Several pharmaceutical drugs based on cannabis, in purified and standardized form, have been made available for medical use. However, the use of herbal cannabis in medicine remains highly controversial, in part because of the lack of standardization among products to ensure safe and consistent dosing and in part because of disagreement over legalization. In the United States, for example, while the cultivation, possession, and consumption of cannabis is illegal, some states have enacted laws that legalize the use of herbal medical cannabis specifically. Likewise, while the use of herbal medical cannabis is permitted in some European countries, it is illegal in the United Kingdom. The latter does, however, permit the prescription of a cannabis-based drug known as nabiximols (Sativex).
Despite the legal issues, researchers and drug companies continued to investigate and develop herbal cannabis products. For instance, a standardized cannabis product known as CanniMed was developed for medical use in Canada under Health Canada’s Medical Marihuana Access Regulations (MMAR), which were enacted in 2001. The cannabis plants cultivated for CanniMed are grown under carefully controlled conditions, and the drug is standardized to contain approximately 12.5 percent THC. A similar approach has been taken in the Netherlands, where several herbal cannabis products are available, including Bedrocan (19 percent THC) and Bedrobinol (12 percent THC).