As Congress now deliberates on the rationale for legalizing medical marijuana, the medical community again raises its strong objection to the proposed House Bill, highly concerned of opening another portal or gateway to addiction, especially among our youth
By Lyka Mae P. Chiang
Cannabis, commonly referred to as marijuana, is a psychoactive drug derived from Indian hemp plants such as Cannabis sativa and Cannabis indica. Historically, cannabis has been used for medicinal purposes with claims of treating various diseases and conditions like rheumatism, gout, malaria, constipation, menstrual disorder, absent-mindedness, among others.
However, due to its psychoactive properties, the United States Federal of Narcotics began in the 1930s the campaign to recreate its image from being an ancient herbal plant to that of an addicting one that would result in narcotics addiction. Four decades later, the Controlled Substance Act declared marijuana as a Schedule I drug, which means it has the highest potential for abuse and no approved therapeutic claims.
Public health threat
According to the United Nations data, 158.8 million people or more than 3.8 percent of the planet’s population use marijuana despite being an illegal substance with numerous adverse health effects. Dr. Carissa Paz Dioquino-Maligaso, head of the National Poison and Management Control Center (NPMCC), discussed the evidence for harm of marijuana use during the Health Forum on Medical Cannabis Legalization spearheaded by the Philippine College of Physicians (PCP).
“High levels of cannabis use increase the risk of psychosis,” said Dr. Dioquino. “The risk is 3.9 times higher to develop a mental illness when you use marijuana.”
This is an outcome of the acute psychotic reaction of AKT1 gene polymorphism to cannabis along with dependence on the drug and baseline schizotypal symptoms. However, these are only some of the harmful effects of marijuana on mental health as it has also been linked with depression, anxiety, and paranoia.
Dr. Dioquino also reiterated the addicting effect of marijuana on its users. She cited a study by the US National Institute of Drug Abuse in 2002 which found that roughly 9 percent of marijuana users will become dependent on the substance. Moreover, marijuana use is associated with an increased risk of alcohol, nicotine, and other drug use disorder. (Blanco et al, 2016)
Other adverse health effects of marijuana are lower birth weight of offspring for maternal cannabis smokers and impaired neurodevelopment which interrupts the brain’s function to perceive learning, memory, and attention.
Marijuana legalization in the US
As of 2017, the United States legalized medical cannabis in 20 of its states, while three states legalized the use of recreational marijuana. The PCP and its allied societies considered this move to be a “natural uncontrolled experiment,” which suggests that it may bring potential harm to human lives. This is due to the lack of informed consent, missing approval from a professional institutional review board, zero protection from the Food and Drug Administration (FDA), and no recourse for adverse outcomes.
While many may have already been familiarized with the direct impact of marijuana use on public health, only a few know its potentially fatal effects.
A National Highway Traffic System Safety Administration’s Fatality Analysis Reporting System data showed that in the District of Colorado, one of the three US states to legalize recreational marijuana, the rate of fatal motor vehicle crashes has significantly increased by about 40 percent from 2013 to 2016.
Furthermore, among the 115 drivers involved in fatal crashes in 2016, 71 were found positive for Delta-9 tetrahydrocannabinol (THC), the psychoactive ingredient in marijuana, in their blood. Of those, 63 percent were found to have higher levels than the state’s limit for driving.
Aside from the rise in vehicular accidents, marijuana legalization also raises concern for abuse among the youth. Dr. Leonor Cabral-Lim, president of the Philippine League Against Epilepsy (PLAE), stated that legalization of medical marijuana can lead to increased use, especially among the youth, due to decreased perception of risks.
“As attitudes become more tolerant and cannabis becomes more available, adolescents begin to perceive cannabis as more beneficial and are more likely to use it,” she added.
She also affirmed that marijuana legalization in the US is a “political” rather than a medical issue, and the currently limited evidence on the efficacy of medical cannabis and its harmful effects will just expose Filipinos to unnecessary harm if it becomes legalized in the country. Additionally, no health policy— especially public policy that will affect the great majority—must be utilized without strong scientific evidence, and it is the physician’s moral and ethical responsibility to secure the patient’s welfare.
House Bill on marijuana legalization
In 2014, Isabela 1st District Representative Rodolfo Albano III filed House Bill 4477, otherwise known as the “Compassionate Use of Medical Cannabis Bill,” which stated that marijuana “has been confirmed to have beneficial and therapeutic uses to treat chronic or debilitating disease or medical condition” including cachexia or wasting syndrome, severe and chronic pain, severe nausea, seizures, and severe and persistent muscle spasms.
The bill suggested that once enacted, it will establish under the Department of Health Medical Cannabis Regulatory Authority which will allow the use of cannabis for medicinal purposes in the country. It also proposed the establishment of Medical Cannabis Compassionate Center and Medical Cannabis Safety Compliance Facilities, which shall not be located within 1,000 feet from school areas, as well as the implementation of security measures to secure entry and theft of substance.
Under the bill, possession, ownership, and utilization of medical marijuana and its paraphernalia shall not be given illegal charges unless the dosage exceeds the physician’s prescription.
However, due to the vehement opposition from the medical community, it was not taken up at the 16th Congress. The bill was then filed again in 2016 under HB 180 or the “Philippine Compassionate Medical Cannabis Act” with some modifications but with the original intent to legalize the use of medical marijuana.
Despite the strong opposition by most of the technical working group (TWG) on Medical Cannabis Legalization, a substitute bill was recently passed by the Congress Committee on Health and was filed last October 2, 2017 as HB 6517.
With the harmful risks and no tangible evidence to support the therapeutic claim of marijuana, the PCP, along with its allied societies—Philippine Medical Association, Child Neurology Society of the Philippines, Community Pediatric Society of the Philippines, Group of Addiction Psychiatry of the Philippines, Pain Society of the Philippines, Philippine League Against Epilepsy, Inc., Philippine Neurological Association, Philippine Pediatric Society, Philippine Psychiatric Association, Philippine Society of Clinical and Occupational Toxicology (PSCOT), Philippine Society of Adolescent Medicine Specialist, Philippine Society for Developmental and Behavioral Pediatrics, and UP-PGH National Poison Management and Control Center (NPMCC)– strongly oppose the legalization of medical marijuana in the country.