top of page

The Road to Medical Marijuana

Updated: May 15, 2020

An introduction into the vast and complex world of alternative medicine


Theme: Ethics and Controversy


Carlotta Ceccarelli

“Cannabis is becoming increasingly understood that it is a very interesting and versatile medicine with much less toxicity than some of the pharmaceutical products it replaces.”

- Dr.Lester Grinspoon (Associate Professor Emeritus of Psychiatry at Harvard medical School) [1]


Terms such as ‘Alternative medicine’ or ‘Medical marijuana’ are almost unheard of in the realm of Islamic nations around the world. In cultural societies like that of Malaysia, the implications of cannabinoids are often presumed as no more than remedial; people are tight-lipped when it comes to modern innovation or potential research surrounding this topic. Like many countries, cannabis is illegal in Malaysia. However citizens as for example Amiruddin Nadarajan Abdullah are being charged the death penalty for using cannabis as means to cope with chronic disease and debilitating circumstances [2]. This is all despite the fact that offenses regarding drug trafficking do not even meet the threshold of “most serious crimes”, according to the international Dangerous Drugs Act 1952 [3]. This article will be outlining the unestablished upshots as well as the benefits of introducing ‘medical marijuana’ into society today.


There is a forgotten world of medicine hidden behind marijuanas reputation, deriving from the earliest of physicians from respected eras such as the medieval islamics, ancient Egyptians and ancient Greeks. Antiemetic, anti-inflammatory and antipyretic properties have been recorded in history as medication a myriad of times. Yet as of today in the 21st century, it is puzzling to say we have discarded nearly all of its medical associations and exchanged it for an almost spiritual and intangible connotation. Early doctors found its juices to heal the constipated, where its flowers were used for menstrual disorders and its leaves were utilized as dress wounds [4].


There was an untold amount of treatments, so why does it remain so ill-founded in the present day?


At the moment, the FDA has approved of the drugs Dronabinol and Nabilone [5]. These drugs are man-made forms of marijuana, used as a treatment for nausea and vomiting caused by dreadful cancer treatments such as chemotherapy. In addition to this, Epidiolex has been approved as well- a concoction of CBD cannabinoid which treats seizures in two of the most common epileptic syndromes [6]. However it is understood that both forms of medication hamper with signals sent to the brain, alters ion levels and decreases cerebral inflammation, and this is where its alleged relationship with psychosis begins.

Despite having the international Dangerous Drugs act state that regular usage of marijuana is quite benign, there is tentative evidence supporting the fact that its prolonged exposure (medical or recreational) in adolescence can trigger episodes of psychosis. Consistent stigmatisation surrounding mental illnesses, such as schizophrenia, is dangerously influential when set side by side with the uncertainty of up to the minute discoveries [7]. For many, a ‘maybe’ is just not good enough, false acclamations can be the primary reason for deterioration amongst these types of patients. Studies have shown that only the THC cannabinoid is what may allude to the progression of psychosis, this is not the cannabinoid present in most medicinal treatments. CBD on the other hand, was found to actually inhibit this process [8]. Because of this misconception, particularly for asian sociocultural contexts like ours, psychiatric stigma is still very real; concepts such as mental health problems symbolising violence and temporary phases still habitually linger much more than we may realise.


Another misconception, which is often infiltrated in curative circumstances, would be the equitable idea that marijuana is a threatening gateway drug. However the real gateway comes much earlier: cigarettes. Studies show that children smoking tobacco below the age of 15 years old were 80% more likely to use illegal drugs than those who didn’t. There is a trend in people who abuse illegal drugs- trauma, substandard childhoods, depression and genetics. For a Malaysian population where approximately 23% are avid tobacco smokers [9], is such a severe punishment death for obtaining marijuana rational? The real question is whether we should be striving for rehabilitative means.

Prohibition or reintroduction of drugs such as marijuana remains a highly sensitive topic, but one thing that can be deduced is that the implementation of any drug during development is disadvantageous as far as we know. Prohibition is the secret ingredient to making the drug all the more potent and strong, even for the logistics such as increasing THC content so that dealers can distribute ‘pure’ forms in a smaller space for better profit. Legislation could mean for more regulators, calling forth substances with a higher CBD content. However while marijuana remains illegal in the vast majority of countries, funding and sufficient research for its potential benefits and effects remain mostly unknown.


For more information on the science behind what was mentioned, please have a read through my Literature Review:



Glossary:

  • Cannabinoids- any of a group of closely related compounds which include cannabinol and the active constituents of cannabis.

  • Antiemetic- (chiefly of a drug) preventing vomiting.

  • Anti-inflammatory- (chiefly of a drug) used to reduce inflammation.

  • Antipyretic- (chiefly of a drug) used to prevent or reduce fever.

  • Psychosis- a severe mental disorder in which thought and emotions are so impaired that contact is lost with external reality.

  • FDA- (in the US) Food and Drug Administration.

  • CBD- It is one of 113 identified cannabinoids in cannabis plants and accounts for up to 40% of the plant's extract.

  • Schizophrenia- a long-term mental disorder of a type involving a breakdown in the relation between thought, emotion, and behaviour, leading to faulty perception, inappropriate actions and feelings, withdrawal from reality and personal relationships into fantasy and delusion, and a sense of mental fragmentation.

  • THC- tetrahydrocannabinol, a crystalline compound that is the main active ingredient of cannabis. It is what causes the psychoactive effects and is often used recreationally.



References:


1. Chronic Relief. 2014. Quote By Dr. Lester Grinspoon. [online] Available at: <https://mychronicrelief.com/quote-dr-lester-grinspoon/> [Accessed 11 April 2020].

2. Wikipedia. 2020. Cannabis In Malaysia. [online] Available at: <https://en.wikipedia.org/wiki/Cannabis_in_Malaysia> [Accessed 11 April 2020].

3. Amnesty International. n.d. Death Penalty Abolition. [online] Available at: <https://www.amnesty.my/abolish-death-penalty/> [Accessed 11 April 2020].

4. Wikipedia. 2020. History Of Medical Cannabis. [online] Available at: <https://en.wikipedia.org/wiki/History_of_medical_cannabis> [Accessed 11 April 2020].

5. Drugabuse.gov. (2019). Marijuana as Medicine. [online] Available at: https://www.drugabuse.gov/publications/drugfacts/marijuana-medicine [Accessed 11 April 2020].

6. Devinsky, O., Cilio, M. and Cross, H. (2014). Cannabidiol: Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. PMC, [online] pp.791-802. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707667/ [Accessed 11 April 2020].

7. Garey, J., n.d. Marijuana And Psychosis. [online] Child Mind Institute. Available at: <https://childmind.org/article/marijuana-and-psychosis/> [Accessed 11 April 2020].

8. 3 Arguments Why Marijuana Should Stay Illegal Reviewed. 2018. [video] https://www.youtube.com/watch?v=kP15q815 Saw: Youtube.

9. 2015. National Health And Morbidity Survey 2015. [online] Available at: <http://www.moh.gov.my/moh/resources/NHMS2015-VolumeV.pdf> [Accessed 11 April 2020].

235 views

Recent Posts

See All

6 Comments


Malaysia follows the guidance of (as reference regulatory authorities) the Australian TGA, the Chinese Health Authority on Chinese medicinal herbs, the European Commission, Health Canada and the United States FDA. And yes, less economically developed countries tend to follow countries like featured above as means of 'guidance'. For example, due to the vast research of the US FDA, they are able to make arrangements with regulatory partners (such as foreign governments) by protection comparisons. They are able to harmonize in food safety standards with other nations to prevent duplication and overlap of information, maintaining these mechanisms by recognizing the equivalence of their health systems.

Like

Mathew Smith
Mathew Smith
May 05, 2020

Very interesting - I didn't realise certain countries followed the guidance of others as a "reference for illustrative authority for evidence" but it makes sense given the difference in levels of research in the two countries. Which other countries does Malaysia follow the guidance of? And is this standard procedure across countries that lack the research might of western countries?

Like

As of quite recently last year, the Malaysian Ministry of Health (MOH) has confirmed the ability to consider allowing cannabis for a medical use- so long that it is confirmed and reviewed for its safety and effectiveness. There was a mentioning and discussion of the clinical trials conducted for treating the unfortunate symptoms of chemotherapy [1]. Cesamet (drug containing Nabilone) and Marinol (also known as Dronabinol) are the antiemetics mentioned that are US FDA approved, used specifically to treat the severe nausea and vomiting found in cancer patients.


Despite Dronabinol being a synthetic form of THC and Nabilone being a very similar but different synthetic form of the cannabinoid, it is legal in Malaysia to be prescribed the US FD…


Like

Mathew Smith
Mathew Smith
Apr 30, 2020

Thanks for your considered response, Carlotta. Dronabinol and Nabilone are different; Dronabinol actually contains THC, which as you know is the active ingredient in marijuana. I am therefore surprised that this is legal in Malaysia. When you say that these drugs are FDA approved, are you referring to the US FDA? If so, does Malaysian law follow FDA guidelines i.e. guidelines from a different country?

However, Nabilone has a different chemical structure to THC. Does it therefore have different legal standing?

Given its different in structure, does it have less of a pyschoactive impact?

Like

Hi Mr.Smith,

I hope my response here answers your questions, thank you for reaching out to us.


- 'Ganja' as they call it here in Malaysia is illegal to be used or consumed in its raw form. However, CBD based medical products can be marketed here legally- but as you can imagine it isn't very popular. The health ministry can register products with only CBD as a possible active ingredient, the products mentioned 'Dronabinol' and 'Nabilone' can be prescribed by a professional whether it be a doctor or pharmacist. 

- I agree with you on your point about government responsibility, but the primary point I wanted to raise in my article was: Is there really a need to inflict such…


Like
bottom of page