finalfullthesisdjpotter

Chapter 1 Introduction
followed its use and really established the place of cannabis tincture and cannabis
extract in Victorian medicine.
By the end of the century the medicinal use of cannabis was well enough established
for it to be the subject of a reference in Merck’s Manual (1899). This described
cannabis as a hypnotic sedative and very useful for the treatment of hysteria, delirium,
epilepsy, nervous insomnia, migraine, pain and dysmenorrhoea. General practitioners
continued to prescribe complex cannabis formulations up until the middle of the
twentieth century. Many of the central nervous system indications for which cannabis
was used (analgesic, hypnotic, sedative and antiepileptic) were by then met by the
benzodiazepine group of drugs and analgesics like paracetamol and codeine. While
these guaranteed reliable dose control, it was difficult to obtain a consistent response
to cannabis because of the variable cannabinoid content of the plant material available
(Notcutt, 2004). There were also growing international concerns of social problems
caused by recreational cannabis use. This, and awareness of the adverse effects of
cannabis, finally led to its prohibition in the UK when the UK Government ratified the
1925 Geneva Convention on the manufacture, sale and movement of dangerous drugs.
It did however remain available through pharmacies, until it was completely outlawed
as a medicine by being declared a Schedule 1 substance in the Misuse of Drugs Act
1971. This act also outlawed the production and possession of cannabis for
recreational purposes. Amongst three categories of decreasing seriousness described
in Schedule 1 (A, B and C) cannabis was initially placed in Class B. This indicated that
those caught in possession of a small or moderate quantity for personal use would
likely attract a court fine. Repeat offenders and those supplying moderate quantities of
cannabis would be more likely to be sentenced to a community (i.e. non-custodial
penalty), while those producing cannabis and/or supplying large quantities could be
imprisoned for up to fourteen years. In 2004 the UK Government reclassified cannabis
as a Class C drug, which meant that possession could attract a much smaller
maximum prison sentence. Possession of small quantities would be more likely to
attract a police fine, without the offender needing to attend a Magistrates Court. In
2009, contrary to scientific advice from the Advisory Council on Misuse of Drugs,
cannabis was reclassified as Class B (ACMD, 2008).
Despite its continuing prohibition, in the last twenty years in the UK, an increasing
number of patients with severely debilitating diseases such as multiple sclerosis have
used illicit cannabis to obtain symptom relief (Whittle, 2004). Smoking cannabis for
recreational or medicinal reasons in the UK was almost unknown until the 1950s,
although recreational cannabis smoking had become common a decade later (Robson,
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