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Marijuana: From Reefer Madness to THC Gummy Bears

No substance better exemplifies the ambivalence of Western societies toward psychoactive drugs than marijuana. In 2017, it was estimated that there were more than 22 million current users, about 6.7% of the adult population, in the United States. For those aged 18 to 25, the figure was nearly 20%. In the United Kingdom, the prevalence of recreational use of marijuana among males aged 16–34 was put at 15.5%. Despite its widespread acceptance, many regard marijuana as a serious drug of abuse which, if set free, will destroy the fabric of our society. Others see it as one of God’s gifts to humankind and regularly call for its legalization for medical use. By 2018, the United Kingdom and 40 other countries had heeded that call. In the United States, medical marijuana has been approved in 30 states and the District of Columbia with more sure to follow. Going further, recreational use is allowed in 10 of those states. Nonetheless, marijuana possession continues to be illegal under federal law in the United States, and some physicians have been threatened with loss of their licenses for advocating medical marijuana. In 2015, combined state and federal laws led to more arrests for possession of small amounts of marijuana than those for all violent crimes combined. The word marijuana (or the alternate spelling marihuana) does not appear in American medical texts of the 19th century. Instead, the term cannabis referred to flowering tops of the female plant of Cannabis sativa. At that time, while millions of persons in Asia and Africa habitually indulged in cannabis as an intoxicant, cannabis was little used for that purpose in this country. In this chapter, I will use the term “cannabis” to refer to any active material derived from Cannabis sativa and Cannabis indica, the two species—some say subspecies—of the plant. Today’s controversies surrounding “medical marijuana” often ignore its long history in European and American medicine. Beginning in 1850, Cannabis indica and several extracts of the plant were listed in The United States Pharmacopeia, an official compilation of medically useful drugs.