Medical treatment

Getting High with Medical Treatment: Medical Cannabis Use and the Legal Approach – Healthcare Series 14

The use of medicinal cannabis dates back to around 2700 BC. It first appeared in traditional Chinese medicine and was used as medicine during surgery. However, the medical use of cannabis was mainly localized in India. While medical cannabis was used in limited areas in other countries, in India it was used as a treatment in many fields such as anesthetics, antibiotics, tranquilizers and as a painkiller.[1]

Although it had become well established over the centuries, by the start of the 20th century it could be seen that the use of medical cannabis had declined significantly. Due to the plant’s variability and instability, consistent results have been difficult to obtain, leading to growing distrust and declining use.[2] The emergence of drugs and the increase in legal restrictions are also major factors in the decrease in demand for herbal methods. The production, sale and use of cannabis is currently illegal and subject to certain penalties in most places in the world. However, there is an increasing use of medical cannabis, especially in countries like Belgium, Canada, Australia, the Netherlands and some states. inside the United States.

The medicinal value of cannabis

Medical cannabis refers to cannabis and its constituent cannabinoids used as a herbal remedy or therapy to treat diseases and/or their symptoms. Although cannabis has a long history of medical use, currently scientists, doctors and patients are not sufficiently aware of its medicinal value.

In 2017, a report by the National Academies of Sciences, Engineering, and Medicine evaluated over 10,000 scientific studies on the medical benefits and adverse effects of cannabis.[3] The report, “The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research”, have found that cannabis or products containing cannabinoids are effective in treating certain diseases and symptoms such as the following:

  • The cannabinoids in marijuana can reduce chronic pain in adults and may be helpful in treating conditions that cause chronic pain.
  • There is moderate evidence that cannabis or cannabinoids are effective in improving short-term sleep outcomes in people with sleep disorders.
  • Additionally, there is limited evidence that cannabis or cannabinoids are effective in increasing appetite and decreasing weight loss associated with HIV/AIDS and in improving symptoms of post-traumatic stress disorder (PTSD), of Tourette and anxiety.

The Legal Context of Medical Cannabis in the US and EU

In the United States, the use of cannabis for medical purposes – in many treatments, including pain, nausea, and any serious medical condition – is legal in 36 states and the District of Columbia; four out of five permanently inhabited U.S. territories as of May 2021.[4] Although the laws regarding medical marijuana in the states have created problems between the federation and the federal states, as the applicable law changes with each president, it is known that the use of medical cannabis is under the control of the state.

Regarding the United Nations view on this issue, firstly, cannabis use is restricted to scientific and medical purposes under the international drug control agreements (UNODC, 2013)[5]. Over time, the perspective on medical cannabis has changed and some legalization studies have begun. For example, in 2018 the European Parliament adopted a draft resolution[6] tabled by the Committee on the Environment, Public Health and Food Safety on the use of cannabis for medical purposes and encouraged Member States to apply medical cannabis treatment to patients. In this treatment, medical use is supervised and cannabis is prescribed by doctors.

Following the latest statements by the World Health Organization against medical cannabis, the European Parliament has voted on the amended resolution[7] on the use of cannabis for medical purposes in February 2019. In this resolution, the European Parliament calls on the Member States to provide healthcare professionals with appropriate medical training and to encourage a better knowledge of medical cannabis based on independent and wide-ranging research.”

Looking back today, it is possible to see that some countries in the European Union generally allow patients access to imported or locally grown cannabis, while some countries only provide access to medical cannabis.

Medical cannabis use and legal limitations in Turkey

Turkey has a long history of growing industrial cannabis or hemp. Archaeological evidence shows that people living in Anatolia have been growing cannabis since at least 700-800 BC and some believe hemp may have been cultivated as early as 1500 BC. [8]

Although cannabis was produced intensively in the 1960s, following pressure from the United States, Turkey began to strictly control the use and production of cannabis by imposing heavy penalties on those who cultivate, sell and possess the plant, which can result in prison terms of up to five years. Currently, cannabis is highly illegal for recreational use, but allowed for limited medical and scientific purposes in Turkey.

In 2016, with the Ministry of Health (“Ministry of Health”); approval for the sale of the drug, the use of limited medical cannabis – only in sublingual sprays such as Sativex – with a medical prescription has been authorized in Turkey, while all other forms of cannabis and the use of whole plant cannabis remain prohibited.

As mentioned earlier, the Ministry of Health has added Sativex, which can be obtained with a red prescription, to the list of importable drugs. Although not named directly, it can be understood that the ATC name “cannabinoids”, which was added to the list on January 25, 2016 in the list of drugs that can be brought from abroad on February 12, 2016 on the Turkish Medicines Market and Medicines Devices Agency (“TITCK”), refers to Sativex,.[9] In order to obtain these medications, patients must consult a physician licensed to issue red prescriptions. Physicians must assess a patient’s condition and decide that medical cannabis is the best or only treatment.

The Turkish government announced that it had legalized the controlled production of cannabis in 19 provinces of Turkey with the publication of the Hemp Cultivation and Control Regulations in 2016.[10] Under the new regulations, farmers are allowed to cultivate and produce hemp after obtaining a license, which will last for three years. Production is controlled by the Ministry of Food, Agriculture and Livestock and is only used for medical and scientific purposes. Those wishing to cultivate these plants must prove that they have never been involved in the production of illegal drugs.

Conclusion

Cannabis has been used in various medical fields such as pain relievers and antibiotics, as well as in psychotherapy since ancient times. Although the use of cannabis has grown over the centuries, its risks and harmful effects have led governments to develop regulations to restrict its use. As knowledge of the medical value of cannabis becomes more commonplace, lawmakers have taken steps to regulate the medical use of cannabis in the treatment of disease and symptoms. In addition to countries like Canada and the Netherlands, some US states have legalized cannabis for medical purposes. In 2016, Turkey reached a milestone in cannabis cultivation and the use of medical cannabis was approved. It should be kept in mind that cannabis is not completely bad, dangerous and illegal, nor the cure or the solution to all diseases. Therefore, a balance must be observed when regulating the medical or recreational use and restriction of cannabis.