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SPECIAL REPORT: Medical marijuana’s LONG ROAD BACK

May 10. 2019
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By PIYAPORN WONGRUANG
THE NATION WEEKEND

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71-year-old DECHA Siriphat has been licensed to practise traditional medicine, but he has a few more steps to go before he can begin giving his patients marijuana-based medication.

The newly amended narcotics law and associated organic regulations have complicated procedures, say Decha and community-rights advocates. They believe the law should be further amended to “truly free” medical cannabis, which remains classified as a narcotic, so it can be used unconditionally.

The National Legislative Assembly (NLA) approved changes to the 1979 narcotics law that came into effect on February 19. Use of marijuana for medical purposes became legal under conditions set out in the law itself and in new regulations issued by the Public Health Ministry.

The law includes a 90-day amnesty period for anyone in prior possession of marijuana for medical purposes or research. 

Research institutes, practitioners of both modern and traditional medicine and individuals using cannabis as a curative or for pain relief need to report the fact to the ministry to avoid penalty.

“The law is well-intentioned in spirit, allowing the use of marijuana for medical purposes, but conservative people are concerned, and that’s resulted in complicated rules and procedures,” said Witoon Lianchamroon, a director of BioThai, a non-profit organisation involved in community rights, food security and biodiversity.

“It doesn’t make it easy for any traditional medical practitioner, let alone Ajarn Decha. It’s the big drug firms that can meet these rules, not traditional practitioners.” 

 

Courtesy of BioThai.

Ancient roots

Marijuana has been used in traditional medicine in Thailand for more than 300 years, BioThai research determined. It’s first mentioned as a formula ingredient in the “King Narai Medicine Book” published in 1659. Subsequent medical treatises credited its benefits in treating various illnesses, even psychosis.

But the development of its use in traditional medicine came to a halt with its listing as a narcotic in 1979. Anyone caught producing, distributing or just in possession of marijuana could be jailed for up to 15 years and fined up to Bt1.5 million.

The criminalisation of "ganja", as it’s commonly known here, resulted in the gradual loss of knowledge of its possible uses in curing illness. Only now has the quest for further knowledge been able to resume following the law amendment.

Inspite of that, marijuana is still listed as a narcotic and strict controls remain in place regarding its use. Only government-endorsed agencies, researchers, medical practitioners and groupings of cooperatives are allowed to possess, produce and distribute marijuana-based medicines.

The ministry’s added regulations specially require practitioners of traditional medicine to be registered as such with the ministry first.

Decha himself had never before done so, though he’s had years of training in the production of traditional medicine and began examining marijuana’s potential 10 years ago when a family member was diagnosed with cancer.

Decha’s main work has been in the conservation of rice variety at his Khao Khwan Foundation in Suphan Buri.

Settling on a formula he believed could help cure cancer and other diseases, Decha has been giving the medication to patients for free at temples for the past two years. Threatened with arrest even after the law was amended, Decha sought formal registration. 

After clearing up issues with the Office of the Narcotics Control Board of Thailand, Decha applied for a licence late last month. He underwent a week’s training before the provincial health office in Suphan Buri approved the registration.

But it still doesn’t mean he can now legally distribute his marijuana medicine. His famous formula and any others like it he concocts must also be approved by the ministry and endorsed by the Food and Drug Administration or the Thai Traditional and Alternative Medicine Department. Or he has to get his medicine formula approved and added to the list of already endorsed 16 ancient formulas by the TAM.

Or else, new formulas must be approved under a “special access” scheme extended to particular groups of people in need, or by conducting joint research with state-endorsed institutions.

Decha’s medicines could be approved through at least three approaches of these, but he’s decided the last way is the least complicated in terms of regulations.

Just the same, BioThai expects he’ll still have at least four more steps to cover before he can resume distribution.

 

Courtesy of BioThai.

Decha’s quest

Having been registered as a traditional medical practitioner, he and his fellow researchers must obtain approval for their project from a ministry committee on guard against formulas that could affect the recipient’s mental state or nervous systems. 

Their research will next be subjected to “ethical testing”, another time-consuming process with no set deadline.

As a narcotic, the marijuana used in their research can only come from official sources, which currently means authorities like the police or ONCB that confiscate drugs. 

While the research continues, Decha’s patients will be designated as research subjects – and no one else can be given his medicine, a withering restriction for Decha, who wants to help as many people as he can.

Prime Minister Prayut Chan-o-cha instructed officials to make sure Decha’s medicines would emerge from the lab by this month, but Decha, in consultation with allies including BioThai, now says the law must be changed again.

“As Ajarn Decha’s case demonstrates, the laws is full of rules and procedures because it’s still a matter of state control,” said Witoon. “It makes the work really difficult and complicated.

“The point is that access to marijuana for medical purposes is the right of patients and medical practitioners. This is why we want to amend the law again.”

More than 10 organisations involved with community rights and alternative healthcare have proposed this principle of a “right” as the key to the needed amendment.

They’ll be promoting the idea at the Cannabis Walk set to take place once the 90-day amnesty ends on May 19. Decha will lead a 20-day procession from the Phichit temple that distributed his medicine to another one in Suphan Buri.

Decha said the government has to stop thinking of marijuana as a narcotic and regard it as a “controlled substance” such as tobacco, which allows for limitations on excessive use. 

Somchai Sawangkarn, the NLA whip who led work on drafting the legal amendment, has no objection to further changes, but noted that the assembly carefully considered both pros and cons and weighed all factors, including the potential for addiction and parents’ concerns.

The amendment, he said, also faced fierce opposition from groups including transnational drug firms that feared the loss of profits from their drug sales.

Somchai said the amended law was the first step towards replacing expensive drugs with marijuana-based medicines in the healthcare system.

“The NLA made the amendment after thorough thought, taking the country’s readiness into account,” he said. “I don’t say we did the best, but this was the first step and you can take the next step from here.”

 

Read: SPECIAL REPORT: A work life anchored in Dhamma

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