Groups advocating the use of cannabis to treat various illnesses have criticized the Philippine Medical Association (PMA) for “conflating” its medical and recreational uses and exaggerating its supposed harmful effects in blocking a proposed law that will allow Filipinos to legally acquire the drug.

A measure at the House of Representatives, consolidated from 10 bills, was approved in principle by the committees on dangerous drugs and on health on Feb. 7. As of Feb. 28, 10 of the 16 members of the expanded Senate panel on health and demography have signed their committee report endorsing approval of its own version of the bill.

The bills will be submitted to their respective plenaries for second reading, the farthest that similar measures seeking to legalize medical cannabis have gone through the legislative mill alongside each other in the two chambers. 

The advocates say the PMA, the biggest organization of doctors in the country, is also “fear-mongering,” or trying to scare Filipinos into rejecting medical cannabis with allegedly baseless claims of a “clear trend” supposedly showing its harmful effects outweighing the benefits in countries that had legalized marijuana.

The PMA has acknowledged the medical value of cannabis but it suggests that it would be better for Filipinos, especially the youth, to steer clear of the drug and for authorities to keep it out of reach.

It believes that the legalization of medical cannabis will eventually lead to legalizing and decriminalizing the recreational use of marijuana. But both the House and the Senate bills restrict cannabis use to medical purposes only.

“Legalization of cannabis will send a wrong message, especially to our youth, that our government considers cannabis as a safe substance, and therefore expose our citizens to unnecessary harm,” the PMA said. It cited, among other effects, adverse brain development in fetuses and infants of mothers who use cannabis.

“To stand against the legalization of cannabis is to stand for a safer, brighter future for all Filipino children,” it said.

One prominent opponent of medical cannabis, public health expert Dr. Anthony Leachon, said in an interview on the “Dos por Dos” radio program: “Once it is approved, it will open the gateway to recreational marijuana, and God bless us on how we can control it once it comes out.”

Confusing the public

But according to Haraya Policy Center, a nonprofit that promotes access to plant-based medicine, the PMA does not make clear distinctions between the medical and the nonmedical use of cannabis, and this confuses the public.

“Its sweeping generalizations stand on inaccurate information and unscientific assumptions that both misinform and disinform the public,” Haraya said in a statement issued on Feb. 20.

“Using the prospect of decriminalization and recreational use as arguments against medical cannabis is irresponsible of a medical association that is supposed to promote medical science and scientific thinking and genuinely serve the interests of patients without catering to vested interests,” it said.

The PMA argues that it is not necessary to pass a new law specifically to legalize medical cannabis as the Dangerous Drugs Act already permits the importation of certain medicines like cannabis for “compassionate use.”

But Dr. Donnabel Trias-Cunanan, a dentist who heads Cannahopefuls Inc., another group that campaigns for legalized medical cannabis, said the application for compassionate use is so tedious that only one person has attempted it. She said that person eventually gave up due to the protracted process and the very high price of imported cannabis medicine, which is estimated at P1.5 million a year for just one patient.

This complicated process to obtain cannabis medicine makes it “practically impossible” to secure a compassionate special permit, according to Haraya.

For about a decade now, Trias-Cunanan and her group have been pushing for the legalization of medical cannabis to treat people suffering from epileptic seizures. Her 12-year-old daughter has been afflicted with epilepsy—which she calls “kisay” (convulsion)—since she was a baby.

P58K per 60-ml bottle

One popular cannabis oil used to treat epileptic seizures and approved by the US Food and Drug Administration (FDA) is sold for $1,042 (P58,000)per 60-ml bottle.

“We are passionately advocating for an open door to other brands. Eventually we will be able to produce them in the Philippines so that it would be available to many who are poor,” Trias-Cunanan told CoverStory.ph.

The pending bills permit importation and alternatives to imports, plus more options of cannabis medicines from those approved by the US FDA, the reference agency for the Philippine FDA.

“Millions of patients worldwide benefit from cannabis as a treatment for a variety of medical conditions and even for wellness purposes without reporting notable adverse consequences to their health,” Haraya said, adding that no one has died from cannabis overdose.

It acknowledged “isolated cases” of ill-effects, but said these typically resulted from mixing cannabis with alcohol or other toxic substances. “Those isolated cases must not be used to defeat the intent of the bills to provide patients access to safe medical cannabis,” it added.

Dr. Gem Marq Mutia, president of the Philippine Society of Cannabinoid Medicine, said the PMA is “exaggerating the harms—more of fear-mongering—but downplaying the benefits” of medical marijuana.

There is no evidence to back claims that legalization of recreational use has led to the youth’s increased access to marijuana, he said. “How much more when it is for medical legalization?”

Claims by opponents of the proposed law that legalizing marijuana will lead to a rise in the number of motor vehicle accidents and in the incidence of psychosis and schizophrenia are unsubstantiated, he added.

‘First, do no harm’

Mutia said the PMA is playing the “old tune” of “First, do no harm” to justify its opposition to the alleged dangers of medical cannabis.

“These cannot speak to the harm caused by tobacco and alcohol,” he said, citing in particular the growth restriction and deformities in fetuses caused by alcohol consumption. “They even have a name for it—fetal alcohol syndrome. That is how well-known and debilitating alcohol is, and it is perfectly legal and even advertised on TV,” he said. “They do not see the harm in the prohibition [of cannabis].”

Haraya president Chuck Manansala said that while the PMA invokes the physician’s motto, it prohibits access to an important medicine.

“What ‘First, do no harm’ are they talking about? If you deprive your patient of a potential life-saver, are you not doing harm, only because you cannot get over your prohibitionist mentality?” Manansala said.

The PMA and proponents of medical cannabis share some points of agreement—recognition of the medicinal value of cannabis, strict regulations required for its use, no diversion for nonmedical use, and the need for local research into the drug.

Despite these, Manansala is not optimistic about winning over the PMA to support the bills that would legalize and ensure safe access to medical cannabis. “I don’t know how we can do that because we tried,” he said. 

Manansala recalled that when he and other proponents invited the PMA to discuss a bill filed by Rep. Rodito Albano in 2014, they received a dressing down and a “sermon,” and their credentials were questioned by the doctors.

“They blasted every single clause of the bill,” he said. “Immediately after, they held a press conference where they ripped the bill like the Katipunan [ripped the cedulas]. They already condemned medical cannabis.”

Manansala said they received a better response from the Catholic Church, which they initially expected would be harsher toward them. “The Church leaders did not condemn us, and explained that the doctrine of the Catholic Church is that dangerous drugs like marijuana are acceptable at the end stage [of an illness] for the alleviation of suffering,” he said. “At least it was not outright condemnation. There is room for agreement, unlike the PMA.”

Hopeful 

Mutia, an internist, said that despite resistance from the PMA, there is “more openness” among ordinary physicians toward medical cannabis. He is hopeful of the bills’ passage in Congress because, he said, many lawmakers are convinced that it is legal and safe to use.

“Fortunately, it is not up to [the PMA]. We are more concerned with the [Department of Health],” he said. 

Mutia said it is also fortunate that for the first time, the health secretary has officially recognized cannabis as medicine. “And most importantly, [he is] the first secretary to see the weakness of the importation route,” Mutia added.

Health Secretary Ted Herbosa said last year at his confirmation hearing at the Commission on Appointments that he supported and would push for legalizing medical cannabis.

Read more: Proponents urge ‘a little compassion’ in legalizing medical cannabis