Cannabis is one of the world’s oldest medicines, but doctors are still challenged by cannabis potency variability and unpredictable patient reactions.
By the 1890s the medical use of cannabis went into decline overpowered by to two therapeutic innovations. The hypodermic syringe for the delivery of soluble drugs by injection for fast pain relief. Bayer’s aspirin was effective without the risk of addiction. Both made the doctor’s work easier and patient satisfaction rose.
Still, as much as 80% of the world’s population use medicinal plants as primary medicines. Unsurprisingly, when legalization took off, it was driven by medical cannabis backed by a popular perception that the plant is a universal remedy. It is believed that about 1.2 billion  people suffer from a medical condition treatable by cannabis.
Nevertheless, the challenges which doctors faced over a century ago continue to overshadow medical cannabis treatment. It is overwhelmingly based on anecdotal evidence, not proper clinical trials. Consequently, the prevailing medical practice for dosing is to “start low and go slow”, starting with CBD formulations before slowly introducing and increasing THC levels in line with patient feedback and needs. It takes as much as six months to get a patient on the right dosing by following this trial-and-error protocol. These are months of added healthcare costs, poor quality of life for patients, including excessive exposure to higher risk alternatives, such as highly addictive opiates.Additionally, effective treatment is not all about THC and CBD. Cannabis has hundreds of active compounds interacting with each other. We lack much needed knowledge about the synergy between these compounds, often referred to as the entourage effect, and their impact on specific health conditions and the individual needs of patients. Scientists may one day decipher the mysteries of cannabis and identify the therapeutic benefits of specific molecules. The development of a new pharmaceutical drug, however, takes years, costs can spiral over $ 2.5 billion and the approval rate for entering clinical development is less than 12%. It could take years, if not decades, for cannabis products to significantly impact modern mainstream medicine.

In meantime, for the wellbeing of patients worldwide, as well as to ensure regulatory support, producers must strive to deliver high quality products. Labels need to be accurate so that doctors and patients trust medical cannabis products and brands. Therefore, companies need to adhere to good manufacturing processes, including the adoption of comprehensive in-house testing protocols to ensure product safety, quality and consistency. Otherwise, we may witness a repeat of the 1890s.