MONOGRAPH SERIES #3
Synthetic Solutions: How the U.S. Government Tried to Replace Medical Cannabis with Pills – and Failed
In the late 1970s, a new front opened in the fight over medical cannabis in the United States. The battle was not waged only in courtrooms or state legislatures—it was fought in the pages of the nation’s newspapers, in the laboratories of pharmaceutical giants, and in the back rooms of federal agencies desperate to keep control over marijuana policy.
The story of Nabilone and the Group C release of synthetic delta-9 THC is a textbook case of substitution politics: when confronted with a growing public demand for safe, legal access to cannabis, federal agencies attempted to divert that pressure by promoting synthetic alternatives. This was not simply a scientific endeavor—it was a calculated strategy to undercut the political momentum of the medical marijuana movement.
Phase I: Nabilone – The Great White Hope (1977–1979)
By 1976, the medical marijuana movement had achieved something unprecedented. Robert Randall, a glaucoma patient, won the right to legally use cannabis under the doctrine of medical necessity, shattering the federal claim that marijuana had “no accepted medical use.” His victory inspired others—especially cancer and glaucoma patients—to demand access.
The federal government, caught off guard, needed an answer.
That answer came in the form of Nabilone, a fully synthetic cannabinoid developed by Eli Lilly & Co. Press reports—often glowing and uncritical—began appearing in 1977, touting Nabilone’s promise for reducing chemotherapy-induced nausea and lowering intraocular pressure in glaucoma patients. Federal agencies and Lilly positioned Nabilone as “all the therapeutic benefit of marijuana, without the high,” appealing to a medical establishment wary of smoked cannabis.
From 1977 to 1979, stories in outlets from The Philadelphia Inquirer to the Fort Worth Star-Telegram painted Nabilone as the future of cannabinoid medicine. Early trials suggested effectiveness against nausea, vomiting, and eye pressure, and the drug’s crystalline, water-soluble form made it easier to encapsulate than cannabis resin. It was, in the eyes of policymakers, the perfect substitute.
Phase II: The Collapse (Mid-1979)
Then came the crash.
In June 1979, Eli Lilly halted Nabilone trials after beagle dogs in long-term studies developed fatal neurotoxicity. The news stunned physicians and patients who had been waiting for a legal cannabis alternative. The New England Journal of Medicine criticized Lilly for withdrawing a drug that, in human trials, had helped many chemotherapy patients.
The political implications were severe. Federal agencies had publicly backed Nabilone as their preferred medical alternative to marijuana. Its failure left them scrambling. Meanwhile, state-level medical marijuana research laws were spreading—over a dozen states had passed such laws by year’s end—but the federal government refused to release adequate supplies of cannabis for these programs.
Phase III: A New Substitute – Dronabinol (1980)
With Nabilone dead in the water, the FDA, DEA, and National Cancer Institute (NCI) faced a choice:
Partner with the states to expand research and compassionate access to cannabis, or
Find another synthetic product to fill the gap.
They chose option two.
Enter dronabinol—synthetic delta-9 tetrahydrocannabinol. Initially formulated for animal studies and considered “erratic” by researchers in 1978, it was dusted off in 1980 as the new federal alternative. By January, a coordinated press campaign was under way. Stories across the country began talking about “pot pills” for cancer patients, blurring the line between synthetic THC capsules and smoked cannabis.
This was no accident. Using the term “pot pills” was a deliberate tactic to make the public believe the pill would be as effective as natural cannabis. The federal plan was to distribute dronabinol through NCI’s Group C program, a regulatory pathway allowing early access to promising—but not yet fully approved—drugs.
Phase IV: Group C Rollout and Criticism (1980–1981)
In June 1980, the FDA’s oncology advisory committee narrowly approved the Group C release. Critics, including Robert Randall, called the plan “medically reckless,” warning that the capsules were inferior to inhaled cannabis for controlling symptoms. Cancer patients themselves—like Anne Guttentag, who had experience with both the federal cannabis cigarettes and the new pill—openly mocked the capsule’s weak performance.
By early 1981, only about 75 of a possible 300 cancer treatment centers had signed on to dispense the pills. Patients reported that the capsule took hours to work, was difficult to dose effectively, and caused more side effects than smoking cannabis.
Phase V: Locking in the Manufacturer (1981–1982)
The federal government needed a private-sector partner to produce and distribute dronabinol. After several false starts, they landed on Unimed, a small pharmaceutical company in New Jersey. In mid-1981, Unimed filed for FDA approval to manufacture THC capsules for prescription use. By 1982, the plan was in motion.
That same year, Nabilone re-emerged in Canada under the trade name Cesamet, marketed to cancer patients after Canadian regulators concluded that the earlier beagle toxicity results did not apply to humans. Eventually, Cesamet would be sold in multiple countries, including the U.S., but the American political battle over cannabis had moved on.
Phase VI: Temporary Suppression, Eventual Backlash (1980s–1991)
For several years, the “pot pill” strategy worked—at least politically. It allowed federal agencies to claim they were meeting patients’ needs, deflecting calls for marijuana reform. But as cancer patients experienced the pill’s shortcomings, dissatisfaction grew.
By the late 1980s, a new and vocal patient community—the AIDS movement—picked up the banner for medical cannabis. Accustomed to fighting for their lives and their rights, AIDS activists exposed the pill-for-plant substitution as inadequate and pushed for direct access to whole-plant cannabis.
In 1991, the federal government made another political blunder: shutting down the Compassionate IND program for new applicants, effectively closing the only legal avenue for patients to obtain cannabis. Instead of ending the debate, it reignited it—fueling the modern medical marijuana movement that continues today.
The Pattern
The Nabilone and dronabinol story is more than pharmaceutical history. It’s a case study in how federal agencies manage politically sensitive health issues:
Identify the political threat (in this case, the growing medical marijuana movement).
Offer a controlled alternative that appears to address the need.
Market it aggressively while denying access to the natural option.
Use it to stall reform until political pressure subsides—or until a new patient movement forces the issue back into public view.
For a time, they succeeded. But history shows that when patient needs collide with political agendas, the truth has a way of resurfacing.
Primary Sources: The Monograph #3 Carousel
Below, you’ll find the complete set of period news clippings compiled by Alice O’Leary Randall in MjRx Monograph #3: Synthetic Solutions – Nabilone and the Group C Release of delta-9 THC. These documents, spanning 1977 to 1982, reveal in real time how the strategy unfolded—and how the press framed the story for the public.
Use the carousel controls to scroll through the archive.
Key Dates & Players – Nabilone & Group C THC
1976 – Medical Marijuana Breakthrough
Robert Randall wins the first U.S. legal medical cannabis case (glaucoma), creating public demand for patient access.
1977–1978 – Nabilone Hype Begins
Eli Lilly promotes Nabilone, a synthetic cannabinoid, as “marijuana without the high.”
Federal agencies and major press outlets position it as the future of cannabinoid medicine.
May 1978 – NCI Meeting on Cannabinoids
Nabilone introduced to National Cancer Institute researchers; federal THC described as “erratic” and unsuitable.
1979 – Nabilone Collapse
June: Lilly halts trials after beagle toxicity deaths; New England Journal of Medicine criticizes decision.
Medical marijuana research laws pass in over a dozen states, but federal cannabis supply remains locked down.
1980 – Dronabinol “Pot Pill” Strategy
FDA, DEA, and NCI pivot to synthetic delta-9 THC capsules.
Nationwide press blitz frames capsules as equivalent to cannabis (“pot pills”).
June: FDA oncology panel narrowly approves Group C release; Robert Randall calls it “medically reckless.”
1981 – Slow Rollout & Manufacturer Identified
Only 75 of 300 cancer centers join the Group C program.
Unimed Inc. (NJ) files application to produce dronabinol for prescription use.
1982 – Nabilone Returns – in Canada
Marketed as Cesamet to cancer patients through Canadian treatment centers.
U.S. Group C THC program continues under Unimed production.
Late 1980s – Backlash & AIDS Activism
Cancer patients voice dissatisfaction with “pot pill” efficacy and side effects.
AIDS crisis brings new, organized demands for whole-plant cannabis access.
1991 – Compassionate IND Program Shut Down
Federal government closes program to new patients, sparking renewed advocacy and laying groundwork for modern medical cannabis reform.
Key Players:
Robert C. Randall – First legal U.S. medical cannabis patient; vocal critic of synthetic pill strategy.
Alice O’Leary Randall – Co-founder, Alliance for Cannabis Therapeutics; compiler of MjRx Monograph #3.
Eli Lilly & Co. – Developer of Nabilone; halted trials in 1979.
Unimed Inc. – NJ-based company that produced dronabinol for Group C program.
FDA / DEA / NCI – Federal agencies coordinating synthetic substitution strategy.
Anne Guttentag – Cancer patient and public critic of THC capsule’s performance.
