Medical cannabis refers to the use of the drug Cannabis as a physician-recommended herbal therapy, most notably as an antiemetic. The term medical marijuana post-dates the U.S. Marijuana Tax Act of 1937, the effect of which made cannabis prescriptions illegal in the United States.

Due to widespread illegal use of cannabis as a recreational drug its legal or licensed use in medicine is now a controversial issue in most countries.

Early studies on efficacy

New Mexico

Approved by the Food and Drug Administration, the study included 250 patients and compared smoked cannabis to oral THC. All participants were referred by a medical doctor and had failed to control vomiting using at least three alternative antiemetics. Patients chose smoking cannabis or taking the THC pill. Multiple objective and subjective standards were used to determine the effectiveness.

* Conclusion: cannabis is far superior to the best available drug at the time of testing, Compazine, and smoked cannabis is clearly superior to oral THC. "More than ninety percent of the patients who received cannabis ... reported significant or total relief from nausea and vomiting." No major side effects were reported, though three patients reported adverse reactions that did not involve cannabis alone. The report can be read here.

Tennessee

27 patients had failed on other antiemetics therapies, including oral THC.

* Conclusion: 90.4% success for smoked cannabis; 66.7% for oral THC. "We found both marijuana smoking and THC capsules to be effective antiemetics. We found an approximate 23% higher success rate among those patients administered smoked marijuana. We found no significant differences in success rates by age group. The major reason for THC capsule failure was nausea and vomiting so severe that the patient could not retain the capsule."

California

A series of studies throughout the 1980s involved 90–100 patients a year. The study was designed to make it easier for patients to enter the oral THC part of the study. Patients who wanted to smoke cannabis had to be over 15 years old (oral THC patients had to be over 5) and use the drug only in the hospital and not at home. Smoked cannabis patients also had to be receiving rare and painful forms of chemotherapy to qualify.

* Conclusion: Despite the bias towards oral THC, the California study concluded that smoked cannabis was more effective and established a safe dosage regimen that minimized adverse side effects. The full text of the study can be seen here.

A Vapor-Bong for use with medicinal herbs prescribed by a physician. A Vapor-Bong for use with medicinal herbs prescribed by a physician.

Georgia

119 patients that had failed using other antiemetics were randomly assigned to oral THC pills and either standardized or patient-controlled smoking of cannabis.

* Conclusion: All three categories were successful — patient controlled smokers at 72.2%; standardized smokers at 65.4%; oral THC at 76%. Failure of oral THC patients was due to adverse reaction (6 out of 18) or failure to improve (9 out of 18); failure of smoking cannabis was due to intolerance for smoking (6 out of 14) or failure to improve (3 out of 14).