Legalizing marijuana for medicinal purposes:

Marijuana is globally the most commonly used psychoactive substance under international control. In 2013, an estimated 181.8 million people aged 15-64 years used marijuana for nonmedical purposes globally. There is a worrying increasing demand for treatment for marijuana use disorders and associated health conditions in high and middle-income countries, and there has been increased attention to the public health impacts of marijuana use and related disorders in international policy dialogues.

Despite all of this, there is a movement towards the legalization of marijuana for medical purposes. This is based on the belief that the substance has beneficial medical effects. Marijuana is considered in the United States as a Schedule 1 drug. A Schedule 1 drug has a high potential for abuse, has no currently accepted medical use in treatment in the United States and lacks acceptable safety for use under medical supervision.

Marijuana is illegal in most Caribbean countries. Criminal laws against marijuana use remain firmly in place. The sale, purchase, or consumption of marijuana for any purpose is illegal and is punishable by law. Many, if not all, Caribbean countries are party to, and model their local Dangerous Drugs legislations on the United Nations Convention on Psychotropic Substances. This Convention contains four Schedules of controlled substances, ranging from most restrictive (Schedule I) to the least restrictive (Schedule IV). Marijuana is currently placed on Schedule II in the Caribbean, and classified as a dangerous drug, for which possession of any quantity becomes an offence. 

In late 2014, the Jamaican government undertook legislation to decriminalize small amounts (up to two grams) of marijuana, but no law has yet been passed. Over the past few decades a growing number of Caribbean countries have been advocating for the legalization of marijuana. Advocates for its legalization cite the medical and economic benefits, while those against, cite its potential hazardous implications for personal mental health and public health.

Scientific evidence that supports the medical benefits of cannabinoids (the chemical compounds derived from marijuana), also confirms that there are adverse effects of tetra hydrocannabinol (THC), which is the psychotropic or mind-altering constituent found in the plant. Re-classification and making it available for medical use would have to consider whether the benefits to be derived from removal of current restrictions will outweigh possible harms of increased use.

It is illegal for physicians to prescribe the drug. Prescribing marijuana would constitute aiding and abetting the acquisition of the drug. Persons who use the drug for medical purposes seek the drug on their own, possibly because of a physician’s informal recommendation or from cultural beliefs in the therapeutic benefit of the drug. There still exists a dearth of hard clinical data regarding the efficacy in treating certain medical conditions. Aside from the lack of data on efficacy, there are still concerns regarding the form, contents, and dosage.

Notwithstanding this, there are individuals who turn to the use of marijuana for medical purposes, citing that they have found no relief for their ailments from the use of western medicine. Individuals suffering from AIDS, anorexia, arthritis, cancer, migraine headaches, seizures, severe nausea, glaucoma, chronic pain, among others, have testified on the medical benefits of using marijuana.

It may be a perfect time to restart the dialogue on the use of marijuana for medicinal purposes and to examine the legal, ethical, medical, social and religious issues involving medical use of marijuana in the Caribbean context, where marijuana remains an illegal drug.

Dr Rosmond Adams, MD is a medical doctor and a public health specialist. He is also an ethicist with training in research ethics and medical ethics. He is the head of Health Information, Communicable Disease and Emergency Response at the Caribbean Public Health Agency (CARPHA).

He is also a member of the World Health Organization (WHO) Global Coordination Mechanism (GCM) on the Prevention and Control of Non-Communicable Diseases (NCDs).

(The views expressed here are not written on behalf of CARPHA nor the WHO)