A SYSTEMATIC REVIEW OF MEDICAL CANNABIS

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This article is written by Khushi Bansal of 5th Semester of University Institute of Legal Studies, Panjab University, Chandigarh, an Intern under Legal Vidhiya

Abstract:

Varying from spiritual to commercial purposes, the use of cannabis has come a long way in the 21st century. As per the Indian ancient texts, specifically the Vedas, cannabis is one of the five sacred plants. Ayurveda mentions it as a treatment for numerous diseases. In modern times, the medical and industrial aspects of cannabis have also been recognized. In the following article, cannabis is precisely reviewed in medical terms. The medical sciences acknowledge cannabis as a blessed plant as it helps to cure even deadly diseases like cancer. Therefore, medical cannabis is the major focus of the following article. The article begins with an introduction to the basic details about cannabis. Moving further, the article is tilted towards medical cannabis. In the end, there is a conclusion describing the pros and cons of the legalization of cannabis.

Keywords:

Marijuana, Weed, NDPS, Medical Cannabis, Treatment, Deadly diseases, Medical research, Legalization, Regulations

Introduction:

The use of cannabis is so deep-rooted in the history of India that we still find the saints consuming cannabis to remain in a state of meditation. The ancient texts discuss several stories and incidents regarding cannabis that make it hold a special significance in Indian traditions. As per traditional beliefs, cannabis is the same product that was used to prepare Somaras[1] in the Vedic period. The Atharvaveda lists cannabis as one of the five sacred plants on the earth and acknowledges it as a source of happiness and liberator. Moreover, cannabis, in the form of bhang[2], is offered to Lord Shiva, and is often consumed by people during Indian festivals like Mahashivratri and Holi. Not only bhang, the other common cannabis products include charas, ganja, and weed.

Cannabis is a psychoactive drug from the cannabis plant, natively found in Central or South Asia. Belonging to the family Cannabaceae, cannabis refers to a group of three plants with psychoactive properties. The three plants include Cannabis Sativa, Cannabis indica, and Cannabis ruderalis. Cannabis is made up of more than 120 elements known as cannabinoids but Tetrahydrocannabinol (THC) is its main psychoactive component. In present times, the cannabis plant cannot be grown anywhere, like most of the other plants. Being a huge contributor to the problem of drugs in India, the activities related to the cannabis plant are regulated by the legislation and the statutory bodies. Therefore, it has become a vast topic to study about the cannabis.

Different Uses:

In today’s world, people commonly use cannabis as an herbal drug for recreational purposes, i.e. to be high. But cannabis is such a blessing when it comes to its positive uses, especially the medicinal and industrial uses. Beginning from the ancient times, it was used for spiritual purposes. However, in modern times, the use of cannabis is more common among youth as they find it a relaxing product that is available at cheaper rates than other psychoactive products. Cannabis is also used for industrial, scientific, medicinal, and horticultural purposes. Medical cannabis is known for its remarkable pain-relieving and anti-inflammatory properties. The medical uses of cannabis prima facie include lowering blood pressure, reducing inflammation, preventing alcohol addiction as alcohol is more harmful than cannabis, treating anxiety disorders, treating gastrointestinal disorders, preventing seizures, relief from chronic pain, treating glaucoma, dealing with arthritis pain, and fighting cancer. Here medical cannabis comes into the picture.

Though there is no specific definition of medical cannabis, it generally refers to the use of cannabis to treat disease or improve symptoms of diseases. The cannabis plant has always been used for curing deadly diseases as we find its significance in Ayurveda and other ancient medical sciences. Keeping in mind the long history of medical use of cannabis, many of the modern pharmaceutical drugs also use cannabis in their production. In response to a petition to reschedule cannabis under federal law, the DEA Chief Administrative Law Judge, Francis Young concluded in 1988 that in strict medical terms marijuana is far safer than many foods we commonly consume. He added that marijuana in its natural form is one of the safest therapeutically active substances known to man. Marijuana can be safely used within the supervised routine of medical care by any measure of rational analysis. Thus, medical cannabis, as prescribed by physicians, is used as an excellent treatment for various diseases and medical problems. It is noteworthy here that there is no consistent evidence to prove that cannabis is helpful in these conditions. The aforementioned uses are based on low-quality evidence. The sole reason for not having strong and consistent evidence can be the low-quality research.

More about Medical Cannabis:

With time, synthetic medical cannabis has come into existence. Medical cannabis can be either a natural Cannabis Sativa plant-based extract or a synthetic (man-made) product. Controlled and standardized herbal cannabis (plant products) can also be used as medical cannabis. Medical cannabis can be taken by mouth in the form of a tablet, capsule, oil, liquid, or mouth spray. Also, it can be taken as a nasal spray. Products like patches, gels, and creams can be directly applied to the skin and raw cannabis can be vapourized for medical use but not smoked.

There are certain precautions and safety measures to be taken care of while using cannabis as a medicine. There is no standard dose of medical cannabis. It varies from condition to condition. So, it is usually prescribed to begin with a low dose and gradually increase it to maximize the benefits and minimize the side effects. Also, it must be taken care of that the purpose of consuming cannabis does not shift from medicinal to recreational. Usually, people below the age of 18 years are not allowed to use cannabis even as a medicine. Furthermore, medical cannabis is not prescribed to pregnant women, people with heart diseases, and people with a history of psychosis.

Effects:

Due to the restrictions imposed by the government, the medical uses of cannabis have not been rigorously tested. Consequently, only limited clinical research takes place in respect of the safety and efficacy aspects of using cannabis as a treatment. Thus, we do not have sufficient data to strongly conclude about the positive and negative effects of medical cannabis. Medical cannabis has both short-term and long-term effects on a person’s body. Consumption of cannabis leads to relaxation and giddiness but these are short-lived. The short-term effects of cannabis may sound fascinating but consumption of cannabis in any form may also cause some problematic situations like lethargy and hallucinations. The person may also suffer from the problems of increased heartbeat and decreased blood pressure. Consuming cannabis also makes a person prone to anxiety and short-term memory loss.

As discussed earlier, medical cannabis helps to cure diseases. But it may create problems as well. Not every medicine is suitable for all persons. Similarly, medical cannabis may also react adversely in some persons’ bodies and result in critical situations. Beginning its use as a medicine, there are high chances of its addiction. People become dependent on cannabis. When cannabis is used as a medicine, only a prescribed amount is to be consumed as the treatment. In case, the amount exceeds the prescribed one, it leads to an overdose that may result in unexpected and unfavourable situations. Therefore, it becomes necessary to be cautious while consuming medical cannabis. The rules to consume medical cannabis, as informed by the physician, must be strictly adhered to. 

Legal Status of medical cannabis:

Cannabis and its derivatives are regulated by the following three United Nations treaties: the 1961 Single Convention on Narcotic Drugs, the 1971 Convention on Psychotropic Substances, and the 1988 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances. The legal status of cannabis and cannabis products in India is largely influenced by these three major international instruments.

In India, the first attempt to criminalize cannabis was made by the British during their colonial rule over India. It was in the year 1961 that the international treaty Single Convention on Narcotic Drugs defined ‘cannabis’ as a flowering and fruiting top of the hemp plant and classified it as a hard drug. The present Indian law governing cannabis-related issues, i.e. the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985 also maintains the same practice as it prohibits the use of resin and flowers of the plant but permits the use of its seeds and leaves. However, the need to legalize cannabis, especially for medicinal and industrial purposes has grown stronger and stronger over the years. Also, the Government of India has always encouraged the cultivation and scientific and medical research of herbs having low THC content which is one of the main naturally-occurring compounds in the plant.

The NDPS Act authorizes the state governments to permit and regulate the cultivation of any cannabis plant, production, manufacture, possession, transport, import inter-state, export inter-state, sale, purchase, consumption, or use of cannabis, charas being an exception.[3] Using this power, the State governments have formulated their own laws in this matter. With the permission of their respective state governments, people can use cannabis for scientific, medical, industrial, and horticulture purposes. The State of Uttarakhand had become the first state in the country to permit commercial cultivation of hemp crops in the year 2018. A year later, the state government of Madhya Pradesh took a similar step. Currently, the state government of Himachal Pradesh has invested its focus in legalizing and regulating the activities related to cannabis. The Chief Minister of the state Sukhvinder Singh Sukhu recently made a statement that the state is planning to legalize cannabis cultivation for industrial and medical purposes. It is expected that the state will soon take a major reformative action in this regard, keeping in mind the economy and other positive aspects of this legalization.

Recent Development:

Over time, medical cannabis has not been completely banned in India. Rather, the Indian government is looking forward to regulating the matters and the legal framework related to medical cannabis. For instance, on 1 February 2020, India’s first medical cannabis clinic Vedi Wellness Centre has been opened in Koramangala, Bengaluru in the state of Karnataka. India has witnessed a huge reform in the field of medical cannabis. The first organized efforts were made in the year 2015 when the conferences were held promoting to re-legalize cannabis in India. The medical marijuana conferences were held in Bangalore, Pune, Mumbai, and Delhi by the Great Movement Legislation India. In the same year, a Lok Sabha MP supported the legalization of cannabis.

On 2 November 2016, Lok Sabha MP Dharamvir Gandhi made it publicly clear that he had received permission from Parliament to introduce a Private Member’s Bill seeking to amend the NDPS Act aiming to allow for the legalized, regulated and medically supervised supply of “non-synthetic” intoxicants including cannabis and opium. In July 2017, Maneka Gandhi[4] came up with a suggestion at the second meeting to examine the draft Cabinet note for the National Drug Demand Reduction Policy to legalize medical marijuana as it would result in the reduction of drug abuse and aiding cancer patients. Following this statement of the minister, the first-ever license to grow cannabis for research purposes was issued to the Council of Scientific and Industrial Research (CSIR) in collaboration with the Bombay Hemp Company (BOHECO).

On 12 December 2017, Viki Vaurora[5] sent a letter to PM Narendra Modi and all other members of Parliament advocating the urgent need to legalize the cultivation of cannabis and hemp for medical and industrial uses. Considering this letter, the PM Office directed the Ministry of Health and Family Welfare in February 2018 to examine the potential benefits associated with cannabis and issue a response to the letter.

On 5 June 2018, Lok Sabha MP Shashi Tharoor wrote in the support of legalization of cannabis highlighting the health, business, and societal benefits of the reform. A plea was filed by the Great Movement Legislation Trust challenging the ban on cannabis. In July 2019, the Delhi High Court agreed to hear that petition. In the United Nations Commission on Narcotic Drugs held on 9 December 2020, India voted in favour of removing cannabis resin from Schedule IV of the 1961 Single Convention on Narcotic Drugs, and the resolution was ultimately passed with 27 members voting in its favour.

In March 2021, Jai Ram Thakur, the Chief Minister of Himachal Pradesh announced the coming up of a policy permitting controlled cultivation of hemp or cannabis in the state. At the same time, the State Government of Tripura also made a similar announcement to form an expert panel aiming to examine the viability of legalizing cannabis cultivation.

The organizations and individuals advocating the legalization of cannabis for medical purposes got major relief after the central government made a statement in January 2022 that there is no complete ban on cannabis. In a petition challenging the provisions of the NDPS Act that permit the use of cannabis and contending that the drug has medicinal and industrial benefits, the Centre government told the Delhi High Court that the use of cannabis for medical purposes is allowed. Even today, Himachal Pradesh is in the limelight as it is strongly focused on legalizing and regulating the cultivation of cannabis in the state.

Conclusion:

In this ongoing debate on whether cannabis should be legalized or not, it becomes essential to know that legalization would lead to both positive and negative impacts on society. The legalization of cannabis is highly required for medicinal, industrial, and some other uses. Though cannabis is illegal, India has witnessed the consumption of cannabis in a huge quantity. This creates a black market for cannabis. If legalization takes place, people would legally buy the product and pay revenue to the government, improving the condition of the Indian economy. Furthermore, many cannabis sellers also sell adulterated cannabis, mixed with other similar-looking harmful products. This is because there are no regulations to have control over these malpractices. The supporters of this legalization also advocate that when some parts of the cannabis plant are legal, then why the other ones are penalized? They contend that this discrimination shall come to an end and each cannabis product shall be made legal. The strongest argument against the legalization of betting rests on a moral footing. Cannabis, being an easily available drug at cheaper rates, is found to be the biggest cause of drug addiction, especially among youth. It is believed that legalizing cannabis would add to the problem.

Considering the rising demand for the legalization of cannabis, it is high time now that cannabis and cannabis products should be legalized and regulated by the government.

References:

[1] As mentioned in the ninth mandala of the Rigveda, cannabis is an uncommon drink, consumed by the Vedic people that was often offered to the gods and was considered divine and contemplated with medicinal efficacy for restorative treatments.

[2] It is a green-colored edible preparation made from the leaves of the cannabis plant

[3] Section 10(a)(iii) of the NDPS Act, 1985

[4] The then Union Minister of Women and Child Development

[5] The founder of the Great Legalization Movement India

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