Getting High On Medical Treatment: Medical Use Of Cannabis And Legal Approach – Healthcare Series 14 – Cannabis & Hemp
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The use of medicinal cannabis dates to circa 2700 BC. It first
appeared in traditional Chinese medicine and was used as a drug
during surgery. However, the medical use of cannabis was mainly
located in India. While medical cannabis was used in limited areas
in other countries, in India it was used as a treatment in many
areas such as anesthetics, antibiotics, tranquilizers and as a
painkiller.1
Although it became well established over the centuries, by the
beginning of the 20th century, it could be seen that the use of
medicinal cannabis had decreased to a great extent. Due to the
variability and instability of the plant, consistent results were
difficult to achieve, which led to growing distrust and the decline
in its use.2 The emergence of medicinal drugs
and the increase in legal restrictions are also major factors in
the decrease in the demand for herbal methods. The production,
sale, and use of cannabis are currently illegal and subject to
certain sanctions in most places worldwide, there is, however,
growing use of medicinal cannabis, especially in countries such as
Belgium, Canada, Australia, the Netherlands, and some states within
the United States.
The Medicinal Value of Cannabis
Medicinal cannabis refers to cannabis and its constituent
cannabinoids used as a herbal remedy or therapy to treat diseases
and/or their symptoms. While cannabis has a long history of medical
use, at present, there is a lack of awareness among scientists,
physicians, and patients about its medicinal value.
In 2017, a report from the National Academies of Sciences,
Engineering, and Medicine assessed more than 10,000 scientific
studies on the medical benefits and adverse effects of
cannabis.3 The report, “The Health
Effects of Cannabis and Cannabinoids: The Current State of Evidence
and Recommendations for Research”, found that cannabis or
products containing cannabinoids are effective at treating some
illnesses and symptoms such as the following:
- The cannabinoids in marijuana may reduce chronic pain in adults
and may be helpful to treat conditions that cause chronic
pain. - There is moderate evidence that cannabis or cannabinoids are
effective for improving short-term sleep outcomes in individuals
with sleep disturbance. - In addition, there is limited evidence that cannabis or
cannabinoids are effective for increasing appetite and decreasing
weight loss associated with HIV/AIDS and for improving symptoms of
post-traumatic stress disorder (PTSD), Tourette syndrome, and
anxiety.
The Legal Background of Medical Cannabis in the USA and EU
In the United States, the use of cannabis for medical purposes -
in many treatments, including pain, nausea, and any serious medical
condition – is legal in 36 states and the District of Columbia;
four out of five permanently inhabited US territories as of May
2021.4 Although laws regarding medical marijuana in
the states have created problems between the federation and the
federal states, as the applicable law changes with each president,
it is known that the use of medical cannabis is under the control
of the state.
As for the United Nations’ view on this issue, first,
cannabis use is limited to scientific and medical purposes within
the extent of international drug control agreements (UNODC,
2013)5. In the process of time, the perspective towards
medical cannabis has changed and some legalization studies have
started. For instance, in 2018, the European Parliament adopted a
draft resolution6 tabled by the Committee on the
Environment, Public Health, and Food Safety on the use of cannabis
for medicinal purposes and encouraged the Member States to apply
medical cannabis treatment to patients. In this treatment,
medicinal use is supervised, and cannabis is prescribed by
physicians.
Following the latest World Health Organization’s statements
against medical cannabis, the European Parliament voted on the
amended Resolution7 on the use of cannabis for
medicinal purposes in February 2019. In this Resolution, European
Parliament “calls on the Member States to provide medical
professionals with proper medical training and to encourage
increased knowledge on medical cannabis based on independent and
wide-ranging research.”
Looking back today, it is possible to see that some countries in
the European Union standardly allow patients to access imported or
domestically grown cannabis, while some countries only provide
access to medical cannabis.
Medicinal Cannabis Use and Legal Limitations in Turkey
Turkey has a long history of growing industrial cannabis or
hemp. Archaeological evidence shows that people living in Anatolia,
have been growing cannabis at least since 700-800 B.C. and some
believe that hemp may have been cultivated as far back as 1,500
B.C. 8
Although cannabis had been produced intensively during the
1960s, following pressure from the U.S., Turkey began strictly
controlling the use and production of cannabis by imposing heavy
penalties on those who grow, sell, and own the plant, which can
lead to prison sentences of up to five years. At present, cannabis
is highly illegal for recreational use but allowed for limited
medical and scientific purposes in Turkey.
In 2016, with the Ministry of Health’s (“MoH”)
approval of the sale of the drug, the use of limited medicinal
cannabis – only in sublingual sprays such as Sativex – with a
physician’s prescription has been allowed in Turkey, while all
other forms of cannabis and use of whole-plant cannabis remain
prohibited.
As previously mentioned, the MoH has added Sativex, which can be
obtained with a red prescription, to the list of importable drugs.
Although it is not named directly, it can be understood that the
ATC name ‘cannabinoids’, which was added to the list on 25
January 2016 in the list of drugs that can be brought from abroad
dated 12 February 2016 on the Turkish Medicines and Medical Devices
Agency (“TITCK”) website, refers to
Sativex,.9 In order to obtain these drugs, patients
must visit a physician who is authorized to issue red
prescriptions. Physicians must evaluate the condition of a patient
and decide that medical cannabis is the best or only treatment.
The Turkish Government announced it had legalized controlled
cannabis production in 19 provinces of Turkey with the publication
of the regulation on cultivation and control of hemp in
2016.10 In accordance with the new regulation,
farmers are allowed to grow and produce hemp after obtaining a
license, which will last for three years. Production is controlled
by the Ministry of Food, Agriculture, and Livestock and is only
used for medical and scientific purposes. Those wishing to grow
these plants must prove they have never been involved in illegal
drug production.
Conclusion
Cannabis has been used in various medical fields such as
painkillers and antibiotics, as well as in psychotherapy since
ancient times. Although the use of cannabis has grown over the
centuries, its risks and harmful effects have led governments to
develop regulations to restrict its usage. As the knowledge of
cannabis’s medical value is becoming increasingly common,
lawmakers have taken action to regulate the medical use of cannabis
in the treatment of illnesses and symptoms. Along with countries
including Canada and the Netherlands, some US states have legalized
cannabis for medical use. In 2016 Turkey took a big step in the
cultivation of cannabis, and the use of medicinal cannabis was
approved. It should be borne in mind that cannabis is not
completely bad, dangerous, and illegal, nor the cure or solution
for all diseases. Therefore, a balance should be observed when
regulating the medicinal or recreational use and restriction of
cannabis.
With thanks to Ece Mert and Öykü Emecan for
their assistance on this article.
Footnotes
1 Before the Christian era https://www.scielo.br/j/rbp/a/ZcwCkpVxkDVRdybmBGGd5NN/?lang=en
2 Decline and rediscovery https://www.scielo.br/j/rbp/a/ZcwCkpVxkDVRdybmBGGd5NN/?lang=en
3 https://www.ncbi.nlm.nih.gov/books/NBK423845/
4 https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx
5 https://www.emcdda.europa.eu/system/files/publications/10171/20185584_TD0618186ENN_PDF.pdf
6 https://www.europarl.europa.eu/meetdocs/2014_2019/plmrep/COMMITTEES/ENVI/RE/2018/06-28/1155079EN.pdf
7 https://www.europarl.europa.eu/doceo/document/B-8-2019-0071_EN.html?redirect
8 https://www.researchgate.net/publication/330118009_Suclu_Olarak_Bilinen_Bitki_Kenevir
10 https://www.resmigazete.gov.tr/eskiler/2016/09/20160929-3.htm
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