Recently, you might have heard that multiple authorities in Singapore have given their unexpected collective go-ahead for a pharmaceutical product containing cannabinoids to be imported for use by a young girl afflicted with refractory epilepsy, which is a first case of its kind here.

You probably might have found yourself asking if this means that the government is going soft on drugs or if this means that Singapore might see greater usage of such medication (short answers to both: no).

But before we delve deeper into any of these issues, it’s first worth understanding:

What is cannabis?

Cannabis is derived from any part of a plant of the genus Cannabis and is also known as marijuana, weed, pot or ganja.

The drug also contains more than a hundred cannabinoids -- that is, chemical compounds which are found within the plant.

The two main cannabinoids are tetrahydrocannabinol (THC), the psychoactive element of cannabis which produces a high, and cannabidiol (CBD), the compound which is also found in cannabinoid pharmaceuticals and produces no high.

With regard to THC, studies have found that it is addictive with adverse health consequences such as impaired learning and poor memory.

It is also linked to the development of major psychiatric illnesses.

As such, THC is caught under the broad description ‘cannabinol derivatives’ which is listed as a Class A controlled drug under the Misuse of Drugs Act.

What about Cannabidiol (CBD)?

While there is some evidence to support the use of cannabinoids for some conditions, there are insufficient studies on the long-term effects of using such drugs.

There are currently no proven ways of removing THC completely from pharmaceutical CBD products. The U.S. Food and Drug Administration (FDA) has also found that several CBD products do not contain the levels of CBD that they claim to contain and are not approved for the treatment of illnesses and ailments.

Singapore is therefore adopting a cautious approach towards the matter.

In January 2018, Singapore’s National Research Foundation (NRF) said it would develop synthetic chemical compounds found in the cannabis plant as part of a broader S$25 million investment into synthetic biology.

Projects funded by the foundation will identify genes that can create cannabinoids synthetically, avoiding the need to grow the plant. These synthetic cannabinoids will also be without THC, minimising any of the harmful effects and social ills associated with the drug.

Concurrently, scientists hope to unlock the therapeutic potential of these synthetic cannabinoids.

In the meantime, Singapore’s criminalisation of the use of raw and unprocessed cannabis, whether claimed for so-called “medical” or recreational purposes recreational will be here to stay.

But isn’t there research showing cannabis as beneficial for one’s health?

Here, it’s worth looking at a review that was carried out by the National Academies of Sciences, Engineering, and Medicine in the U.S. on 10,000 studies published since 1999 about what is known about the health impacts of cannabis and cannabis-derived products.

The study found that there was some medical evidence for the use of cannabis in treating chronic pain, and for the use of oral cannabinoids in treating chemotherapy-induced nausea and vomiting and symptoms of multiple sclerosis.

It also found that addiction to cannabis, the development of psychoses such as schizophrenia, and an increased risk of car crashes are major risks associated with the use of cannabis.

Health drawbacks to cannabis use has also been reported in international media.

Both The Guardian and Vox further reported that there is substantial evidence that smoking cannabis can result in addiction and withdrawal, which can present as anxiety, depression, insomnia, and a disrupted appetite.

Additionally, there is also the risk of exacerbated respiratory symptoms and a greater frequency of chronic bronchitis episodes.

Usage of the drug also results in impairment of memory, attention and coordination, The Guardian further reported.

And constant exposure to potent strains of cannabis can result in the impairment of communication between the two sides of the brain.

What’s more, the risk that cannabis poses today is far greater than it was 20 or 30 years ago, as cannabis is now far more potent than the strains available in the past.

According to a US study - in the early 1990s, the average THC content of confiscated marijuana was roughly 3.7 percent. By contrast, a recent analysis of marijuana for sale in Colorado’s authorized dispensaries showed an average THC content of 18.7 percent.

Cannabis’ status as a gateway drug has also been established, according to the New York Times (NYT), with people addicted to cannabis being three times more likely to be addicted to heroin.

So why is Singapore hard on recreational use of cannabis?

In Sep. 2018, the Ministry of Home Affairs (MHA) stated any review of Singapore’s position on cannabis will have to be “based on scientific evidence”.

This statement was issued in the aftermath of news coming out of Malaysia and Thailand that both countries are exploring making medical cannabis a reality.

Accompanying it was the mention of a literature review which had been conducted by the Institute of Mental Health (IMH) experts in Singapore, who confirmed that cannabis is addictive and harmful, especially to the brain.

In February 2019, the extent of the IMH literature review was a public talking point.

Minister for Law and Home Affairs K Shanmugam said IMH reviewed 500 articles on the effects of cannabis between 1964 and 2015, and the results were that it causes serious brain damage, with one in two getting addicted.

He also told CNA that pharmaceutical companies are pushing a different line on accepting cannabis for medical use, for financial gain, by conflating highly-specific medical cannabis scientific research and the alleged benefits of raw cannabis for recreational use.

Shanmugam added that the aim was to loosen punitive laws related to cannabis use -- or to make taking cannabis more socially-acceptable.

In 2016, the Minister had stated that Singapore needed to maintain its strict laws as it was near the Golden Triangle of Myanmar, Laos and Thailand, the second largest heroin production centre in Asia, according to The Straits Times.

He added, “With 200 million people travelling through our borders every year, and given Singaporeans' purchasing power, a soft approach will mean our country will be washed over with drugs.”

What happens if a Singaporean or Permanent Resident abuses drugs overseas then?

According to the Central Narcotics Bureau (CNB), any Singaporean found to have abused drugs overseas will be treated as though they had abused drugs in Singapore.

Such a law is not unique to Singapore, as countries such as South Korea also have legislation similar to this.

This reminder of Singapore’s existing drug laws was released in October 2018, shortly after Canada legalised recreational use of cannabis, and amidst discussions by Thailand to do so for medical cannabis.

It is worth noting that for the recent case in Singapore of the young girl suffering from refractory epilepsy, the application for the drug was put forward by her doctor after she had exhausted all registered medications and failed to respond to multiple therapies.

Approval for the drug was subsequently granted by a total of four authorities: MHA, MOH, CNB and the Health Sciences Authority (HSA).

So, what are the penalties for cannabis?

Cannabis is classified as a Class A controlled drug under Singapore’s Misuse of Drugs Act.

Possession or consumption of cannabis here can lead to jail terms of up to 10 years and a fine of up to S$20,000.

As for the cultivation of cannabis, the maximum penalty is a jail term of 20 years, a fine of S$40,000, or both.

Those who traffic, import or export certain quantities of cannabis may face the death sentence.

And if you’re wondering how addiction can set in, immerse yourself in "HIGH", Singapore’s first-ever interactive film directed by award-winning local director Royston Tan.

"HIGH" follows the story of Nick, a successful 28-year-old executive who finds who is invited to the world of drugs and hardcore partying after meeting a young woman Sienna on a dating app.

You can play the movie and help Nick make decisions that will either cause him to descend into addiction, or find his way out.

This article was brought to you by the National Council Against Drug Abuse (NCADA).

Top image from CNB and ICA