The Cannabis Conundrum

LEGALISING MEDICAL MARIJUANA

To legalise or not to legalise, that is the question! The debate on whether Malaysia should legalise marijuana has been around, and escalated especially since last year.

Cannabis sativa and Cannabis indica are two species of cannabis and was traditionally used by the Malays, Indians, Chinese, and the other races in Malaysia for hundreds if not thousands of years. Cannabis was also used openly until about 1985 when former Prime Minister Tun Dr. Mahathir waged a war on drugs (following President Nixon in the US). This made things worse as users are now recognised as “criminals” that deserve to be “hanged to death.”

Cannabis was put under Schedule 1 of the Dangerous Drug Act 1952 in Malaysia. This category means it does not have any medical benefits.

Then things took for a turn. On 4th October 2020, the National Pharmaceutical Regulatory Agency (NPRA), the body under the Ministry of Health (MOH) which governs Schedule 1 substances announced that they are open for clinical trials to be conducted using cannabis.

Fast forward to 4 June 2022. The then-Minister of Health, Khairy Jamaluddin, said that the government would later that year announce a framework for the registration of prescription drugs containing Cannabidiol (CBD).

Today, the current Health Minister, YB Dr. Zaliha Mustafa says that the MOH welcomes any research and clinical trials on products containing cannabis extract for medical purposes. If the product is scientifically proven to be effective in treating certain diseases, the relevant party can apply for the registration of the product with the Drug Control Authority and subsequently market it in Malaysia.

Until March 8, 2023, no application for Clinical Trial Import Licence (CTIL) or Clinical Trial Exemption for Manufacturing (CTX) has been received and issued by the Ministry of Health for the importation of products (medicines) containing cannabis extract for the purpose of conducting clinical trials in Malaysia.

A feasibility study on 1,722 members of the general public and 200 professional medical practitioners, was done by the Malaysian Agricultural Research and Development Institute (MARDI) on the potential of the medical cannabis market in Malaysia, with focus on the development of the medical cannabinoid industry.

It showed tremendous support for the uptake of medical cannabis in Malaysia.

81 percent of the general public supported the use of cannabis as an alternative treatment, while 74 percent of medical practitioners agreed with the marketing of medical cannabis in Malaysia for specific patients, subject to strict government control.

Roping in academia, the IIUM Working Committee for the Use of Cannabis and Mitragynine for Medical Purposes in Malaysia from the Faculty of Pharmacy and Faculty of Medicine was also invited by the Malaysian Agricultural Research and Development Institute (MARDI) to present their views and recommendations on the future of medical cannabis in Malaysia. The IIUM team presented the evidence-based findings and reality (waqi’)-based evaluation in the context of Malaysian population.

It looks like we are getting there.

International Business Review explores the probable impacts of legalising medical marijuana on Malaysia’s economy, society, and the medical industry.

The Dilemma of Marijuana

Marijuana is a product of the cannabis plant, and it contains two main chemical substances: tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is the substance known to give that “high” feeling, affecting the mind and mood. CBD, on the other hand, performs different magic as it has shown promising potential as a medical treatment.

Research suggests that marijuana can effectively alleviate pain, reduce nausea and vomiting associated with cancer treatments, manage epilepsy, and aid in opioid addiction recovery. Moreover, there is evidence indicating that it may have a positive impact on individuals suffering from social anxiety.

The two sides of the weed debate make valid points about their stance on the legalisation of medical marijuana. Legalising marijuana, or any other component of the cannabis plant, can raise concerns regarding addiction, health implications, and marijuana being perceived as a gateway drug.

Marijuana can be addictive, and its use may lead to impaired judgment, decreased motivation, and an increased risk of accidents. Marijuana use can even lead to an increased risk of developing psychosis and lung problems. There are also concerns about the social impacts of normalising drug use.

Most importantly, the opponents of legalisation argue that the research findings that prove the benefits of medical CBD are not sufficient.

On the plus side, case studies and statistics have shown that legalised marijuana has had a positive impact on drug-related violent crime rates and, of course, on the economy.

About half of the prisoners in Malaysia, and over 75 percent of those on death row, are convicted of drug-related crimes. A well-known case is Muhammad Lukman’s. He was arrested together with his wife in 2015, and was sentenced to death for possession of 3.1 litres of cannabis oil, 279 grams of compressed cannabis, and 1.4 kilograms of substances containing THC. In his defence, he says he was producing those substances for their medical benefits and to help his friend’s aunt with her cancer pains. Although the death penalty was lifted in an Appeal court, he eventually served five years of jail time and ten strokes of cane.

Economy-wise, legalising medical marijuana will open opportunities for a whole new industry. From research and development (R&D) to cultivation, processing, manufacturing, distribution, and retail, many jobs will be created in a new lucrative field of the medical industry. A whole new industry also means new tax revenue. For example, the State of California alone collected US$1.074 billion (RM5.03 billion) in marijuana taxes in 2022.

In addition, the legalisation of medical cannabis in Malaysia has the potential to revolutionise the country’s medical industry. By embracing

medical cannabis as a legitimate option, Malaysia can diversify treatments, attract investments, and stimulate economic growth in the medical sector. Integrating medical cannabis into the healthcare system would enhance patient care and establish Malaysia as a progressive leader in medical innovation.

The Horatio of Thailand: A Case Study

In Shakespeare’s famous play, Hamlet looks up to Horatio’s intellect and decisiveness. So, in our context, Thailand’s historic legalisation of marijuana in June 2022 could be something to investigate and learn from. Thailand’s landmark decision, however, has sparked a hot debate over its implications. Examining Thailand’s experience provides valuable insights and lessons for Malaysia.

Notably, Thailand has witnessed both economic benefits and a decline in drug-related violent crime rates since cannabis legalisation. The projected marijuana market in Thailand is expected to reach an impressive THB42.9 billion (RM5.72 billion) by 2025. However, domestic cannabis businesses face the challenge of competing with well-established Western producers emphasising the need to protect the domestic market and support local growers and farmers.

Concerns have also emerged regarding a significant increase in addiction cases since legalisation, which strains healthcare resources. Moreover, political tensions have arisen due to the absence of a comprehensive legal framework. It is important to recognise that Thailand’s decriminalisation encompasses all parts of the cannabis plant, whereas Malaysia is likely to focus specifically on medical use. Thus, while Thailand’s experience offers valuable lessons, it may not fully align with Malaysia’s unique path forward.

Ophelia: The Current Legal Framework

In our Hamlet metaphor, the law is our Ophelia: complicated, yet so dear. It is a knot that seems to be too complicated to untie. The vagueness of the regulations leaves room for interpretations that could even contradict with one another.

According to DDA 1952, “any part of any plant of the genus Cannabis from which there is found to be present resin irrespective of its quantity, and by whatever name the plant may be designated,” possession of over 200 grams is deemed a trafficking offense punishable by death. Lesser offenders can face up to ten years of imprisonment. At the same time, Sections 4 and 5 make an exception for importation and exportation of cannabis with the authorisation of the Minister, and Section 6B states that the Minister may authorise the cultivation of cannabis for research, educational, experimental, or medical purposes.

Drafting precise laws that benefit the nation is a daunting task, as the legal framework needs to minimise the potential risks and maximise the benefits while leaving enough wiggle room for a free market. However, the clock is ticking as more countries are joining the legal-medical-weed club. The CBD-based medicine market is growing fast, and market saturation on a regional and international scale is on the horizon. Slow and complicated bureaucracy will only set us back from another competitive market.

Hamlet must decide and act swiftly. Behind his silent contemplation over the legalisation of medical marijuana lies immense economic, societal, and medical potential that can be exploited now.

If medicinal cannabis could be given top priority, and this new law takes place, thousands of critically ill patients will gain access to a life-changing treatment. At the same time, CBD hair and skincare products will become a national boom.

It also makes sense that the “recreational” use element be also legalised within the next few years to avoid the flood of illegal products from neighboring countries.