)
Meanwhile, in 1910, an educator named Abraham Flexner, who had never set foot into a medical school, published a substantially influential, richly funded, strategic, and cornerstone report of medical education which proclaimed and established a German-style, hyper-rational, pedagogic, and research-focused approach to patients as the gold standard of medical education in North America. This resulted in the definitive ethos of the model we know today in North America as ‘conventional medicine’. In this report, Flexner attacked all integrative medicine and healthcare systems as “nontraditional and charlatan”.
Solidified in an age of social and political reforms, including education, the Flexner prototype contributed to 100+ years of subsequent health inequity in the United States, born from intrinsic and extrinsic racism (in this case, directed specifically toward Black and Jewish people).
According to the Yale Journal of Biology and Medicine, the Flexner standard recommendations problematically set North American medical educational modeling on a German-based course, overly inflated with live laboratory research and extremely focused on scientific discovery. Arguably, this created excellence in science; however, it proved neglectful of any comparable excellences in beneficent healing and clinical care. The current environment, reflecting the U.S. physician’s loss of authenticity as a trusted healer, can be directly credited to the espousal of such ‘gold standard’ doctrines. These standards, in turn, precipitated our current acute-care-based model which, while widely considered second to none for infectious disease and physical trauma, do not address any form of wellness or the maintenance thereof.
It is believed that the Flexner report set back American healthcare by over a century and served as a watershed, especially when viewed through the lens of plant medicine. The report and its aftereffects paved the way for ancient remedies such as cannabis to be vilified and to justify the maltreatment of races and cultural groups across the nation. As stated in Evidence-Based Complementary and Alternative Medicine by Frank W. Stahnisch and Marja Verhoef:
“… treatment is not an isolated event in patients’ lives, but it takes part in [their] own bio-psycho-social context, which includes social networks, patients’ subjective experiences, and their mental health status, along with the patient-provider relationship (a system). These elements are crucial to testing an intervention, as a patient is not an average patient, with average beliefs, devoid from any contextual influences”
There’s the Rub | 1930’s and 1940’s
In 1931, Harry Anslinger was appointed as the first commissioner of the Federal Bureau of Narcotics. He spent his three-decade tenure capitalizing on the already prejudiced views of the American public by spreading falsified, viral, and racist horror stories of cannabis consumers compromising America. Anslinger connected cannabis use with what he framed as – and American society accepted as – “outsider culture,'' which included Mexicans, Malays, Indians, and Persians. After the Spanish-American War, negative American sentiment regarding Hispanic culture(s) had been growing exponentially. The Mexican Revolution (1910-1920) brought many Mexican immigrants across the border due to fear of their own government. In Mexican (and other) culture(s), cannabis’ longstanding utilization had been widely incorporated into medical and entheogenic practices, and its continued application in many contexts intensified the derogatory racial views that white Americans harbored toward immigrants of color. Newspapers across the nation baselessly portrayed these immigrants as uncontrollable and engaging in behaviors such as property crimes, murder, and seduction of children.
Similar prejudices can be traced and observed towards the African-American community in the New Orleans jazz scene and tied with cannabis’ popularity in said musical communities. Anslinger (along with other powerful politicians at the time) despised African-Americans. Jazz culture was connected to cannabis repeatedly and publicly through images of the “demented, knife-wielding, half-crazed hashish user running senseless through the streets, slashing at anyone to cross his path.”
Anslinger capitalized on opportune American fear, insecurity, and misinformation to successfully drive public support for himself while singling out cannabis as a way to specifically criminalize Mexican immigrants, African-Americans, and virtually anyone seen as “non-White”. These punitive measures were not only a catalyst for eventually stricter federal cannabis legislation, but worked synergistically with the 13th Amendment to systematically disable, disarm, and handicap the American Black population. States across the US began to fall in line, banning cannabis and furthering/emboldening maligned perceptions of racial connections.
As states created their own restrictions on cannabis, political influence and citizen unrest began to push federal government laws toward national cannabis prohibition. Anslinger used this time of social, political, and economic unrest to capitalize on a weakness in the medical community. The American healthcare industry was struggling with a newly isolated concern: patient safety. Various laws were being passed to regulate and standardize food, drugs, and other ingestibles under the guise of protecting the consumer. With the passage of the Marijuana Tax Act in 1937, Anslinger proved successful in using his political position to influence Congress to criminalize cannabis. While the Act didn’t outlaw possession of cannabis, it made access incredibly difficult. Several regulations, including astronomical fees and fines for its importation, were put in place as a foundational and foreshadowing federal step. As goods were inspected, strict regulations had to be met. Perhaps most crushingly, education and research regarding the plant’s medicinal and therapeutic properties were stifled due to such exorbitant fees around not only its purchase but the subsequent attainment of required research approval (an obstacle that is currently still in existence). In 1941, cannabis was forthwith removed from the USP-NF.
A Few Good Men | Mid-Century Cannabis in North America
A contemporaneous and anti-prohibition movement, this time resisting recent changes in cannabis legislation, was led by former New York City mayor Fiorello La Guardia. In partnership with The New York Academy of Medicine, he put together a commission that produced The La Guardia Committee Report: The Marihuana Problem in the City of New York (1944), which directly countered the Bureau of Narcotic’s propaganda. The New York Academy of Medicine issued the report, stating, “marijuana was not addictive, [...] use was not motivating major crimes, and that use among children was not common. [...]The publicity concerning [...] marijuana smoking in New York City is unfounded.”
Anslinger hushed and publicly discredited the commission’s report, calling it “unscientific”. In 1945, he decided to commission his own report by the American Medical Association in order to support his agenda. Sadly and imminently, the AMA administration glossed over basic evidence-based findings, and instead indulged Anslinger’s morally bankrupt socio-political agenda.
Almost two decades later, John F. Kennedy signed an executive order directly involving cannabis research, which came up with similar findings to the LaGuardia Report. Devastatingly, and as a result of having arrived at the White House only days before his assassination, it never received proper notoriety or publication.
The War on Drugs’ Global Influence | 1970’s
Sadly, and in place of that morosely aborted version of political history, Nixon took office in 1969 and utilized the War on Drugs as a key factor in his well-known “Southern Strategy”: to vilify racial minorities. Nixon capitalized on and cultivated Anslinger’s output, propagating the foundation of unsubstantiated White American fears that variegated the early twentieth-century racist narrative.
Simultaneously, the U.S. was forced to deal with an out-of-control opium trade. Americans were all too willing to believe the rhetoric about cannabis, so pairing doctored and rancorous images of cannabis practitioners with equally pejorative and racist imagery killed two birds with one stone for the Nixon administration. They used the Supreme Court case Leary v. United States to launch The War on Drugs, which culminated in the passage of the Controlled Substances Act (CSA) in 1970. Passage of the CSA was the legal criterion Nixon needed to push the rest of his mission forward. Under his tutelage, the Drug Enforcement Agency (DEA) labeled cannabis as a Schedule 1 substance under the CSA, which has five (5) Schedules. Schedule 1 is the most dangerous designation, and reflects three things about a substance:
there is no currently accepted medical use;
there is a lack of accepted safety information, and
there is a high potential for abuse of the substance
The CSA established the National Commission on Marihuana and Drug Abuse, which would put together a new report. Nixon personally selected 9 of its thirteen members. He named his friend, Raymond Shafer, and former Pennsylvania Gov. (R), as the chairman of the commission. The final report, Marihuana: A Signal of Misunderstanding was published in 1972, and it was not what Nixon had expected. Interestingly, and to the amusement of activists everywhere, the report’s findings aligned with LaGuardia’s report – directly opposing Nixon’s earlier and current policy choices, and even questioning cannabis’ connection to increased crime levels – decidedly challenging the cost-benefit ratio of criminalization. The report laid into question Nixon’s assumptions about the use of his War on Drugs as a primary political platform – strategies that he had specifically commissioned it to uphold. While the report explicitly opposed the legalization of cannabis, it stated that “marihuana use is not such a grave problem that individuals who smoke marihuana, and possess it for that purpose, should be subject to criminal procedures.”
A capable and deserving leader would have listened to evidence-based data and industry experts. Nixon chose to dismiss and publicly shame his own self-commissioned report in a similar fashion as his predecessors. This provided the movement with all the fuel needed to support his party’s fear-based rhetoric and ultimately help get him re-elected in 1972, continuing the War on Drugs into his second administration.
Nixon’s White House counsel, John Ehrlichman, has recently and publicly uncovered this hard truth, stating explicitly that Nixon’s drug policies were racially motivated: “The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people,” former Nixon domestic policy chief John Ehrlichman told Harper’s writer Dan Baum for their cover story:
“You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course, we did.”
The scheduling of cannabis by the CSA, along with several amendment proposals by the United States, built upon the dubious entrance of cannabis into the global drug control system by the United Nations (again relying on personal opinions of few, instead of expert positions), and paved the way for even more restrictions within the 1972 Protocol amending the original convention.
Wait – How Did We Get Here? | Present-Day Cannabis
In 2003, the United States US Department of Health and Human Services (HHS) was issued a patent by the United States Patent and Trademark Office for cannabis' neuroprotective and antioxidant properties, which can be helpful in the treatment of multiple diseases. This hypocritical schism harbors HHS on one side, holding the patent; on the other reside multiple federal regulatory bodies insisting that cannabis has no acceptable medical use (DoJ, DEA, FDA, USDA, etc). The United States government has continued to display conflicting and contradictory actions through a multitude of federal agencies and departments, providing a clear context for generic, obvious, and infinite dysfunction.
In 2016, a Cannabis Expert Panel organized through the USP formed a technical working group, which supported the revival and restoration of the USP monograph. The product of their work can be accessed in the Journal of Natural Products, which outlines their project, detailing all tests and specifications that can someday reappear in a revived USP cannabis monograph. Because of its current, though scientifically unfounded, yet presently incontestable, Schedule 1 designation within the CSA, it was decided by the Cannabis Expert Panel that the information regarding cannabis’s many benefits would not be published as the standard reference for USP-NF until there was federal regulation in its regard (e.g. removal from CSA as a Schedule 1 drug).
Cannabis prohibition was successful – in North America and by proxy, globally – because it took advantage of a vulnerable environment at the right place at exactly the right time. The moment was ripe for a scapegoat industry, particularly one involving drugs and a message that produced a false feeling of safety among American voters. As an added bonus for politicians and industrialists, its prohibition shaped and drove a century of success in specific industries such as alcohol, tobacco, pharma, textiles, and general agriculture.
The effects of cannabis prohibition were so invasive and pervasive in North America and by proxy, globally, because it took advantage of a vulnerable environment at the right place at exactly the right time. The moment was ripe for a scapegoat industry, particularly one involving drugs and a message that produced a false feeling of safety among American voters. As an added bonus for politicians and industrialists, its prohibition shaped and drove a century of success in specific industries such as alcohol, tobacco, pharma, textiles, and general agriculture.
What’s Going On Currently? | Meet 21st-Century Cannabis
In 2020, ahead of anything the United States has completed or even equitably discussed within over a century, the UN Commission on Narcotic Drugs reclassified cannabis to recognize its real and potential therapeutic uses.
In 2022, facing midterm-heavy opposition and growing pressure as more and more states (and voters) decide that prohibition has been nothing but a racket, President Joe Biden (D) made a statement pandering to the cannabis industry listing three “priorities”:
Announced mass pardon for past federal cannabis convictions
Encouraged state governors to follow suit
Instructed the Secretary of HHS Xavier Becerra and current AG Merrick Garland to “review the classification schedule of marijuana”
Some view this statement as a message to big pharma, tobacco, and alcohol companies eyeing the burgeoning industry to get their financials ready to pounce. Organizations, corporations, and activists are falling on both sides of the issue. Will cannabis be controlled by the pharmaceutical companies lobbying for their slice of the pie (let’s be real - all of the pie)? Will it be controlled by alcohol or tobacco giants? All three? Will our representatives open eyes and ears to medical practitioners and traditional healers? It’s an exciting and stressful time. There are many bills federally and in all states regarding cannabis’ future in the United States. Stay tuned!
Sick of the racket? Get involved.
Register to vote or check your current registration – headcount.org
Join the Association for Cannabis Health Equity and Medicine (ACHEM) or donate to the ACHEM Freedom Initiative – because no one should go to prison for using medicine
Check out the latest reports and model policies of the Parabola Center
Support cannabis as medicine through Americans for Safe Access – or Discover your state’s official cannabis grade with their annual State of the States Report
Visit the Alliance for Sensible Markets to find out why interstate commerce in cannabis doesn’t have to wait for federal legalization
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