Cannabis, popularly known as Marijuana, is listed as a Schedule I drug which means that it is

prohibited in our country

At the time of its classification, it has no accepted medical use, lacks safety data, and has high
potential for abuse.

However, illegal use of marijuana is still rampant in our country. In 2017, cannabis second to
methamphetamine or shabu in the list of Commonly Abused Drugs posted by the Dangerous
Drugs Board.

Last January of this year, legislators from the House of Representative approved on its third and
final reading a bill that would legalize and regulate the use of medical marijuana with a total of
163 affirmative votes.

As future pharmacists, we should be informed on this bill or on the Legalization of Medical MJ in

the Philippines; Recent appraisal in the congress.

Here is the outline of my presentation. At the end of the session, the audience should be able
discuss whether legalization of medical marijuana is needed in the Philippines.

Cannabis is obtained from the dried leaves, stalks, flower and seed, commonly of Cannabis
sativa. It contains 421 chemicals, 61 of which are cannabinoids. The primary psychoactive
component is (Δ 9 -THC). Marijuana for recreational use is commonly smoked by joint.

Cannabinoids bind to and activate two types of receptors: CB1 and CB2. CB1 receptors are
mostly found in the brain while CB2 receptors are found in immune cells. When these are
activated, it produces a plethora of effects.

The most prominent effects are euphoria and relaxation. However, this is accompanied by a
reduced ability to concentrate and do complicated tasks, and a loss of short-term memory

Psychological dependence can also occur. It can lead to hallucinations, depression, anxiety, and
panic.

Additional effects of cannabinoids such as increased appetite, attenuation of nausea, decreased

IOP and relief of chronic pain have led to the use of cannabinoids in medicine.

Here are four US-FDA approved cannabis-based drugs.

Epidiolex is indicated for the treatment of seizures

Sativex for symptom improvement in patients with Multiple Sclerosis

Marinol for anorexia associated with weight loss in patients with AIDS

Both Cesamet and Marinol are indicated for nausea and vomiting associated with cancer
chemotherapy.

All of them are expensive and is not available in our country.

House Bill No. 6517, is also known as the Philippine Compassionate Medical Cannabis Act. The
bill’s primary objective is to legalize and regulate the use of medical cannabis to benefit patients
suffering from debilitating disease. Examples of debilitating diseases referred to in the bill, are
cancer, glaucoma, multiple sclerosis, epilepsy, and hiv/aids. It also include medical conditions that
produces the following: wasting syndrome, severe and chronic pain, severe nausea, seizures, and
severe and persistent muscles spasms.

House bill no. 6517 mandates the Department of Health (DOH) to be the principal regulatory
agency for medical cannabis, in coordination with the Philippine Drug Enforcement Agency
(PDEA) as the monitoring and regulatory body.

The bill also establishes an Advisory Committee on Medical Use of Cannabis under the DOH
which shall serve as the advisory body in the formulation and implementation of policies and
regulations.

The bill also requires the Secretary of DOH to submit an annual report which shall contain basic
information on the use of cannabis

The bill also provides criteria for one to be a qualified medical cannabis physician, patient, and
caregiver.

A medical cannabis physician should have an established bona fide relationship with the patient,
a license to prescribe from the PDEA, and professional knowledge of course on cannabis.

A medical cannabis patient should be diagnosed by a qualified medical cannabis physician as

having a debilitating medical condition.

A medical cannabis caregiver should have a license to administer from the PDEA and must not
have been convicted for use of any dangerous drugs.

The bill also provides for the licensing and operation of Medical Cannabis Compassionate
Centers and Medical Cannabis Research and Safety Compliance Center.

A medical Cannabis Compassionate Center refers to any entity that acquire, possess, deliver,
transfer, transport, sell, supply and dispense cannabis.

Medical Cannabis Research and Safety Compliance Facility refers to any entity that conducts
scientific, and medical research on the medical use of cannabis.

The bill also authorizes the UP NIH, UP Manila, and the Philippine Institute of Traditional and
Alternative Health Care and other organizations to conduct research on the use of medical
cannabis.

The bills also provides penalties for the commission of prohibited acts. Examples of prohibited
acts stated in the bill are:

1. Use of cannabis in any mode of public transportation or in any public plaice

 2. Use of Cannabis for purposes other than treatment of a debilitating medical condition
3. Undertake tasks that would require motor functions impaired under the influence of
cannabis

Penalties include:

Fines of 50,000 to 100,000 pesos or higher

Imprisonment of 6 to 12 years

Suspension or revocation of professional licenses or registrations.

The proposed law would not decriminalize the use of cannabis, neither would it allow smoking.
Recreational use, growing, or possession of raw forms of marijuana would still be banned.
Medical cannabis shall not be used in its raw form and only the a finished dosage form is allowed.

An existing law on dangerous drugs or RA 9165 provides penalties on the possession, use, and
cultivation of cannabis. It is important to note that under section 2 of RA 9165, it states that

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.

Thus, for some, there is no need for any new legislation allowing access to medical marijuana

AO No. 4s 1992 states that patients can apply for a "compassionate special permit" from the
Food and Drug Administration (FDA), which allows unregistered drugs in the country to be used
for medication.

Application for CSP is only for patients with aids, cancer, and life threatening conditions. The
application must include____.

Last 2017, UPM expressed its objection to proposals legalizing medical cannabis.

The enactment of medical marijuana laws could lead to a change in community attitudes on both
medical and non-medical marijuana use, including reduced disapproval and perceived riskiness of
use, which could subsequently influence marijuana use and abuse/dependence.

As pharmacists, we should be updated with the laws regarding dangerous drugs. For proper
dispensing, we need to inspect every yellow rx carefully, follow proper documentation protocols,
screen for possible drug interactions, and counseling to ensure the proper use of the drug.

As pharmacists, drug discovery, research and formulation is important to find an alternative drug
for patients with debilitating diseases.

Ma’am Pena asked me to share my opinion in this. For this, I would like to borrow 2 statement
from two personalities. I am sure we all know what Ms. Universe 2018 said during the pageant.
For me it is a good but somehow safe answer. Medical marijuana, though palliative, brings hope
to patients with debilitating diseases.

However, we should consider a lot of factors. We are taking Pharmacoeconomics and Public
Health and I am sure we can all relate to what DOH Undersecretary Domingo said.
With that I will end my presentation with a question. Do you think our country is ready for such
law?