A 1997 Review Supported Pharmaceutical THC for Nausea and Appetite but Opposed Prescribing Raw Marijuana
After reviewing 21 years of research, the authors supported using pure THC formulations for chemotherapy nausea and appetite stimulation but concluded that evidence did not support reclassifying crude marijuana as a prescribable medicine.
Quick Facts
What This Study Found
Following the passage of ballot initiatives in California and Arizona making marijuana accessible to patients, the authors reviewed all relevant research from 1975 to 1996 on medical applications of THC and marijuana.
The evidence supported selective use of pure THC preparations for two conditions: nausea associated with cancer chemotherapy and appetite stimulation. Evidence was less convincing for glaucoma and spinal cord spasticity.
However, the authors drew a sharp distinction between pharmaceutical THC and crude marijuana. They cited THC toxicity delivered in any form while supporting its clinical use, and concluded that the evidence did not support reclassifying crude marijuana as a prescribable medicine. They argued for the pharmaceutical pathway (pure, standardized compounds) over the herbal one.
Key Numbers
Twenty-one years of research reviewed (1975-1996). Two supported therapeutic applications: chemotherapy nausea and appetite stimulation. Two insufficient applications: glaucoma and spasticity.
How They Did This
Literature review of research published between 1975 and 1996 on medical applications of delta-9-THC and crude marijuana, covering nausea, glaucoma, appetite stimulation, and spasticity. Legal precedents were also reviewed.
Why This Research Matters
Published in the Annals of Internal Medicine at a pivotal moment when two states had just passed medical marijuana ballot initiatives, this review represented a mainstream medical position that supported therapeutic cannabinoids but opposed crude marijuana prescribing. This distinction between "medicine" and "marijuana" shaped the medical establishment's response to the growing medical cannabis movement.
The Bigger Picture
This review captures a position that has become less common over time. As more states legalized medical marijuana and whole-plant products demonstrated utility that single molecules did not fully replicate (the "entourage effect"), the sharp distinction between pharmaceutical THC and crude marijuana became more contested.
What This Study Doesn't Tell Us
The review was explicitly positioned against crude marijuana reclassification, which may have influenced the framing of evidence. Published before the wave of clinical trials on whole-plant cannabis that followed state legalization. The "toxicity" framing did not include comparison with other approved medications' risk profiles.
Questions This Raises
- ?Has subsequent evidence changed the case for crude marijuana as medicine?
- ?Does whole-plant cannabis offer advantages over pure THC that this review did not consider?
- ?How has the medical establishment's position evolved since 1997?
Trust & Context
- Key Stat:
- Evidence supported THC for nausea and appetite but not crude marijuana as prescribable medicine
- Evidence Grade:
- A narrative review in a prestigious medical journal. Authoritative synthesis but reflecting a specific policy position that has been contested by subsequent evidence.
- Study Age:
- Published in 1997, shortly after California and Arizona passed medical marijuana ballot initiatives. The medical cannabis evidence base has expanded enormously since.
- Original Title:
- Medicinal applications of delta-9-tetrahydrocannabinol and marijuana.
- Published In:
- Annals of internal medicine, 126(10), 791-8 (1997)
- Authors:
- Voth, E A, Schwartz, R H(3)
- Database ID:
- RTHC-00063
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Did the review support medical cannabis?
It supported pharmaceutical THC (like dronabinol) for chemotherapy nausea and appetite stimulation, but opposed reclassifying crude marijuana as a prescribable medicine.
What conditions had evidence?
Nausea from chemotherapy and appetite stimulation had the strongest evidence. Glaucoma and spasticity evidence was considered insufficient.
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Cite This Study
https://rethinkthc.com/research/RTHC-00063APA
Voth, E A; Schwartz, R H. (1997). Medicinal applications of delta-9-tetrahydrocannabinol and marijuana.. Annals of internal medicine, 126(10), 791-8.
MLA
Voth, E A, et al. "Medicinal applications of delta-9-tetrahydrocannabinol and marijuana.." Annals of internal medicine, 1997.
RethinkTHC
RethinkTHC Research Database. "Medicinal applications of delta-9-tetrahydrocannabinol and m..." RTHC-00063. Retrieved from https://rethinkthc.com/research/voth-1997-medicinal-applications-of-delta9tetrahydrocannabinol
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.