In December 2018, Thailand passed a bill that legalized marijuana and kratom for medical purposes within its borders becoming the first country in Southeast Asia to legalize the use of these two plant stimulants for medical use. The junta-appointed parliament is responsible for the legalization having voted to approve the use of Marijuana for medical use on December 25th. The 166-0 vote by the parliament, even with 13 members of parliament absent was a big win for Thailand’s community in need of alternative medicine.
The move by the Thailand National Legislative Assembly (NLA) passed amendments to the bill presented to the house to permit the production, import/ export, the possession, as well as the use of both cannabis and Kratom only for medicinal purposes.
The passed bill also permits the use of a specific concentration of cannabis and Kratom for treatment of illness, but only with a prescription or a certificate from a licensed medical professional. Stricter regulations are, however, expected on the possession of the two Schedule 5 Drugs with regulations on possession expected to be approved by the National Narcotics Control Committee. As a result of the legalization move, the members of the committee increased from 17 to 25.
Members of the public in Thailand excited about the legislation will, however, have to wait for a while to get prescriptions and legally acquire either marijuana or kratom since the amendment of the Narcotic Act bill of 1979 is yet to be published in the Government Gazette.
For the control of the use of the two substances, the amendment made it clear that only persons and organizations authorized by the public health minister could be licensed to produce, import, sale, export, or possess cannabis and kratom. Anyone who violates the bill – by possessing the substances in larger than acceptable levels or using either substance for recreation – would be subjected to between 5 and 15 years in prison and/or fined a maximum of 1 million baht which is valued at about $30,731.50.
Note that besides the fines, the recreational use of marijuana or kratom remains illegal and it attracts the harshest punishment in the world. Trafficking of marijuana is punishable by death, and the new bill does not change this.
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The Use of Marijuana and Kratom for medical purposes
Thailand beat the state of New York with its December parliamentary move to pass the bill amendments required to legalize the use of Medical Marijuana. However, the US and Thailand bear a commonality: the fact the two countries prohibited the use of marijuana in 1930. In both countries, marijuana was availed by apothecaries and the substance used for pain relief and the management of anxiety.
While marijuana was still used in Thailand, albeit illegally, before the move to legalize it, the legalization promises to ensure better access to the product by persons suffering from different diseases.
Medical Marijuana in Thailand
Marijuana refers to dried leaves, flowers, seeds, and stems of the hemp plant, Cannabis sativa. Its active ingredient is delta-9-tetrahydrocannabinol or THC.
Medical marijuana is marijuana without the high, and often, medical marijuana comes from the CBD-dominant strains of marijuana. It lacks or has trace amounts of THC (tetrahydrocannabinol) yielding medical benefits like pain relief without causing a significant alteration of consciousness. THC is the compound that gives a high.
The difference between medical cannabis and recreational cannabis is that the recreational form of cannabis will leave you feeling foggy with an amnesia haze, but not medical cannabis. The difference, according to the experts, lies in the distribution of the compound cannabidiol or CBD in relation to the distribution/concentration of THC. Medical cannabis carries more CBD than THC. While THC is recognized for its high and mood elevation, CBD is great at relaxing muscles and pain relief, along with several other benefits. THC is regarded as the accelerator while CBD is annotated the brakes. CBD. Often the THC to CBD ratio in recreational versus medical cannabis is 2:1.
The other difference is that medical marijuana is regulated, but there isn’t much regulation when it comes to recreational THC.
Note: CBD first came to light in 2013 when a girl with life-threatening epilepsy had the disease under control when she used oil with high levels of CBD cannabis.
Why Use Marijuana for medical reasons?
The use of medical marijuana starts with endocannabinoids or eCBs along with their receptors located throughout the human body. Endocannabinoids originate from the endocannabinoid system, in endogenous and lipid-based retrograde neurotransmitters which bind to the cannabinoid receptors. The system is found in the immune cells, the nervous system, glands, connective tissues, and internal organs. The eCBs system has a homeostatic role and has been characterized by the Eat, Sleep, Relax, Forget, and Protect roles.
However, the biggest effects of the eCBs lie in the pathology of disorders, as well as the protective function they offer to various medical conditions. It’s even been proposed that medical issues like migraines, irritable bowel syndrome, depression, schizophrenia, Huntington’s disease, multiple sclerosis, anorexia, Parkinson’s disease, and fibromyalgia, among other pathologies, result from an eCBs deficiency syndrome (CEDS).
The system has also been shown to represent a microcosm of mind-body medicine or Psycho-neuroimmunology. This system has receptors, ligands, and metabolic enzymes, and the stimulation of the CB1/ cannabinoid receptor 1 (G-protein–coupled receptors) or CB2 cause several physiological effects on the neuronal and the non-neuronal pathways.
The stimulation of the receptors is the reason for the healing or medical benefits of cannabis.
THC, being a psychoactive compound activates the nervous system by activating the CB1 receptors while CBD effects CB1 and CB2 receptors hence the pharmacological effects of medical marijuana.
In simpler terms, THC will only fire up the central nervous system while CBD fires up the receptors that give off therapeutic effects. The pharmacological effects of CBD are anti-inflammatory, antiepileptic, antipsychotic, anxiolytic, and neuroprotective.
These effects of CBD are why medical marijuana is recommended for medical use.
Uses of Medical Marijuana
Before we look at some of the illnesses that marijuana could help manage, it should be noted that besides THC and CBD, marijuana has over 400 chemicals. At least 60 of the chemicals are cannabinoids meaning that there could be many other unexplored possibilities and medical conditions treated by marijuana.
Currently, the following are the medical conditions that could be managed by marijuana.
- Treatment of chronic pain. Several reports point to the fact that marijuana is an effective pain reliever. In a report published recently by the National Academies of Sciences, Engineering, and Medicine, pain relief is the top medical use of marijuana. Marijuana’s effectiveness in treating chronic pain comes from the combined effects of THC and CBD. While the mechanism of pain relief is not yet clear, it would appear that the cannabinoids in marijuana play a significant role in pain relief.
- It’s beneficial to persons with multiple sclerosis. Studies indicate that medical marijuana has modest effects on the spasticity and pain associated with multiple sclerosis. The effects are associated with cannabinoids, particularly THC and CBD. In MS patients, marijuana has been shown to be effective the management of the symptoms of the disease.
- Marijuana for depression, social anxiety, and PTSD. Cannabinoids could be extremely effective in treating the symptoms of most mental illnesses including depression, anxiety, and PTSD because of its ability to relieve those symptoms. However, the authors of this report which was published in the Clinical Psychology Review caution against the use of marijuana for mental illnesses like psychosis and bipolar disorder.
- Marijuana could help people struggling with alcoholism and even drug addiction. According to the comprehensive review published in the Clinical Psychology Review-Journal, the use of medical marijuana could be effective in dealing with addiction or alcoholism. While this suggestion is one of the most contentious suggestions yet, the report indicates that the use of cannabis could be helpful in dealing with mental issues associated with alcoholism or drug addiction.
- Management of Epilepsy High-CBD cannabis is recommended for the treatment and the management of severe forms of epilepsy, particularly the Dravet Syndrome and the Lennox-Gastaut Syndrome. High-CBD cannabis or pure CBD is recommended for treatment of children and even adults with epilepsy. The effects of CBD have been shown to be extremely effective in children with the Dravet Syndrome. This syndrome is associated with repetitive, prolonged and even lethal seizures with one in every child with Dravet Syndrome reported not to reach 20 years.
- It stops the spread of cancer. The pharmacological cannabinoid in weed, CBD can stop the spread of cancer cells as seen in a report by the researchers in San Francisco’s California Pacific Medical Center. The cannabidiol has been shown to stop cancer cells from spreading by turning of the marker gene ld-1. The studies also show that the treatment with weed reduced the expression of the ld-1 gene. At the same time, a study that was published in the American Medical Association in 2012 indicated that weed could help reverse the lethal carcinogenic effects of tobacco, improving lung-health in the process. Besides stopping the spread of the diseased cells, marijuana taken orally helps in fighting nausea/ vomiting that comes with chemotherapy.
- Treatment of glaucoma. Cannabis treats glaucoma by lowering intraocular pressure in the eye, slowing down the progression of the disease in the process.
- Relief from arthritic discomfort. Weed is not only effective in reducing pain, but it also promotes sleep and reduces inflammation. The result is pain relief and the alleviation of discomfort around the joints.
The other benefits include:
- Improved mental clarity
- Management of Crohn’s disease
- It slows down the progression of Alzheimer’s disease and Parkinson’s disease.
- It protects the brain in people who have had a stroke
The health risks of medical marijuana
Short term effects
- Giddiness
- Relaxation
- Increased appetite
- Altered time and events’ perception and delayed time reaction
- Coordination issues
- Nausea
- Anxiety
- paranoia
- A drop in blood pressure
- An increased heart rate
Long term effects
- It exacerbates mental health conditions like bipolar disorder and psychosis
- There is some evidence pointing to the fact that marijuana could increase men’s risk of developing the slow-growing seminoma, a subtype of testicular cancer
- Smoking cannabis could cause cancers of the lung and gums.
- Smoking could also increase a user’s risk of developing a chronic cough and worsening of asthma or COPD.
- Exposure to cannabis early in life, say in the teenage years could cause memory and even learning problems.
- In the long terms, users could develop dependence issues.
- Higher risk of stroke or developing cardiovascular disease.
How To Use Medical Marijuana
- Smoking
- Topical application
- Oral administration: few drops of concentrated oil under the tongue
- Inhalation
- Eating as in cookies or candy
Kratom in Thailand
ThorPorre [CC BY 3.0 (https://creativecommons.org/licenses/by/3.0)], from Wikimedia Commons
Kratom (Mitragyna speciose), on the other hand, is a natural stimulant obtained from the tropical evergreen tree that comes from the coffee family. It is native to Southeast Asia. The leaves of the kratom plant contain 7-hydroxymitragynine and mitragynine, alkaloid compounds with psychotropic effects.
Traditionally and for the longest time, kratom works as a stress buster, an energy booster, and it also boosts mental alertness and concentration. Recently, however, kratom’s gained popularity as the next best alternative to opioid pain medications such as hydrocodone/ Vicodin and oxycodone.
The reason for its use: 7-hydroxymitragynine and mitragynine are believed to control and suppress pain by attaching to opioid receptors in the brain hence the reduction in pain perception. Kratom works in a manner similar to the opioid drugs but reducing pain through its influence on the brain regions that regulate emotions.
Note, however, that despite the efforts to legalize kratom, its use should be highly controlled. If we are to go with the sentiments of the CDC, at least 250 people are reported to have died from overuse and wrong use of kratom and kratom-containing substances. For Thailand, this would mean controlling the dosage the patient gets.
The possible side effects of Kratom
Short-term effects: stimulant effects, itching, nausea, dry mouth, sweating, constipation, diarrhea, loss of appetite, increased urination, drowsiness, hallucination, agitation, palpitations, and even the loss of muscle control/ coordination.
In the long-term, some of these effects still manifest but could be accompanied by weight loss, insomnia, seizures, tremors, hyperpigmentation, and even psychosis,
The side effects are not similar across the board.
The recommended dosage for kratom varies depending on age, weight, and health but should be between 1 and 15grams of the raw leaves.
Psychonaught [Public domain], from Wikimedia Commons
How to Use Kratom
- The dried leaves are too tough though you could chew on them. Crush into powder and mix with water or any other liquid then drink.
Conclusion
Although the legalization is a great step for Thailand, there are reports noting that some people are against it: they see it as a way of sabotaging Thai’s medical R&D on cannabis. However, there is no denying the fact that the legalization of medical marijuana in the West has had significant positive effects on the quality of life for several patients. Efforts will need to be made to educate the public, but also and more importantly the physicians: only by studying the existing papers on the topic they will eliminate the bias surrounding these herbal remedies and will become comfortable in prescribing them to treat the diseases they already have been proven effective for. The new Narcotics Act’s changes will become law once published in the Royal Thai Government Gazette, which can take up to four months.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/
- https://www.businessinsider.com/health-benefits-of-medical-marijuana-2014-4?IR=T#theres-also-strong-evidence-medical-cannabis-can-help-with-muscle-spasms-2
- https://www.thegrowthop.com/cannabis-health/cannabis-medical/how-does-medical-cannabis-differ-from-recreational-cannabis
- https://www.webmd.com/a-to-z-guides/qa/what-is-medical-marijuana-used-for
- https://www.health.harvard.edu/blog/medical-marijuana-2018011513085
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358713/
- https://www.greenspiritrx.com/education/20-health-benefits-of-marijuana
- https://emedicine.medscape.com/article/1361971-overview
