Understanding medical cannabis: What's Malaysia getting into?

KUALA LUMPUR: Medical cannabis remains a popular topic of debate in Malaysia, having consistently made headlines in the last few months.

Despite persistent stigma on the matter, policymakers have taken an open stance towards its possible use as an alternative treatment for various ailments.

A bipartisan Medical Cannabis Caucus was formed last October and has since raised several policy issues surrounding the hemp industry to Prime Minister Datuk Seri Ismail Sabri Yaakob.

The Health Ministry has also welcomed clinical studies on the use of medical cannabis. That being said, there remains a lack of research on its effects for Malaysian patients.

Cannabis, marijuana, hemp: What’s the difference?

The terms cannabis, marijuana and hemp are often used interchangeably in public debate. Dr Nur Azzalia Kamaruzaman from the National Poison Centre at Universiti Sains Malaysia said this has contributed to misunderstandings on the topic.

She explained that cannabis was a broader classification that contains both hemp and marijuana. They are made up of various chemicals, of which the two most common ones are tetrahydrocannabinol (THC) and cannabidiol (CBD).

“THC is well-known for its psychoactive compound. It is mind-altering, it causes euphoria, and it is connected to the high feeling you usually associate with ganja or marijuana,” said Azzalia.

“CBD does not have psychoactive properties and has a lot of therapeutic potential, which is what people focus on when they talk about medical cannabis.”

Hemp contains up to 20 per cent of CBD and less than 0.3 per cent of THC, an amount that is unlikely to get one high. Anything beyond the 0.3 per cent threshold is considered marijuana.

“The public, politicians and policymakers should be aware of the distinction between these types of plants. Once they understand, then perhaps they would be less inclined to have a certain stigma or taboo when we talk about hemp, marijuana, ganja, pot or weed.”

Currently, Malaysia’s Dangerous Drugs Act 1952 only uses the term “cannabis” and does not make the distinction between hemp and marijuana.

Possession of more than 200g of cannabis is presumed to be trafficking, which carries a mandatory death sentence.

Most recently, nasyid singer and composer Muhammad Yasin Sulaiman was charged with cultivating cannabis plants and trafficiking 214g of the drug, which he said was used to treat his bipolar disorder.

Medical cannabis vs prescription drugs

One study in Denmark finds that medical cannabis is frequently used as a substitute for prescription drugs, particularly pain relievers, antidepressants and arthritis medication.

Results from another paper by the University of Michigan saw that in comparison to pharmaceutical drugs, patients rated medical cannabis better on effectiveness, side effects, safety, availability and cost. Up to 42% stopped taking a pharmaceutical drug in favour of cannabis.

Azzalia said cannabis has shown to have therapeutic effects which some conventional medicine cannot provide.

She cited the case of Charlotte Figi, whose use of CBD oil to treat her epilepsy helped popularise its medicinal use in the United States.

Figi was first diagnosed with a rare form of epilepsy called the Dravet syndrome at three months old. This caused her to have up to 300 seizures per week and rendered her unable to eat, talk or move.

Eventually, her parents looked into CBD after experimenting with dozens of medications that did little to help ease their child’s symptoms.

Following treatment using CBD oil, Figi’s seizures reduced to around once a month and she lived up to the age of 13, before passing from complications related to COVID-19.

Azzalia said Figi was one of the many examples, adding that there were also cases in Malaysia where people imported illegal cannabis to treat themselves or their children.

“People have to resort to illegal means to get access because conventional drugs aren’t working,” she said. “Still, without proper research, you won’t know the long-term effects.”

Allowing medical cannabis: What doors will it open?

Globally, over 40 countries have legalised medical use of cannabis, including Thailand and Sri Lanka.

In Malaysia, a framework would soon be announced to enable CBD products to be registered by 2023.

This framework, however, would not include the cultivation of cannabis. CBD products will only be available on a prescription basis and not for self-medication or recreational use.

Azzalia said this development would provide opportunities for CBD product research and exploration and expressed hope for further expansion in the future.

Noting that all drugs came with side-effects, including the commonly prescribed paracetamol, she added that hemp should not be treated any differently.

“The thing is with cannabis; we shouldn’t hold back on the possibility of research. It could be a game changer and life saver.

“If you have the opportunity to save lives, to cure disease, then why aren’t we taking up that opportunity?”

She added that many countries were still actively studying medical cannabis, with animal and human clinical trials being conducted for various indications such as cancer, Alzheimer’s disease and Parkinson’s disease, among many others.

“You don’t just make the leap to legalise medical cannabis, you need to understand it,” she said.

“Of course, if you want to legalise this, there needs to be proper control and regulation, but the world is opening up their doors and they’re moving forward.”

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