'CBD oil is derived from cannabis, but is legal'

Syed Tahir Hassan, MD, one of a handful of registered doctors in India who actively prescribe cannabis-derived medical products, recalls how he became interested in the medicinal properties of various parts of the cannabis plant. It started a few years ago when someone in his family was suffering from cancer, and he began looking up ways to alleviate their pain and discomfort beyond regular prescription drugs, he says, on the phone from Kerala.

Having access to Ayurvedic medicines, which often generously use cannabinoids, compounds derived from the cannabis plant, he started reading up about their efficacy and was convinced they could supplement prescription meds in the treatment and management of not only cancer but a host of ailments like arthritis, chronic headaches, depression and anxiety, as well as other conditions that induce chronic pain, such as sports injuries.

“I am a holistic medicine guy. I believe in integrative therapy, which includes allopathy medicine as well as traditional forms of medicine like Ayurveda. If something works, and has been proved to work, why should we not use it, especially since it is completely legal?" asks Dr Hassan, who is a member of the Society of Cannabis Clinicians, a global non-profit alliance of healthcare professionals promoting research and awareness of medical cannabis.

Cannabinoid drugs, which use extracts of cannabis leaves (referred to as the Vijaya leaf in Ayurveda) and other parts of the cannabis plant, can be sold in India with a licence under a host of legal instruments such as the Narcotic Drugs and Psychotropic Substances (NDPS) Act, and the Drugs and Cosmetics Act, 1940. Not all cannabis products are hallucinogenic or psychoactive, nor is their consumption a crime. Yet, in the wake of the recent controversies over “drug use" following investigations into the death of actor Sushant Singh Rajput, CBD oil and other patented medications which contain extracts from the cannabis plant have also come under increased scrutiny, along with a flood of misinformation, misunderstanding and baffling demonization.

Medical cannabis products from Beheco (left) and Vedi Herbals

In recent years, Indian companies such as Vedi Herbals, Bombay Hemp Company (Boheco) and Himalayan Hemp have worked towards mainstreaming products made from hemp, a member of the Cannabis sativa species used for extracting CBD, which contains low quantities of the psychoactive compound THC (tetrahydrocannabinol). Are they now worries about stigmatization of their products?

Dr Hassan, who consults with several such companies, including Vedi Herbals, does not believe the bad press around cannabis will impact the sale and use of CBD and other products containing medical cannabis extracts in India. “I might have got one or two calls from patients asking if it was okay to use CBD oil after this whole media controversy began but I am not worried about the future of these medications. Their popularity is spreading by word of mouth and their efficacy is not in doubt by anyone who has used and benefited from them," says Dr Hassan, citing the example of patients who have been able to reduce their dependence on pain medication, which can be habit-forming and harm the liver and kidneys, after using medicines containing cannabis extracts.

There is an urgent need to differentiate between recreational drugs containing high amounts of THC, and CBD products, says Jahan Peston Jamas, co-founder and director (strategy & collaborations), at Boheco. “We need a constructive discussion around CBD, THC and other cannabinoids rather than this hysteria, and thankfully, medical cannabis is getting a lot of legitimacy from the political and medical fraternity," says Jamas.

For instance, the Union Ayush (Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy) ministry gave its blessings to a 2018 study conducted by the Central Council for Research in Ayurvedic Sciences (CCRAS) on cancer patients at the Tata Memorial Hospital in Mumbai. The study found cannabis leaves to be effective in alleviating pain and other symptoms post chemotherapy and radiotherapy. A similar, larger-scale study at the All India Institute of Medical Sciences in Delhi is on the anvil.

“The main thing right now is to create a distinction between the illicit use of cannabis flower extracts for recreational purposes and the legitimate, medicinal use of leaves and other parts of the plant. It’s really Church and State," says Jamas.