Region should explore billion-dollar ganja industry, Caricom heads toldMonday, August 31, 2015
THE Caribbean Community (Caricom) is considered to have some 'competitive' advantage in the cultivation of the marijuana plant for medicinal purposes and may wish to explore any commercial benefit from a potential multi-billion dollar industry, according to a report now before Caricom heads.
The report followed a request by St Vincent and the Grenadines Prime Minister Ralph Gonsalves and was compiled on behalf of the Caricom Bureau which overseas the regional grouping between Heads of Government Conferences. It has not been officially released but the Jamaica Observer has obtained a copy.
The report cited the work of Jamaican scientists Professor Manley West and Dr Albert Lockhart who pioneered ganja-based medicines to treat glaucoma and asthma, and suggested that the billion-dollar industry could include research and development and production of medicinal marijuana products. It al;so referenced the work of Jamaica's Dr Henry Lowe. Following is an edited version of the report:
At its twenty-seventh meeting held in Trinidad and Tobago in September 2013, the (Caricom) Bureau:
Engaged in preliminary discussion following on the correspondence from the Prime Minister of St Vincent and the Grenadines (Ralph Gonsalves) to the chair of the conference, requesting that the Community address, in a sensible, focused and non-hysterical manner, the matter of the medical use of marijuana.
Requested the secretary-general to arrange for the conduct of the necessary desk research (on the medical and legislative aspects) and preparation of a paper to facilitate consideration of the matter by all heads of Government at the Twenty-Fifth Inter-Sessional Meeting of the Conference to be held in St Vincent and the Grenadines in February 2014;
Agreed that the Concept Paper prepared by the National Drug Council of Trinidad and Tobago should be taken into account in the conduct of the research.
Marijuana (also known as hemp, weed, ganja, pot, hashish) is the common name for the Cannabis sativa plant, which has a long history of cultivation and use in many societies and cultures.
Historically, Cannabis sativa was used as a source of food, oil and industrial fibre to manufacture rope, cloth and paper. When it was discovered that the plant had the ability to alter thinking and behaviour, it began to be used as an entheogen and later gained widespread use for recreational purposes.
With respect to its medicinal application, Cannabis sativa is described as one of the oldest psychotropic drugs known to humanity. Originating in Central Asia, earliest records of its use as medicine are from China, during the reign of the Emperor Chen Nung, where it was eaten or drunk as a tea and used as a folk medicine alongside ginseng, ephedra and other herbs. Historians have also documented its use in Indian Ayurvedic practice to promote sleep, appetite and digestion and as an aphrodisiac.
Similarly, 13th Century monographs from the African continent also record its importation and use as a herbal remedy.
Early medical use
A British physician by the name of O'Shaughnessy is credited with its medical introduction into Western cultures. Having learnt its application in India, O'Shaughnessy began developing and using marijuana preparations to treat patients in the 1830s. His findings quickly spread to the United States, sparking research interest and by 1854, Cannabis sativa was listed as an item in the United States Dispensatory, and by 1860, the first American conference on its clinical use was held by the Ohio State Medical Society.
In the Caribbean, Marijuana was brought to Jamaica in the late 1800's by the indentured East Indian labourers, who were brought here to work on the plantations after slavery had ended. Therefore, contrary to popular belief, the use of marijuana in Jamaica is not unique to Rastafarians.
Before Rastafarianism began, ganja was used by herbalists in Jamaica as a medicine in teas. It was also mixed with tobacco for smoking. Rastafarians consider Ganja the "wisdom weed" as its use is thought to help one to gain wisdom. Rastafarians also use it as a part of religious rites and as a means of getting closer to their inner spiritual self.
Ganja tea is consumed as a medicine and attributed as having various therapeutic and prophylactic qualities. The tea is said to make the body strong and less susceptible to illness. It is also often drunk, if someone suffers from a fever or a cold. Furthermore, ganja is said to be a good remedy for stress. Ganja tea is drawn from the young, green plant.
What is the current state of scientific knowledge regarding the effectiveness of marijuana and its chemical constituents in medical treatment in humans?
Basic research has confirmed that cannabinoids (active ingredients in marijuana) impact upon the following physiological processes in humans: movement and coordination; memory functioning; appetite; pain perception; pain transmission; immune system performance; visceral sensations; nausea and vomiting; and muscle spasticity.
Many anecdotal reports are available from people who smoke or use marijuana that attest to its benefits: pain alleviation, appetite stimulation, reduction of nausea and vomiting, reduction of muscle cramps and spasticity. There are similarly many scientific studies, including clinical trials. In the Caribbean, for example, seminal controlled studies conducted by Professor Manley West and Dr Albert Lockhart at the University of the West Indies in the 1970s, demonstrated a reduction in intraocular pressure, in patients suffering from glaucoma, after the application of cannabis-based eye drop. Later similar studies demonstrated its utility in treatment of some asthmatic conditions.
It is noteworthy that marijuana has had reported, historic research for medicinal purposes, eg with varying research papers in the USA 1840 - 1930. Marijuana extracts formed part of the United States Pharmacological Formulary up to 1943. However, most research after 1940 explored not its potential benefits but rather its harmful effects. There are inherent challenges involved in the research of illegal substances:
(i) Sourcing the material substance
(ii) Securing approval from the relevant authorities
Professor West and Lockhart alluded to some of these challenges in their seminal work in Jamaica on marijuana.
Summary of Findings
The use of cannabis or its constituents as a medicine is a keenly debated issue. Based on numerous anecdotal reports and findings from clinical trials, those in favour assert its analgesic, antiemetic and antispasmodic and appetite stimulant properties. This document provides a synthesis of the findings, starting from systematic reviews that evaluated the clinical effectiveness of cannabis. The results may be summarised as follows:
A. Positive findings: Clinical effectiveness established
* Synthetic cannabinoids for the treatment of chemotherapy induced nausea and vomiting
* Synthetic cannabinoids for treatment of acute and chronic pain
* Synthetic cannabinoids and extracts from the cannabis sativa plant for treatment of spasticity in multiple-sclerosis patients.
B. Negative Findings: No clinical impact on treatment of the following diseases
* Dementia; neuro-muscular diseases.
C. Knowledge Gaps: There is insufficient evidence; need for further research
* Asthma; appetite stimulant for the treatment of cystic fibrosis; appetite stimulant for HIV/AIDS anorexia; Tourette's Syndrome; glaucoma; spinal cord injury; epilepsy.
No evidence of the clinical effectiveness of smoked marijuana for treating any disease condition has emerged. Available studies do not stand up to the rigour of a systematic review of clinical outcomes.
The health effects of marijuana smoking due to the tar content of the "cigarettes" is an area for future research. Additionally, the long term use and psychotic illnesses has been studied inconclusively.
Approved cannabis-based medication
Several cannabis-based medications have been approved and registered for use in some countries. This includes Marinol® for use in the treatment of HIV/AIDS anorexia, Canasol for treatment of intraocular pressure associated with late-stage glaucoma and Asmasol for relief of asthma and allergy symptoms. The clinical efficacy of the preparations has not, however, been determined by the most rigorous scientific methods.
In 1971, the United Nations classified marijuana in the Convention on Psyschotropic Substances, among controlled substances. In 1987 it was reclassified to Schedule II (Schedule I are drugs of no therapeutic value with potential for abuse). In the last 10 years, many States in the USA have legislatively adopted a less restrictive classification than the Federal Government. Twenty States of the USA have now voted to legalise the use of medicinal marijuana. In December 2013, Uruguay legalised marijuana and brought all aspects of its trade, sales, growing and dispensing under regulation.
Most Caricom Member States are party to a number of International instruments that seek to regulate/control the use of narcotic substances including the following: The United Nations (UN) Single Convention on Narcotic Drugs (1961); the UN Convention on Psychotropic Substances (1971) and the UN Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988).
Cannabis (marijuana) is identified as a controlled substance on Schedule IV of the UN Single Convention on Narcotic Drugs (1961). Schedule IV (the most restrictive) is the category of drugs, such as heroin, that are considered to have "particularly dangerous properties" in comparison to other drugs. According to Article 2 of the Single Convention "the drugs in Schedule IV shall also be included in Schedule I and subject to all measures of control applicable to drugs in the latter Schedule" as well as whatever "special measures of control" each Party deems necessary.
In most, if not all Caricom Member States, cannabis is identified as a dangerous drug in their Dangerous Drugs Acts. Possession or trafficking is liable upon conviction or indictment to fines and/or imprisonment. In some Member States eg Trinidad and Tobago, this however, does not apply to: a person who has the possession of a dangerous drug under a license issued pursuant to section 4 of the Act permitting him to have possession of that dangerous drug; a medical practitioner, dentist, veterinary surgeon or pharmacist who is in possession of a dangerous drug for any medicinal purpose; a person who obtains a dangerous drug for medicinal purposes from or pursuant to a prescription of a medical practitioner, dentist or veterinary surgeon; a person authorised under the regulations to be in possession of a dangerous drug and a person who is acting for and under the supervision of a person mentioned in (a), (b), or (d) above.
Medical use of marijuana
The UN Single Convention repeatedly affirms the importance of medical use of controlled substances. The Preamble notes that "the medical use of narcotic drugs continues to be indispensable for the relief of pain and suffering and that adequate provision must be made to ensure the availability of narcotic drugs for such purposes". Articles 1, 2, 4, 9, 12, 19, and 49 contain provisions relating to "medical and scientific" use of controlled substances. In almost all cases, parties are permitted to allow dispensation and use of controlled substances under a prescription, subject to record-keeping requirements and other restrictions.
Though recreational use of marijuana is still illegal in the US, the popularity of the drug for medicinal purposes is on the rise with more states legalising medical cannabis each year. Currently, 20 US states and the District of Columbia have enacted laws to legalise the use of marijuana for medicinal purposes. Public opinion in several countries, including the US, is swinging in favour of medical cannabis, especially for chronically ill patients.
Support for the legalisation of marijuana products, primarily for medical health uses, has also come from renowned Caribbean professionals including Dr Henry Lowe, a distinguished Jamaican cancer researcher and chemist.
The Dangerous Drugs Acts of some Member States make provision for the use of marijuana for medical purposes upon the issuance of a license. Any consideration of a change in this position must of necessity be informed by research on the issue.
As previously mentioned, there are various active ingredients in the marijuana plant. Some producing "undesirable effects, or a high" (THC), others producing "therapeutic effects" (cannabinoids). Plants can be and are being "engineered" to produce more of one or the other. Therefore it is foreseeable that a marijuana industry for medicinal purposes may be developed selecting plants grown for "cannabinoids" rather than THC. This is one area that regional scientists and entrepreneurs may be encouraged to further explore.
Recently, December 2013, it was announced that Dr Henry Lowe launched a business venture in medical marijuana. He opined that the Caribbean should not be left behind in this potentially lucrative business. The Region may be considered to have some "competitive" advantage in the cultivation of the marijuana plant. Our Scientists (West and Lockhart) are considered as trailblazers (Asmasol and Canasol development). The Region may wish to therefore explore any commercial benefit from a potential multi-billion dollar industry including Research and Development and also production of Medicinal Marijuana products.
The following should be noted:
(i) The Region has already made a contribution to medical research on marijuana (Canasol and Asmasol). Whilst our licensed pharmaceutical products find use in some countries of the Region, the research rigour required for licensing elsewhere has not been met.
(ii) The licensing of medical marijuana for personal use will require a legal template similar to that of Uruguay and Europe which requires a doctor to prescribe, registration of all persons with permission to purchase, the determination of an amount that can be purchased over unit time, and strict regulation of the growing, control of harvesting and sale to distribution points and regulation of those points of sale. It will also require the review of anti-marijuana laws and our position regarding the UN Convention on Psychotropic substances.
(iii) In addressing the medical uses of marijuana, the issue of decriminalisation of its use in some forms or quantities, while not part of the remit of this Paper, may well have to be considered. This has been implied above by reference to its use in infusions or "teas" or "tonics" for example. There is as well, significant debate about the negative impact of incarceration for the possession of or use of small quantities of marijuana. This is of particular concern with respect to our young people.
THE CONFERENCE is invited to consider the findings of the desk research.
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