Experts bat for cannabis-based medicines in India, seek regulatory changes

New Delhi: In the recent past, we have seen how cannabis has made its way into the medical mainstream in Western nations owing to its efficacy in multiple health conditions, however in India the patients are denied cannabis-based medicines despite a historical background to the usage of herb in both treatment as well as during religious festivals. 

India needs to tweak its legal regulatory system on the lines of countries like Canada and Netherlands to establish newer categories of medicinal products derived from Cannabis, and expand the interpretation and definition of cannabis and its by-products so that cannabis-based medicines become more widely available. This was summed up by experts at a conference titled “Cannabis R&D in India: A Scientific, Medical & Legal Perspective,” jointly organized by the Bombay Hemp Company (BOHECO) and the Council of Scientific and Industrial Research (CSIR)’s Jammu based institute, Indian Institute of Integrative Medicine (IIIM).

The day-long conference saw the participation of prominent medical experts, policymakers and researchers, including Dr Jitendra Singh, Minister of State for Prime Minister’s Office. 

Dr Ram Vishwakarma, Director, CSIR-IIIM in his address welcomed the minister and called for a revisit to the regulations surrounding the research into cannabis for medical usage. He thanked Dr Singh for this support for the initiative.

In his keynote address, Dr Jitendra Singh remarked that the cannabis-based products like Bhaang have been a part of Indian culture, social customs and festivals. “There is a very thin line between use, misuse and abuse of a substance, and it is our responsibility to draw that line so that we do not throw the baby out with the bathwater,” he however cautioned.

“Research into cannabis-based medicines is going to be very important for the management of chronic diseases like diabetes which cause excruciating neurological pain and for which currently there is hardly any relief. Now, as the incidence of non-communicable diseases increase in India, we need to conduct pioneering research on drugs originating from plants and herbs found in the Indian mountainous regions. In the middle of the last century, such research gave us mint, which has now become an internationally used product. We need to replicate this kind of success by exploring the full medicinal potential of cannabis for the treatment and management of pain and health conditions for which there is currently no effective cure,” mentioned Dr Singh.

Mr Jahan Peston Jamas, Co-founder, Bombay Hemp Company which was the co-organizer of the event stated: “The geriatric population of India is poised to reach 100 million people by 2020-2025. Unfortunately, R&D work with other forms of medicine for several critical conditions afflicting the elderly has plateaued. Cannabis has properties of binding with CB1 and CB2 receptors within the human body. Health conditions like mental disorders, rheumatism, osteo-based ailments and heart diseases can be greatly alleviated with the use of cannabis which has almost negligible side-effects, as shown by a range of global regulatory and research work.”

Several challenges exist in mainstreaming the production and consumption of cannabis-based medicines in the country. As per experts, cannabis plant is a victim of misperception despite being an integral part of Indian culture.

Talking about why cannabis-based modern medicines have a nominal presence in India, Avnish Pandya, Director of Research & Development, Bombay Hemp Company, said: “Any medicine requires a standard, stable and predictable dosage for it to be clinically effective. In India, there is a lack of distinct standardized cannabis plants with standard cannabinoid output derived from their flowering tops to get consistent medicine. There is also a lack of clinical trials on cannabis and its isolated compounds.”

Explaining how cannabis despite being a psychoactive drug and causing intoxication, has a lower addictive potential than that of tobacco, alcohol heroin, cocaine, etc, Dr Vivek Benegal, Professor, Centre for Addiction Medicine, NIMHANS mentioned, “In fact, the cannabis plant and its commonly used forms like ganja, bhang, charas etc. contain many chemicals which are not psychoactive, and are seen to have opposite actions to that of THC (the predominant chemical which causes intoxication and addiction). One such chemical, Cannabidiol, is arousing interest in the scientific community due to its medical and therapeutic capabilities. It is observed to reduce the intoxicating and addictive properties of THC in cannabis addicts. This is interesting since there are currently no licensed treatments for persons with cannabis dependence.”

As per Mr Prasanna Namboodiri, Senior High Court Advocate dealing with NDPS matters: “The bar under Section 10 (2) (d) of the NDPS Act, 1985, requiring cannabis to be delivered by the cultivators to the officers of the state government is a major impediment in the cultivation of cannabis plant for medical and scientific purposes through extraction of cannabinoids. The failure of many state governments in India to frame NDPS rules providing for cultivation of cannabis is a major hurdle.”

Speaking at the conference, experts said that India lacks three very important aspects to bring it up to the level of Western nations in terms of cannabis-based medicines. These include non-availability of standard cannabis varieties or strains which will have predictable outputs; negligible clinical research on cannabis due to lack of standard material; and absence of standard product development from standard cannabis varieties. They asked Indian Government to provide support on the plant-breeding side of cannabis ecosystem, as standard cannabis has not been bred in India since 1985.

Talking about the main challenges in the production and consumption of cannabis-based modern medicines, Dr Dhiraj Vyas, Head of Dept. – Plant Biotechnology, CSIR-IIIM, said: “There are no standard varieties or seeds of cannabis to cultivate in India. As cannabis is considered a narcotic commodity under the NDPS Act, research is restricted due to the non-availability of research-grade material. Research projects to produce standard varieties of cannabis have only recently begun in India by CSIR-IIIM in collaboration with the Bombay Hemp Company, and there are no standard extracts from which medicines can be produced. Since there are no standard medicines available, patients are reluctant to try cannabis in the form of oils, etc. and doctors lack awareness about endocannabinoids and the endocannabinoid system that is present within every mammal. As a result, only a few doctors in India are currently in a position to prescribe cannabis-based medicine to anyone.”

Among others who were present during the panel discussions included Dr Rajendra Badwe, Director, Tata Memorial Centre, Mumbai; Dr Dharamvira Gandhi, Member of Parliament (Lok Sabha); Dr Rajender Pal Singh, Former DDG (North Zone), Narcotics Control Bureau; Dr Sanjay Kumar, Director, CSIR-Institute  of Himalayan Bio-resource Technology; Dr Manjari Tripathi, Head (Neurology), All India Institute of Medical Sciences; Dr Anurag Srivastava, Head (Surgery), All India Institute of Medical Sciences.

Experts felt that the cannabis plant is a victim of misperception despite being an integral part of Indian culture. For thousands of years, it has been a trusted ingredient in the treatment of various ailments. Yet cannabis is mired in ambiguity when it comes to its application in modern healthcare.