Medical marijuana in India: still a long way to go

Maneka Gandhi, the Union Minister of Women and Child Development, has suggested legalising marijuana in India for medical purposes.

Speaking at a recent group of ministers (GOM) meeting, she said the US, Australia and Canada had legalised marijuana, both recreationally and medically, and made some breakthroughs in the healthcare sector. She also suggested that regulation of the drug will not only help in bringing down the number of illegal users but also help in medical research as shown in other countries.

But for medical marijuana to even have a chance, doctors need to be on the same page and not view marijuana as just a psychoactive substance, as it has been labelled under Schedule I of drugs alongside life-threatening drugs such as heroin, cocaine and tobacco.

Short-term benefits

According to Ravi Dorairaj of Dr Agarwal’s Eye Hospital, there are not enough studies to suggest marijuana helps in treating glaucoma or cataracts. “They say it reduces intraocular pressure for sometime, that is just for a short time. But in glaucoma there needs to be a constant reduction of the pressure, so it (marijuana) has just short-term benefits.”

He continued: “If it helps for just an hour or so, that doesn’t mean a patient can keep smoking marijuana all day. Other than this, there are side effects like lack of concentration, decreased blood flow to the optic nerve and short-term memory loss.”

Dr Prashanth L K, a consultant neurologist at Apollo Hospitals, Sheshadripuram, feels people have noticed various benefits of using medical marijuana. Despite being approved in various states in the US, a practitioner cannot prescribe cannabis but can only suggest it to the patient. “They have been tested in certain neurodegenerative disorders such as Parkinson’s and there have been publications which have seen both positive and negative effects,” he said. “These tests are based on a small number of patients and it doesn’t have a big enough group to say that it is unequivocally beneficial to the patient. So bigger research and more studies are required. Benefits should also outweigh the potential side effects.”

Thorough tests needed

Not all doctors are against cannabis, though. Dr Vishwanath S, a consultant medical oncologist at Apollo Hospitals, feels there should be extensive research in India, too. “Though cannabis comes under Schedule I with the likes of heroin and cocaine, studies have shown that it has medicinal effects despite its psychoactive properties. Since most of the evidence is from preclinical studies and anecdotal case reports, there is a long way to go as more research regarding the safety in clinical use is required before it can be considered as a therapeutic option in cancer treatment.”

He continued: “There should be different phases of trials and through testing. These trials will also help in ascertaining the dosages that a patient should get.”

There are already synthetic compounds of cannabis which have been approved by the US Food and Drug Administration and are easily available in the Indian market under the names of Dronabinol and Nabilone.

Cannabis treatment

Cannabis, which has two main components, Cannabidiol and Tetrahydrocannabinol, has been used in treating seizure disorders, glaucoma, Parkinson’s, nausea and vomiting caused by chemotherapy and HIV/AIDS.

Mumbai-based Bombay Hemp Company (BOHECO) will participate in the first legal project to grow cannabis and study its medicinal properties for use in treatment of epilepsy and cancer. The research will be conducted along with the Council of Scientific and Industrial Research (CSIR). The study will take place in Jammu & Kashmir, where researchers will grow 20 different accessions of medical cannabis that have been collected from different parts of the country.