Authors: Nadia Faradiba, Alfi Nabila, Dinda Ganisawati Javada, and Farid Al-Firdaus
Is it safe to use cannabis for medical use?
The urge to use marijuana from the black market into the legal market as an option of medication has caught the attention (Lazarjani, 2021). Cannabidiol is a substance extracted from the marijuana or Cannabis plant that has shown therapeutic effects on a range of conditions, such as anorexia in HIV patients, pain after chemotherapy, and reduced symptoms in severe forms of epilepsy (National Academies Press, 2017). Of the good advantages of this substance, the government should generate adequate regulations and instruments to provide the cannabinoid as a medication option. Thus, it can prevent the misuse of cannabis. Creating more options for curing the people can support the first pillar of Indonesian vision 2045 to raise the health degree of the citizens. Cannabidiol is proven to improve health in severe seizure patients. It has been approved as a medication in the United States by the Food and Drugs Administration (National Conference of State Legislatures, 2022).
What are the government and IT perspectives about cannabis legalization?
The Indonesian government needs to address three main issues regarding cannabis for medical use before legalizing it by adjusting its regulations on cannabis. Those are proving cannabis can be a drug, the halal status of cannabidiol, and ways to control the use of medical cannabis to avoid its abuse.
Making cannabidiol a treatment option requires careful research and clinical trials before using it due to the possibility of developing side effects. However, the researchers face two main obstacles. First, based on Law Number 35 of 2009 concerning Narcotics (Narcotics Law) as amended, marijuana or cannabis is included in category I of narcotics that are prohibited from being used for the benefit of health services. Therefore it can not be used for research and medical purposes (Idham, Gunawan Wijaya, 2021). However, researchers still have a chance to solve this problem. According to a BBC article (2022), the Ministry of Health plans to issue new regulations on cannabis research and give researchers a chance to prove that cannabis is eligible to be legalized for medical purposes. Moreover, if the law is too long in its process, the researcher may ask permission to do cannabis research for medicine.
Second, the availability of human resources, facilities, and infrastructure for cannabis research is another challenge. Researchers can collaborate with hospitals, universities, or research institutes to overcome this obstacle. However, given the prohibition and strict regulation of the use of marijuana, it would be better if the government was involved in the research. Then for the equipment needed, if Indonesia can still not produce equipment for cannabis research, researchers can import it. According to Minister of Finance Regulation Number 200/PMK.04/2019, the import of goods for research can be exempt from import duty and tax.
On the other hand, one remaining issue in Indonesian society regarding cannabis as a medicine is its halal status. As a Muslim-majority country, the halal status of cannabidiol is a matter of debate. Therefore not only proving the effectiveness of cannabis for medical treatment but also deciding the halal status of medical cannabis needs to be considered. LPPOM MUI needs to cooperate with the Ministry of Religious Affairs and Ministry of Health to make a new policy regarding the standardization criteria of cannabidiol based on the clinical trial.
Next, to prevent cannabidiol abuse, the government can use information technology to control it. The Ministry of Health must assign one holding state-owned pharmaceutical company. They will do research and extract cannabidiol for medical treatment. After that, The Ministry of health needs to develop a website to manage vendor and buyers in one online marketplace. Thus, cannabidiol will have only one portal web to request. This website will require multiple layers of validation for the buyers.
The central concept of this website, like the public catalog, presented extract cannabidiol. The limited buyers who access this general catalog are medical specialists addressed to type A-hospital. The buyers who want to order must register using the national ID card, and the system integrates the official web from the Ministry of Home Affairs (https://dukcapil.kemendagri.go.id/).
The following validation is the buyers must attach STR (Surat Tanda Registrasi), then the portal web will be directly integrated to The Indonesian Medical Council’s website (kki.go.id) and The Directorate General of Health Service’s website (sirs.yankes.kemkes.go.id).
After successfully validating the buyer’s identity, the portal website will make the last validation in the delivery address. The buyers can only send the cannabidiol to type A-hospital to anticipate delivery for unexpected addresses.
What are the steps of policy making to legal cannabis for medical use?
Making detailed regulations and technologies is essential before legalizing cannabidiol as an option for treatment as it is vulnerable to misuse.
As the first step, there should be a public hearing between health workers and the government discussing the medical aspects of cannabidiol, such as benefits, indications, adverse effects, dosage, and contraindications. The health workers can be represented by professional organizations: the Indonesian Medical Association (IDI) and the Indonesian Pharmacist Association (IAI). The government can be represented by the Directorate of Pharmaceutical and Medical Devices also the National Food and Drug Agency. The discussion should decide if the regulations of legalizing cannabidiol in Indonesia are feasible. Meanwhile, at the same time, it is necessary to discuss with the Indonesian Islamic Ulema Council and the Halal Product Assurance Agency the status of cannabidiol for treatment following the culture and religion of the people in Indonesia.
The second step should be an advocate between the Directorate of Pharmaceutical and Medical Devices to discuss the regulation of procurements of the medical devices needed. Suppose the device needed for research comes from imports. In that case, an audience can be held with the Directorate General of Customs and Excise to discuss the feasibility of using import facilities for research purposes, both procedural and fiscal.
The third step is a collaboration between the government and two private sectors, laboratories, and information technology companies. Laboratories have roles in extracting cannabidiol from the cannabis plant, so it is safe as a medicine. At the same time, information technology companies’ roles are making the secure website the portal of the cannabidiol supply.
Reference:
https://www.ncbi.nlm.nih.gov/books/NBK425767/
https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-021-00087-9
https://www.webmd.com/a-to-z-guides/medical-marijuana-faq
https://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx#1
Republic of Indonesia. Indonesian Law No. 35, 2009 regarding Narcotic. State Gazette Year 2009 No.143, Add. No.5062.
Republic of Indonesia. Minister of Finance Regulation Number 200/PMK.04/2019 regarding Exemption from Import Duty and Excise On The Import of Goods For The Purpose Of Scientific Research and Development.
BBC News Indonesia. (2022, July 4). Menteri Kesehatan akan izinkan riset ganja, bagaimana dampaknya terhadap upaya legalisasi untuk keperluan medis? https://www.bbc.com/indonesia/indonesia-61977271
Idham, Gunawan Widjaja. 2021. Legal Politics of Medical Cannabies in Indonesia. Multicultural Education. Volume 7. Page 297 – 300
https://islami.co/hukum-ganja-dalam-islam/
https://www.nu.or.id/nasional/pandangan-fikih-soal-ganja-medis-4vJrv
https://www.halalmui.org/mui14/main/detail/hukum-memanfaatkan-ganja