Marijuana as medicine

Scientists have found evidence to support marijuana use for medical purposes, such as relief from multiple sclerosis pain or combating nausea after chemotherapy.—AFP

(First of two parts)

While President Rodrigo Duterte maintains a violent, hardline approach to ridding the Philippines of illegal drugs, a groundbreaking bill is said to be gaining support in the House of Representatives to legalize medical marijuana in the country.

The contrast is so glaring, it’s hard to ignore: While the war on drugs has led to thousands of deaths, House Bill No. 180, or the proposed Philippine Compassionate Medical Cannabis Act, would improve, if not prolong, the lives of people who ingest marijuana as medicine.

The bill is being reviewed by a technical working group, said Isabela Rep. Rodito T. Albano III, its principal author.

Albano is pushing for the bill’s approval despite opposition from what he calls “uninformed” quarters.

In the Philippines, marijuana is at the top of the list of dangerous drugs under Republic Act No. 9165, or the Comprehensive Dangerous Drugs Act of 2002.

Medical need

But in that same law is a provision, in Section 2, Paragraph 2, second sentence, that does not entirely prohibit the use of dangerous drugs:

“The government shall, however, aim to achieve a balance in the national drug control program so that people with legitimate medical needs are not prevented from being treated with adequate amounts of appropriate medications, which include the use of dangerous drugs.”

When the Inquirer asked Albano if he had set a time frame for the bill’s passage, Albano said: “That’s what I’ll discuss with the Speaker (Davao del Norte Rep. Pantaleon Alvarez).”

Albano said he filed the bill in 2014 “to let patients have access to medical cannabis.”

The medical conditions of those patients range from autism to epilepsy to cancer.

There are no official statistics, but private groups estimate the number of Filipinos with autism at more than 1 million and epilepsy, more than 500,000.

A study by the University of the Philippines’ Institute of Human Genetics, National Institutes of Health showed that 189 in 100,000 Filipinos are afflicted with cancer, while four Filipinos die of cancer every hour.

Efficacy

Although Filipino doctors are divided on legalizing medical cannabis, a growing number of them are convinced of its efficacy in, for instance, pain management.

“There is already compelling scientific evidence for the use of medical cannabis,” the department head of a top hospital in Metro Manila, who requested not to be named, told the Inquirer.

He said cannabis had been proven to prevent nausea, ease pain and stimulate the appetite, especially among chemotherapy patients.

“My son has global retardation with autistic features,” the doctor said. “He does not talk but understands most things that the family tells him. He has seizures, too. Medical cannabis helps him calm down.”

The doctor said he was prepared to work slowly for the legalization of marijuana.

“We can start with research, where patients can gain access to it. There are patients who need it. We cannot turn our eyes in the other direction. There is a need for it,” he said.

He added: “Its uses in other conditions are equivocal. That is what medical science should work on, to find more evidence and show its benefits.”

Evidence

The primary evidence is contained in the scientific papers written by Dr. Raphael Mechoulam, an Israeli chemist who, in his research on cannabis in 1964, discovered that among its numerous chemical compounds, only one is active: delta 9-tetrahydrocannabinol (THC), which is responsible for the drug’s psychoactive effects (the “high” that is felt when marijuana is smoked).

Another compound, cannabidiol (CBD), acts on many of the same receptors as THC, but without the psychoactive side effects.

CBD is the main ingredient in cannabis oil.

In the paper, Mechoulam says THC can be used as “an antivomiting and antinausea drug for cancer chemotherapy, and as an appetite-enhancing agent.”

He says THC is being tested to help patients suffering from multiple sclerosis, and that “recent work with cannabidiol in animal models of rheumatoid arthritis may lead to clinical investigations. A synthetic cannabinoid, HU-211 (Dexanabinol), is in advanced clinical stages of investigation as a neuroprotectant in head trauma.”

In 1988, scientists Allyn Howlett and William Devane of St. Louis University Medical School in Missouri made what Mechoulam called “an important discovery about cannabis:” the human brain contains a receptor for THC, which they named CB1 (cannabinoid receptor No. 1)

CB1 has been identified for its compatibility, or its ability to interact with certain parts of the human brain called the endocannabinoid system.

The endocannabinoid system helps regulate sleep, appetite, digestion, hunger, mood, motor control, immune function, reproduction and fertility, pleasure and reward, pain, memory and temperature regulation.

The discovery confirmed what recreational users believe, based on their own experience, that marijuana induces a natural, or safe, interaction with the human body—which itself has elements of cannabis.

Cannabis oil

Medical cannabis comes in various forms, including vapor, capsules, lozenges, dermal patches and oil.

In the Philippines, cannabis oil is made by private sources to help cancer patients.

A few years ago, an American residing in the Philippines was diagnosed with a “high-grade AA” brain tumor.

In 2013, he underwent open brain surgery, then went through 42 days of radiation, which was followed by six months of chemotherapy in 2014.

After a short period of remission, the American, who requested anonymity, said the tumor came back in mid-2015, which required another round of radiation and chemotherapy.

In late 2016, the tumor returned for a third time. That was when he decided to try cannabis oil and go on a vegetarian diet.

“I take the oil three times a day in very small dosages,” he said. “I still battle cancer, but I feel healthy and strong and I’m able to live a normal life and go to work daily.”

He added: “I look forward to the day when medical cannabis will receive the credit it deserves and becomes available for all people suffering from cancer.”

‘Cancer-free’

A female doctor, who also requested anonymity, decided to administer cannabis oil to a brother-in-law who was suffering from mouth cancer.

Another doctor, who facilitated the supply of cannabis oil to his colleague’s brother-in-law, told the Inquirer that the patient was declared “cancer-free in two weeks, with no need for chemo.”

But the most astounding case the Inquirer has learned about was that of an 8-year-old boy afflicted last year with stage 4 brain cancer. His father, who also requested anonymity, recounted his son’s dramatic journey.

When tests confirmed that the boy had multiple tumors in the brain, doctors recommended five days of radiation for six weeks, and chemotherapy once a week for 10 months.

The father said three weeks of radiation therapy made his son “sluggish, weak, moody, have a hard time sleeping, lose his appetite as well as his concentration.”

When friends told him about cannabis oil, he researched the subject and was willing to give it a try. He met a doctor who helped him get the oil and advised him on administering it to his son.

He, however, did not inform his son’s doctors that he would be trying out cannabis oil on the kid.

Starting with a dose of one drop, thrice a day, of 1 ml cannabis oil through rectal suppository, the boy was observed to “sleep soundly, had energy to play and his mood swings lessened.”

On the advice of his cannabis oil source, the father gradually increased his son’s dosage while continuing radiation.

Two months later, the boy was taken off radiation, but went on taking the oil till the dosage reached five drops, thrice a day.

The attending neurosurgeon requested an MRI (magnetic resonance imaging) procedure before the boy started his chemotherapy. The MRI results showed “all four tumors in the brain shrank significantly up to the point that one of the tumors disappeared.”

When the boy started undergoing chemotherapy, his father continued giving him cannabis oil for five months.

A second MRI yielded results that the father described as “mind-boggling to the point of disbelief: All tumors are now gone except for one that is suspected as a ‘scar tissue’ and is yet to be ruled out in the next MRI. I asked the doctor if we are on track with my son’s progress, and his answer was, ‘No, we are way ahead. I have never seen such a case respond so fast to this medical protocol. We’ve been praying for a miracle. I believe this is a miracle.”

On June 12, attending doctors declared the boy “in remission, no maintenance meds needed, patient in very good condition, is steadily gaining weight and his energy is back. Patient is still taking the oil five drops, thrice daily, orally but stopped the suppository.”

Skeptics may dismiss such testimonies as merely anecdotal evidence. Yet marijuana—from which cannabis oil is made—has, for thousands of years, been regarded as medicine, until the US government outlawed its cultivation and use, and the Philippines adopted that law.