Medical Cannabis and Cannabinoids

In 2020, the global cannabis market was valued at US$20.5 billion, with most of that coming from the recreational industry. But another big part of it comes from the medical side. As science and legalization advances in more and more territories around the world, medical applications of cannabis are increasing, along with social acceptance of this plant.

The history involving cannabis and medicine has at least 5,000 years in the making. In the year 2900 B.C., the Chinese Emperor Shen Nung was already researching cannabis for medical purposes, he is credited by many historians as the first to prescribe marijuana tea for the treatment of gout, rheumatism, malaria and even bad memory. The earliest written reference about medical cannabis is found in the 15th century B.C. Chinese pharmacopeia.

Many civilizations have used cannabis for medical purposes: Egyptians in Africa, Vedas in India, even the royal physicians for Queen Victoria used cannabis. Up until the start of the prohibition era, many doctors used cannabis as a common remedy for insomnia and many other illnesses. Now, science has told us why cannabis has medical properties.

Thanks to scientists like Dr. Raphael Mechoulam, we know about cannabinoids; for example, Delta-9-Tetrahydrocannabinol, better known as THC, the most abundant and the one that produces psychoactive effects. But we also know about other cannabinoids, such as cannabidiol or CBD, cannabigerol or CBG. These are the active ingredients in cannabis. Science has described 114 different cannabinoids along with other substances like terpenes, which give cannabis its peculiar flavor and smell.

When all of these substances, cannabinoids and terpenes work together they are more potent, which is called the entourage effect. Thanks to technical advances, we now have isolated cannabinoids and even synthetic varieties. The US Food and Drug Administration has approved four cannabis-derived drugs, one plant-derived — Epidiolex (cannabidiol) — and three synthetic cannabis-related products: Marinol (dronabinol), Syndros (dronabinol) and Cesamet (nabilone), all chemical analogues of CBD or THC. It’s important to differentiate between approved drugs, herbal remedies and cosmetic products.

In places where cannabis is legal, the market is rife with a variety of products infused with THC, CBD and full-spectrum extractions but only four products are considered medicinal. North America accounts for the largest share of the medical market, with Europe closely following as the fastest-growing market. This is because of the variety of illnesses for which cannabinoids have scientifically demonstrated to be auxiliary and complementary treatments, such as for Alzheimer's, ALS, cancer, Crohn's disease, epilepsy, seizures, hepatitis C, AIDS, glaucoma, multiple sclerosis, posttraumatic stress disorder, chronic pain or severe nausea.

Let’s think about potential. According to the World Health Organization around 4 percent of the global population consumes cannabis recreationally. Only taking in account the legal revenue, it was over US$2 billion. Estimates suggest that 20 percent of adults suffer from pain globally and 10 percent are newly diagnosed with chronic pain each year. If cannabis were to become a viable option for pain treatment around the world, it could potentially reduce the consumption of opioids and other painkillers that right now are causing health problems.  

This is not the only case; cannabis can also improve the quality of life for geriatric patients. The therapeutic use of cannabis is safe and efficacious in the elderly population and could help decrease the amount of prescription medications they have to use daily for the chronic and degenerative diseases that come with age.

Due to the nearly 100 years spent in prohibition, research for its medical properties is fertile territory for the development of pharmaceutical patents. In Mexico, medical cannabis was legalized in 2017 but there were no clear rules, so the industry couldn’t start operations. Four years later, in January 2021, Mexico’s Health Department finally published the rules but with an unclear law. It won’t be easy for this industry to begin generating revenue.

According to the German statistics site Statista, Mexico’s market value for medical cannabis in 2018 was US$47.3 million. It is forecasted to reach more than US$1.3 billion by 2028 but there has to be an acting industry to achieve this.

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