The WHO has released the results of the 2018 report evaluating the medicinal value of cannabis. It was the first evaluation of medicinal cannabis by the WHO in more than 80 years. The UN has received the conclusions recommending the reclassification of CBD in the Schedule of Controlled Substances, as well as a critical review of the scientific literature on the plant.
Cannabis, a special case for the WHO until now
In 2017, the World Health Organization (WHO) announced its plans to make the first official evaluation of the therapeutic value of cannabis in 82 years. It was the first time since the international ban on cannabis, and included all of the major derivatives of cannabis. In 2018, the WHO released these results to the public.
On July 23 2018, the Secretary General of the United Nations (UN), António Guterres, received the conclusions of the preliminary study. It was formally called the “pre-review”, carried out by the Expert Committee responsible for this important task. It recommends a relaxation of the severe international controls on the therapeutic use of cannabis. It marks a milestone and a necessary step towards the long-awaited and necessary reclassification of cannabis within the international conventions on narcotics.
For the time being, this is only one step, the first taken by the WHO in more than eight decades. However, it places this specialized UN agency on the right track to put an end to the paradoxical (il)legal situation of cannabis at international level. In order to lead the management and coordination of public health issues at international level, the recommendations should be based on up-to-date scientific evidence. And that had not been the case for cannabis since this international body was created in 1949.
What scientific evidence tells us today, according to UN experts
The 40th Meeting of the WHO Expert Committee on Drug Dependence(ECDD), was held in June 2018 in Geneva, Switzerland. This committee is made up of experts in fields such as pharmacology, toxicology, biochemistry and clinical practices, and its mission is to review the therapeutic value of cannabis and its derivatives, based solely on scientific evidence.
In the conclusions and recommendations of the “pre-review” written by the experts, the following was concluded:
- The International Drug Control Treaties should not control products made with pure Cannabidiol (CBD), one of the main active compounds of cannabis that has no psychoactive properties. It is therefore necessary to reclassify it in the List of Controlled Substances. The commission recognizes that there is no evidence of any case of abuse, dependence or public health problems related to the use or consumption of CBD.
- In what concerns the cannabis plant, the Committee recognizes that there is sufficient scientific evidence demonstrating the need for a critical review of the scientific literature on cannabis. This includes its resin, extracts and tinctures (also those with high CBD content), as well as THC and THC isomers. It recognizes that the current classification is not consistent with the inclusion criteria of that list, as the plant and its derivatives are not susceptible to abuse, nor do they produce dangerous harmful effects as those of the other substances included in Schedules I and IV.
The much-needed CBD (re)classification
Although Cannabidiol is not specifically included in the UN Schedules of Controlled Substances, cannabis extracts and tinctures are, which also encompasses CBD among other cannabinoids. Strikingly, extracts and tinctures are in Schedule I, together with substances as cocaine, heroin, methadone, morphine and opium.
Schedule I is reserved for substances with addictive properties that present a serious risk to public health. Despite this classification, both clinical and scientific research, as well as medical practice, have for years shown that the therapeutic applications of cannabis are plentiful. This includes the use of CBD, THC and other cannabinoids medicinally.
When a substance is not included in any of the UN control schedules, it is understood that its production and supply are not subject to strict international controls. Rather, each country should decide on its legal status. More concretely, the case of CBD shows that society is often ahead of legislators and global health agencies. Many countries have already officially recognized its medicinal value (Netherlands, Switzerland, USA, etc.) or have legalized its use in some way, thanks to the work of lobbyists.
The importance of CBD reclassification lies in the fact that many patients need and deserve access to CBD for the treatment of a whole array of diseases and ailments. In general, these conditions are resistant to conventional treatment, and patients require an effective alternative. Due to the current legal status of cannabis, however, many of these patients do not have access to CBD products. Depending on a person’s geographical location, it may be completely illegal for them to acquire CBD and other cannabis derivatives.
Hence, the WHO endorses its previous conclusions, describing CBD as a low-risk cannabinoid. The WHO recognizes that it provides health benefits and therefore recommends that it should not be included in any of the above-mentioned schedules or lists.
What about the rest of the cannabis plant?
The WHO has finally come to the conclusion that there is enough scientific evidence to recommend to the UN a critical review of cannabis. The review will deal with the cannabis plant and its derivative; namely its resin, extracts, tinctures, THC and THC isomers.
Since 1961, cannabis has remained in Schedules I and IV, which are reserved for the most harmful and dangerous narcotic substances that possess no or little medicinal value. The WHO did not have any scientific evidence confirming its complete lack of therapeutic value. Interestingly, neither did the international treaties themselves. Finally, the WHO has officially admitted that there is scientific evidence to the contrary.
In this new document, the Committee acknowledges that there is no record of a single death related to a cannabis overdose and describes it as a “relatively safe substance”. It also refers to the “large amount of pre-clinical literature” showing that cannabinoids “reduce the proliferation of cancer cells” inhibiting “cancer cell migration and angiogenesis in numerous cancer cell types”.
Similarly, the report confirms the existence of sufficient scientific evidence demonstrating the effectiveness of cannabis-based treatments for diseases and symptoms including:
- Appetite stimulation
- Chronic pain
- Neuropathic pain
- Opiate dependence
- Post-traumatic stress disorder, and
- Sleep disorders
The WHO should be reminded that the lack of prior medical research on the potential benefits, or harms, of cannabis has been hampered by the strict irrational regulations that apply to substances in Schedule 1. The ECDD pre-review states that, although “adverse”, but mild effects are possible, and despite the fact that cannabis may cause physical dependence, its current classification in international treaties “may not be consistent with the criteria” for inclusion in that list.
On the right path, but there remain steps to be taken
The 41st meeting of the Expert Committee was held between 12 and 16 November 2018. The WHO’s critical review of cannabis was discussed by the Expert Committee for the potential reclassification of cannabis, its active components and derivatives. Finally, in March 2019, the UN Commission on Narcotic Drugs reviewed WHO’s recommendations. The UN was to sit again for a 62nd regular session to act upon the draft decision, but decided to postpone the voting on WHO’s recommendations.
There seems to be more reason to be optimistic than ever. The WHO has officially recognized that CBD has medicinal health benefits, as well as admitting that there is enough scientific evidence to prove that the same could apply to the cannabis plant as a whole. Moreover, the fact that the UN Secretary General was the prime minister of Portugal when the nation decriminalized the use and possession of all drugs, a policy that has been praised internationally as a success, increases the grounds for optimism.
The final critical review by the WHO recommends that the UN removes cannabis from strict scheduling. If the UN, which has the power to strengthen or relax international controls, were to decide to change the current status of cannabis within international law with its reclassification, it would give the freedom to member states to push their own reform efforts. The world eagerly awaits the UN’s decision with the hope of moving forward on the path leading to cannabis legalization for countries of the UN.
- Disclaimer:While every effort has been made to ensure the accuracy of this article, it is not intended to provide legal advice, as individual situations will differ and should be discussed with an expert and/or lawyer.