Legalization of medical cannabis: the need, the risks, the manipulation and alternatives

You can buy oils, juices, seasonings, cosmetics, or, having issued the appropriate licensing documentation, independently grow variegated therapeutic varieties and heal or treat yourself on an ongoing basis. In addition, in Ukraine there is an experience when to the “green mass” quot; plants add appropriate conductors and catalysts, and the resulting substance, which excludes extraction (currently prohibited by law), is extremely effective in the treatment of very serious, including chronic diseases. There are documented examples in Ukraine of the treatment of inoperable forms of cancer and persons with the fourth (terminal) stage of cancer.

To legalize medical cannabis - this proposal, supported by Uliana Suprun about a week ago, caused a great resonance in the network: thousands of reposts, even more preferences and comments. This idea seems to be liked by all. Is there really a need to legalize medical cannabis, is there an alternative, what are the risks and why the decision has not yet been made.

What and why did Uliana Suprun suggest?

A post on a social network that has already gathered over five thousand reposts in. about. The Minister of Health began with the thesis that the use of narcotic substances, even for medical purposes, is a rather complicated topic that is not difficult to manipulate. At the same time, Ulyana Suprun noted that the use of cannabis in medicine is normal international practice, and patients' access to drugs based on it is the realization of their right to medical care.

 The use of drugs for any purpose, even for medical purposes, is a complex topic. Therefore, it is easy to manipulate, even when it comes to vital patient care.

Medical cannabis helps alleviate the suffering of patients and normalize their well-being in a number of serious diseases and conditions. Therefore, to use it in medicine, with certain reservations, of course, is a normal world practice.

Medical cannabis has many proven curative and palliative effects, and is permitted, for example, in 25 states of the USA, Australia, Canada; its use has long been settled in many European countries. Cannabis is prohibited in Israel, Romania, Macedonia and Puerto Rico, but is permitted in cases of incurable diseases.

As for Ukraine, the use of medical cannabis for medical and scientific purposes is completely prohibited. Although the use of such drugs would help almost two million citizens suffering from chronic pain and other disorders.

Patient access to cannabis-based drugs is the realization of their right to medical care. It is important to support the legalization of the use of medical cannabis for scientific purposes and medicine ", - Uliana Suprun is convinced.

Is there really a need for medical cannabis use?

Gennadiy Shabas, expert of the NGO "Ukrainian Association of Medical Cannabis"  noted that there is a scientifically proven effect of cannabinoids in the treatment of a number of serious diseases. Therefore, the legalization of medical cannabis can significantly alleviate the suffering of patients.

"When we say" medical cannabis ", we mean medicines in various pharmaceutical forms that combine the active substance that is used - these are cannabinoids and other active cannabis ingredients, according to a WHO report, about 500 of them are discovered. These components, together or in isolation, interact with cannabinoid receptors in the human body, which leads to a therapeutic effect in a number of diseases. In our requirements, we rely on the scientifically proven effect of cannabinoids in the treatment of chronic pain, epilepsy, anorexia, post-traumatic syndrome, immune system diseases, arthritis and rheumatism, asthma, Alzheimer's disease, Parkinson's disease, Getington, herpes, ulcers, AIDS weight loss, diabetic neuropathy, various forms of sclerosis and many other serious diseases.

Legalization of medical cannabis should be understood literally to enact a law that sets the rules for controlled limited circulation for the production of such medicines and the professional maintenance of their use. The law will provide access to cannabis preparations for medical patients under the supervision of doctors, ”the expert is convinced.

Lyudmila Goncharuk , Assistant of the Department of Internal Medicine and Infectious Diseases of the Higher State Educational Institution "Bukovinian State Medical University", today medical cannabis is widely used in many countries . As for Ukraine, the expert emphasizes: the need for legalization really exists, since the use of medical cannabis can alleviate the suffering of seriously ill Ukrainians and become a step towards the civilized standards of other developed countries.

 Today, medical cannabis is successfully used in 29 states in the United States, Uruguay, Canada, Israel and some European countries (Lithuania, Poland, etc.). However, it is necessary to remember the UN convention where cannabis is blacklisted.

What is cannabis? This whole leaves plant is hemp, the crushed parts are marijuana. The main component of hemp is tetrahydrocannabinol, which has a psychotropic effect on the human brain. Besides it, there is also cannabidiol, which has a healing effect.

Ukrainian patients today have no legal right to such treatment. Although, scientists and the medical community are asking to legalize cannabis for more than a year.

There is a well-known practice of effective use of medical cannabis for idiopathic epilepsy, cancer, AIDS, etc.

There are more than 50 thousand children in Ukraine with various forms of epilepsy. In neighboring Poland, cannabis, which, by the way, was recently resolved under public pressure, effectively reduces seizures in this nosology. The number of cancer patients in Ukraine is about 1 million. Treatment of these patients is often accompanied by side effects, such as nausea, vomiting, pain, insomnia, and fear. Literary sources indicate the appropriate use of cannabis to alleviate the condition and improve the quality of life of these patients.

The perspective is to add medical cannabis to the list of narcotic drugs whose circulation is limited. Following the example of the use of morphine or amphetamine, where a system of administration of these drugs is clearly developed. This is a prerequisite for alleviating the sufferings of seriously ill Ukrainians; this is a significant step towards the civilized standards enjoyed by developed countries, ”the doctor is convinced.

However, commenting on the use of medical cannabis, and. about. The Minister of Health noted that the drug may have side effects, and the doctor must weigh the benefits and risks of its consumption.

"Medical cannabis also has side effects: dizziness, indifference, impaired memory and addiction, effects on cardiovascular and respiratory diseases. Of course, before any prescription, the doctor weighs the benefits and risks of the use and prescribes the consumption of such drugs only when necessary, ”Suprun added.

Alexander Ignatyuk , President of the association "Ukrainian Technical Cannabis", on the contrary, believes that the number of patients who need medical cannabis is in fact exaggerated. 

"The initiators of the appeal to the Verkhovna Rada claim categorically that about 2 million patients need cannabis-based drugs in our country. This figure is definitely overstated. For comparison, in Israel (8.9 million & nbsp; population), where more than 20 years of active use Medical cannabis and preparations based on it are used, cannabinoid therapy is used by about 25-30 thousand patients. In the countries of the European Union and Canada, the number of patients who use the therapeutic properties of cannabis or preparations based on it can be compared with Israeli figures. But this is not the 2 million citizens in question in the Ukrainian petition “,” Alexander Ignatyuk is convinced.

How to legalize, and tried to do it before?

According to Gennady Shabas, there have already been attempts to legalize medical cannabis, but the initiators of the bill have not finalized their idea, so everything must be started anew. But on the situation today: legally in Ukraine it is impossible not only the use of drugs based on hemp, but even scientific research.

 Now the legal status of cannabis makes it impossible not only to manufacture and register medicines based on it, but also to conduct scientific research. Changes are needed to a number of laws and regulations to make limited circulation permissible and to ensure effective control over such treatment.

The need for these changes is documented in the State Policy Strategy on Drugs, which deals with the research of cannabinoids, as analgesics and other drugs.

The first attempt to translate this point of the state strategy into practice took place in 2016, when the bill No. 4533 was registered. However, it was not developed in time by people's deputies, outdated and in need of refinement & raquo ;, - Explained the expert.

But political analyst Vladislav Serdyuk is convinced that legalizing medical cannabis can make life easier for drug importers. In turn, the expert suggests not to legalize, but to decriminalize the consumption of medical cannabis.

"I am not in favor of legalizing medical cannabis, because I believe that the final beneficiaries will not be patients, but people who import drugs to Ukraine. The main task of drug importers is to legalize their transportation in any possible form. But our task is not to make life easier for importers through the legalization of drug supplies in Ukraine?

A more appropriate solution would be to decriminalize cannabis consumption. This will allow the end user (including the patient) to avoid problems with the law, but not regulate the supply of drugs to Ukraine. Along with decriminalization, its consumption can be argued for medical reasons, which means everyone except drug dealers will benefit from it.

Of course, it should be understood that the final word in this question is behind the Ministry of Internal Affairs, which should give good  legislators and declare that after legalization they will take the situation under control. Otherwise, this question will not find its answer in the form of a legislative act , Serdyuk believes.

Alexander Ignatyuk has a completely different point of view. He is convinced that the issue of using cannabis for therapeutic purposes should be viewed positively, but this does not mean that the legislative framework should be changed to meet the requirements of companies from other countries, since Ukraine has enough technical varieties of cannabis, the use of which is not only more affordable financially, but is also more productive .

"To the question of amending the legal framework, according to which the therapeutic properties of cannabis will be used not only in industrial, but also for scientific and medical purposes, must be treated positively. But there is no need to change the legislative base in the interests of foreign companies that lobby for the opening of the market for exporting products of dubious quality to our country. Ukraine has created technical varieties of therapeutic hemp, the use of which gives a better result at a much lower price than pharmaceuticals, imposed on us from abroad.

How successful is cannabis treatment practice? If we talk about the national practice of treatment with leaves and inflorescence of technical hemp , the therapeutic focus is extremely effective. No need to buy very expensive foreign preparations based on hemp extract. You can buy oils, juices, seasonings, cosmetics or, by issuing the appropriate permits, you can grow yourself without theces therapeutic varieties and on a permanent basis to heal or treat. In addition, Ukraine has experience when to & quot; green mass & quot; plants add appropriate conductors and catalysts , and the resulting substance, excluding extraction (currently prohibited by law), is extremely effective in the treatment of very serious, including chronic diseases. There are documented examples in Ukraine of the treatment of inoperable forms of cancer and persons with the fourth (terminal) stage of cancer.

Now there is no need to focus on amending the laws of Ukraine - it is very long and ineffective. There is a much simpler and more effective way - making changes to the relevant decree of the Cabinet of Ministers of Ukraine, in which it is necessary to allow the use of cannabis leaves and inflorescences for industrial purposes, in which dried tetrahydrocannabinol content does not exceed 0.08 percent. Experience shows that PCMU is being reviewed and accepted within 4-5 months. In fact, if such changes are adopted, since July 2019, citizens of our country can be treated with the help of  green mass technical hemp therapeutic orientation, and from April 2020 one who wants to be able to grow potless varieties that have a significant therapeutic effect in the case, if you issue the necessary permits in such cases. I emphasize right away that there are no special difficulties with the execution of the relevant documents. There is a procedure following which within a month interested business entities have been drawing up relevant documentation for years, the expert believes.

Are there risks in legalizing medical cannabis?

Gennady Shabas, commenting on this question, noted that most of the fears and cautions arise because of the banal misunderstanding of the mechanism for creating legal trafficking of cannabis.

 I personally would like to hear the arguments against, but so far I have not been lucky to hear them. But warnings and fears are voiced, usually the reason is that people do not fully understand the mechanism for creating legal trafficking for cannabis. Cautions relate mainly to the range of patients who will have access to treatment. And the concern is whether the state will be able to control this process. But this is the task of the law - to establish adequate restrictions and effective control ", - the expert believes.

Dmitry Sinchenko, the chairman of the NGO "The Association of Political Sciences", is also convinced that the risks do not exist. According to him, legalization will only allow sick patients to get the necessary medicines, but those who use cannabis for non-medical purposes will continue to do so, regardless of the decisions of the authorities.

 In my opinion, there are no risks. Patients will receive effective medicines, and those who have used cannabis for non-medical purposes will continue to do so, regardless of the legalization of medical cannabis. And the fact that marijuana, unlike, by the way, from tobacco and alcohol, not to mention other narcotic substances, is not addictive, makes sure that the risks of “turning Ukrainians into drug addicts” does not exist at all & raquo ;, adds the expert.

Should we expect manipulations?

Reflecting on the legalization of medical cannabis, Uliana Suprun assured that there could be many manipulations in the context of this issue. But Gennady Shabas said that certain manipulations begin from the term “drugs”, since in fact it is not only what kills, but also what heals people.

 Drugs is a word that in the last century became a definite bogeyman who is frightened and who is frightened because drugs kill people. However, narcotic substances and save people, being in legal circulation, as vital medicines. In English, the word drugs at the same time means both drugs and medical devices. Illicit trafficking is a struggle, and legal - provides access to drugs for those who need it. The essence of an effective state drug policy is to ensure a balance between these things, but this is a sphere for expert discussion, it does not make sense to bring it to a national discussion. The question whether it is humane to give painkillers to a patient is not decided in referendums ", - the expert believes.

But Dmitriy Sinchenko does not rule out manipulations against Uliana Suprun herself, in particular in the form of charges of allegedly “putting Ukrainians on drugs”. Despite international experience and the fact that Suprun itself has become a symbol of one of the most successful reforms in the country.

"The manipulations are not difficult to predict: obviously, Ms. Uliana is accused of wanting to hook the Ukrainians on drugs and finally break their" spiritual clips ". And when emotions speak, logic is silent. And everyone will not care that medical cannabis is allowed in Canada, Israel and Lithuania, and even in very conservative Poland. Just as indifference to the benefits of medical reform, which Uliana Suprun embodies, is today, which today has become, without exaggeration, a symbol of one of the most successful Ukrainian reforms, ”said Sinchenko.

So why haven't you decided the question yet?

According to Dmitry Sinchenko, there are several reasons for the continuation of discussions around this topic. In particular, we are talking about the traditions of Soviet times, the shadow drug business and the conservatism of the Ukrainians themselves.

 Several factors play a role here. First, it is a tradition, or even inertia since Soviet times. And we began to abandon the majority of Soviet traditions only after 2014, and this process is not only not completed, but is only gaining momentum, so much "of soviet" of "quot; inherited our state, and so conservative was our state leadership.

Secondly, the shadow drug business is not interested in state intervention in its sphere. And even more are not interested in this & quot; law enforcement officers & quot; who and the & quot; roof of & quot; illicit drug trafficking in Ukraine, including marijuana.

Thirdly, Ukrainian voters are very conservative. They do not see any problem in smoking tobacco or drinking alcohol, which is much more dangerous to health than smoking marijuana. However, cannabis and all other illicit drugs are sharply negative. Ukrainians, mostly older, rarely realize that morphine and amphetamine are used for medical purposes for a long time, but they are afraid of legalizing cannabis even for medical purposes, because of stereotypical thinking, ”the chairman of the NGO Association of Political Science . Has said.

Gennady Shabas is convinced that the question is actually not debatable - there has been a scientific consensus in it for a long time. Moreover, Suprun is not the first head of the ministry with a similar position. According to the expert, the lack of public inquiry and the debatability of the problem solving algorithm stand in the way of legalization.

 I would say that there is a consensus on this issue. There is a scientific consensus - for two years scientists have been demanding a procedure for conducting scientific research from the government. There is a consensus among doctors - it exists even at the level of managers of the Ministry of Health of different years, and at least two predecessors of Ulyana Suprun in this position share her position on medical cannabis. The over-sensitivity of this issue and the absence of a clearly formulated request from civil society have so far solved the problem.

An algorithm for solving this problem can be debatable: how the law will solve the problem of patients' access to drugs, what will be the conditions for the use of plants in medical and scientific activities, who will be able to get licenses and how quickly .