The use of medicinal cannabis can be dated back to 2700 BC. It first appeared in traditional Chinese medicine and was used as a drug during surgery. In India, cannabis had been greatly used as a treatment in many areas, such as anaesthetics, antibiotics, tranquilizers, etc.1
After the 20th century, the use of medicinal cannabis decreased dramatically, although it has been used over the centuries. This is due to the variability and instability of the plant.2 The emergence of medicinal drugs and the increase in legal restrictions are also major factors in the decrease in the demand for herbal methods. The production, sale, and use of cannabis are currently illegal and subject to certain sanctions in most places worldwide, there is, however, growing use of medicinal cannabis, especially in countries such as Belgium, Canada, Australia, the Netherlands, and some states within the United States.
The Medicinal Value of Cannabis
Medicinal cannabis refers to cannabis and its constituent cannabinoids used as a herbal remedy or therapy to treat diseases and/or their symptoms.
In 2017, a report from the US National Academies of Sciences, Engineering, and Medicine assessed more than 10,000 scientific studies on the medical benefits and adverse effects of cannabis.3 The report of "The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research" found that cannabis or products containing cannabinoids are effective at treating some illnesses and symptoms such as:
Cannabinoids in marijuana may reduce chronic pain in adults and help treat conditions that cause chronic pain.
There is moderate evidence that cannabis or cannabinoids are effective for improving short-term sleep outcomes in individuals with sleep disturbance.
In addition, there is limited evidence that cannabis or cannabinoids are effective for increasing appetite and decreasing weight loss associated with HIV/AIDS, and improving symptoms of post-traumatic stress disorder (PTSD), Tourette syndrome, and anxiety.
In recent years, many countries introduced specific laws and programs to allow patients to use cannabis in various forms to treat diseases. Therefore, cannabis has been used to relieve chronic pain, muscular cramps, spasticity, and neurogenic pain.
The Legal Background of Medical Cannabis in the US and the EU
In the United States, the use of cannabis for medical purposes—in many treatments, including pain, nausea, and any serious medical condition—is legal in four out of five permanently inhabited US territories as of February 2022, including 37 states and the District of Columbia.4 Although laws regarding medical marijuana in the states have created problems between the federation and the federal states as the applicable law changes with each president, it is still known that the use of medical cannabis is under control.
As for the United Nations' view, cannabis use is limited to scientific and medical purposes within the extent of international drug control agreements (UNODC, 2013)5. In the course of time, the perspective toward medical cannabis has changed, and some legalization studies have started. For instance, in 2018, the European Parliament adopted a draft resolution6 tabled by the Committee on the Environment, Public Health, and Food Safety on the use of cannabis for medicinal purposes. It encouraged the Member States to apply medical cannabis treatment to patients. In this treatment, cannabis can be used only with a physician's prescription.
Following the latest World Health Organization's statements against medical cannabis, the European Parliament voted on the amended the Resolution on the Use of Cannabis for Medicinal Purposes7 in February 2019. In this Resolution, European Parliament "calls on the Member States to provide medical professionals with proper medical training and to encourage increased knowledge on medical cannabis based on independent and wide-ranging research.”
At present, some countries in the EU standardly allow patients to access imported or domestically grown cannabis, while some countries only provide access to medical cannabis. A medicine based on cannabis extracts has been authorized in some European countries, and some have specific legal processes governing the distribution and use of medical cannabis.
Medicinal Cannabis Use and Legal Limitations in Turkey
Turkey has a long history of growing industrial cannabis or hemp. Archaeological evidence shows that people living in Anatolia have been growing cannabis since 700-800 B.C. Some believe hemp may have been cultivated as far back as 1,500 B.C.8
Currently, cannabis is illegal for recreational use but allowed for limited medical and scientific purposes in Turkey.
In 2016, the Ministry of Health ("MoH") approved the sale of medicinal cannabis—only in sublingual sprays such as Sativex—with a physician's prescription. However, any other forms of cannabis and the usage of whole-plant cannabis remain prohibited.
Besides, MoH also added Sativex to the list of importable drugs. Although it is not directly named, the ATC name of "cannabinoids" can be referred to as Sativex, which was added to the list on January 25, 2016, in the list of drugs that can be brought from abroad dated 12 February 2016 on the Turkish Medicines and Medical Devices Agency (TITCK) website9; and even as of July 8, 2022, "cannabinoids" still remain in that list10. In order to obtain these drugs, patients must visit a physician who is authorized to issue red prescriptions. Physicians are required to evaluate the patient's condition and decide whether medical cannabis is the best or the only treatment.
The Turkish Government legalized cannabis production for medical and scientific purposes in 19 provinces along with the publication of the regulation on the cultivation and control of hemp in 2016.11 As per the new regulation, farmers can grow and produce hemp after obtaining a license with a validity period of three years. The Ministry of Food, Agriculture, and Livestock will supervise the hemp production. The person intending to plant the hemp must prove he/she has never been involved in illegal drug production.
Conclusion
Although cannabis has been used in various medical fields over the centuries, its risks and harmful effects have led governments to develop regulations to restrict its usage. Along with countries including Canada and the Netherlands, some USA states have legalized cannabis for medical use. In 2016, Turkey took a big step in the cultivation of cannabis for the benefit of medical purposes. Cannabis is not completely bad, dangerous, and illegal, but also not the cure or solution for all diseases. A balance should be observed when regulating the medicinal use and restriction of cannabis.
Disclaimer
This article is originally published by CETINKAYA Attorneys-at-Law
CETINKAYA is a full-service law firm based in Istanbul servicing local and international clients. CETINKAYA lawyers have extensive expertise in advising on dispute resolution, business crime, technology, data protection, and intellectual property.
CETINKAYA prides itself on helping clients navigate their way through a constantly changing and challenging legal landscape. With a seamless multi-disciplinary approach positioned at the intersection of industry knowledge and legal expertise, CETINKAYA provides clients with legal solutions that are tailored to their needs in Turkey.
