By: Samuel Pimping
Ever since she was just 3 months old, Dr. Donnabel Trias-Cunanan’s daughter started having recurring epileptic seizures.
Her daughter, Julia, was diagnosed with Dravet syndrome. Conventional antiepileptic drugs were ineffective. Every seizure leaves her unable to breathe and on the verge of death. They would come to find that cannabis, or marijuana, may be the key to saving her life.
Marijuana—demonized by mass media and canonized by few. The drug has been illegal in the Philippines since the Dangerous Drugs Act of 1972, and to this day, many still consider it taboo, associating it with gateway drugs that lead to harsher substances such as methamphetamine (shabu), cocaine, or ecstasy.
But is it even as dangerous as most are led to believe? In fact, world nations have recently recognized cannabis for its indisputable medicinal benefits.
In 2021, it was removed from Schedule IV (the strictest category) of the Single Convention on narcotic drugs based on a scientific assessment by the World Health Organization (WHO). This means international law acknowledges its substantial therapeutic advantages and that it should be subject to less restrictions. Strangely, its inclusion in Schedule IV had no scientific basis at all in the first place.
So, what can medical marijuana be used for? The two important compounds extracted from the cannabis plant for medical uses are cannabidiol (CBD) and tetrahydrocannabinol (THC).
The non-psychoactive component, CBD, treats various conditions such as seizures, chronic pain, inflammation, depression, psychosis, and other mental disorders. CBD is the essential compound in treating Julia’s condition. THC is responsible for the high sensation and helps with pain, nausea, muscle spasms, glaucoma, insomnia, appetite disorders, and more. Both compounds have been observed to possess few potential side effects.
Before looking at cannabis-based treatment, Donnabel and Julia had practically resided in a hospital for almost 5 years to accommodate her intractable seizures. They tried every conventional form of treatment and medicine they could find over the years and used seven to eight antiepileptics.
While they do help with convulsions to a certain extent, antiepileptics come with a litany of debilitating long-term side effects—causing Julia allergies, pancreatitis, and insomnia. Because of this, Donnabel hopes to treat her daughter’s seizures with a CBD extract that can be legally prescribed and used within the Philippines.
Seeing the potential of cannabis in protecting not only her daughter’s life but also that of other children, Donnabel started religiously pursuing her advocacy in 2013 and founded Cannahopefuls, Inc.—a non-profit organization of parents, patients, advocates, and volunteers dedicated to endorsing the legalization of safe, affordable access to medical marijuana.
While marijuana remains illegal in the country, the law makes an exception for patients like Julia. From 2016 to 2017, Donnabel applied for a compassionate special permit under the Food and Drug Administration (FDA). It allows the importation of unregistered medication including medical marijuana, subject to restrictions.
Ironically, Donnabel shares how the process in applying for a special permit is far from compassionate. Apart from all the paperwork and long periods of waiting, she had to acquire the entirety of Julia’s medical history and beg her doctor to prescribe cannabis.
Alas, after completing all requirements, they were met with another obstacle. The only drug that meets the FDA’s stringent guidelines is Epidiolex, which is a synthetic CBD extract produced abroad that costs $32,000 or roughly ₱1.80 million (good for only 6 to 12 months) in today’s currency. The highly prohibitive guidelines in conjunction with exorbitant costs of procurement bar patients and parents from receiving the ideal treatment for their children.
In short, there are currently 3 problems in reaping the medical benefits of cannabis:
1. Unreasonable amount of time and effort required to secure a permit. Potentially saving lives requires a sense of urgency. Parents can only turn to what can at least give their children the chance to live a full life when conventional medication is not an alternative. For many, cannabis is their last and only choice.
2. Unaffordable costs. Because of how marijuana cannot be cultivated legally within the country and exacting guidelines, importation of more expensive medicine becomes the only option. Additionally, the burden of importation brings additional costs and more waiting time before treatment.
3. Lack of research and incentives. Marijuana is still deemed a dangerous drug in the country despite WHO’s assessment. Due to this, there is less incentive to actually study its medicinal benefits locally. Consequently, because its advantages are not thoroughly researched and acknowledged, the Dangerous Drugs Board (DDB) of the Philippines sees little reason to reclassify it as a drug with medical benefits—resulting in a negative feedback loop that has perpetuated the criticism of cannabis.
Senate Bill 230, or the Medical Cannabis Compassionate Access Act, is the latest debate within congress that is yet to be approved. To Donnabel and hundreds of other parents, patients, and advocates, it is their greatest hope of gaining feasible access to medical cannabis.
The bill calls for a strict regulatory framework to ensure that marijuana is used only for medicinal and not recreational purposes. It calls for local production to make it more affordable for those seeking treatment since marijuana naturally grows in the mountains of Cordillera under the country’s humid, tropical climate. The bill contemplates its potential to be an economic contributor to the local industry as well.
That said, the risk of addiction and abuse is never zero. However, just like any other substance or endeavor such as alcohol, nicotine, or even social media, there is always the risk of addiction. Therefore, what makes cannabis any different from these apart from its proven medicinal value? In any case, strict yet reasonable implementation of regulatory guidelines is the answer to mitigation.
In December 2022, Donnabel, as the president and spokesperson of Cannahopefuls, Inc., stated before the senate that 80 patients have died in their advocacy. To date, they are actively fighting for the urgent treatment needed in the hopes of preventing more lives from being taken. They recently petitioned the DDB to reclassify marijuana from a drug with no medicinal value to a category appreciating its need for research and development.
Cannabis is not just for seizures. It has been used in other countries to treat cancer patients with chronic pain that cannot be addressed by painkillers such as morphine. It is known to inhibit symptoms from Parkinson’s disease, provide pain relief from multiple sclerosis, and generally improve quality of life for terminally ill patients.
Today, Julia is 11 years old. She is unable to speak and has developed cerebral palsy and global development delay due to her seizures.
Although there are major developments in the fight for legalization, the battle is far from over. Donnabel and other parents, patients, and advocates are hopeful that future generations will be granted the compassion of the law—without having to endure the same fate.
References
Bordey, H. (December 7, 2022). Parents to Senate: Pass law for swift access to affordable medical cannabis. GMA News Online. https://www.gmanetwork.com/news/lifestyle/health andwellness/853820/parents-to-senate-pass-law-f or-swift-access-to-affordable-medical-cannabis/sto ry/
Gregorio, X. (December 7, 2022). Medical marijuana access rules in Philippines ‘not compassionate,’ advocates say. Philstar Global. https://www.philstar.com/headlines/2022/12/07/22 29211/medical-marijuana-access-rules-philippines -not-compassionate-advocates-say
Danenberg, E., Sorge, L. A., Wieniawski, W., Elliott, S., Amato, L., & Scholten, W. K. (August 1, 2013). Modernizing methodology for the WHO assessment of substances for the international drug control conventions. Drug and Alcohol Dependence, 131(3), 175–181. doi:10.1016/j.drugalcdep.2013.02.032. ISSN 1879-0046. PMID 23548737.
Holland, K. (September 14, 2022). CBD vs. THC: What’s the difference? Healthline. https://www.healthline.com/health/cbd-vs-thc#med ical-benefits
Lalu, G. P. (December 7, 2022). Senate urged to pass bill allowing risk-free purchase of medical cannabis. Inquirer. https://newsinfo.inquirer.net/1702547/senate-urge d-to-pass-bill-allowing-risk-free-purchase-of-medic al-cannabis
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The International Drug Control Conventions Schedules of the Single Convention on Narcotic Drugs of 1961 as amended by the 1972 Protocol, January 22, 2021, [ST/CND/1/Add.1/Rev.7], https://documents-dds-ny.un.org/doc/UNDOC/GE N/V21/004/24/PDF/V2100424.pdf?OpenElement
