House Bill 4477:

The Compassionate Use of Medical Cannabis Bill

__________________________________________________

Byron Jon A. Tulod

The use of cannabis sativa, or widely known as marijuana, for medical purposes
has been an extreme controversial subject all over the countries. The debate over the
legalization issue has long troubled the citizens and the governments especially the
legislators as it was a difficult move to enact a law with uncertainty as regards its
benefits and undesirable effects on the country and its citizens. However, due to some
political and historical aspects which practically undermine the oppositions, many
countries had already moved for its implementation.

Many cultures had already harnessed the plant and used it for primitive medical
procedures. In some of the states, it is now legal to use marijuana for medical
treatments. However, as far as the Philippines context, it is relatively new. Despite the
courage of some advocates, the proposed House (HB) Bill 4477, also known as “The
Compassionate Use of Medical Cannabis Act,” is still pending and under consideration.
Although medical study has already progressed with regard its beneficial and
therapeutic uses, there is still a concern that is left to lawmakers which remains
questionable – the fear of abusive use.

For purposes of this paper, brief history on medical marijuana, legal history of
marijuana as a drug, countries that implemented laws on medical use, our local bill, and
its benefits and arguments must be taken into consideration in order to have a broad
knowledge on the subject and to fully understand the use of medical marijuana.

Brief History on Using the Drug for Medical Purposes

As early as 2737 B.C., the mystical Emperor Shen Neng of China was prescribing
marijuana tea for the treatment of gout, rheumatism, malaria and, oddly enough, poor
memory.1 Around 2000 B.C., the Egyptians used cannabis to treat sore eyes. 2 The drug's
popularity as a medicine spread throughout Asia, the Middle East and down the eastern
coast of Africa, and certain Hindu sects in India used marijuana for religious purposes
and stress relief.3 Doctors in India could be found mixing the weed with milk to use as
an anesthetic.4 Ancient physicians prescribed marijuana for everything from pain relief
to earache to childbirth. In 200 B.C., the Greeks used marijuana to remedy earaches.
Pot even enjoyed its freedom in America's early days. Farmers in colonial Jamestown
were urged to grow hemp, and 19th century medical journals praised the plant's medical
effectiveness.5

Modern research has confirmed the beneficial uses of cannabis in treating and
alleviating the pain, nausea and other symptoms associated with a variety of debilitating
medical conditions including cancer, multiple sclerosis, and HIV-AIDS as found by the
National Institute of Medicine of the US in March, 1999.6

Legal History of Cannabis in United States

To understand how marijuana ended up in the category of drugs, it is important

to note the events that occurred in the United States in the early 1900’s. After the
Mexican Revolution of 1910, Mexican immigrants flooded into the U.S., introducing to
American culture the recreational use of marijuana. The drug became associated with
the immigrants, and the fear and prejudice about the Spanish-speaking newcomers
became associated with marijuana. Anti-drug campaigners warned against the
encroaching "Marijuana Menace," and terrible crimes were attributed to marijuana and
the Mexicans who used it.7 Because of the fear of being dominated by such culture,

1
Patrick Stack, A Brief History of Medical Marijuana, Time, (2009), available at
http://content.time.com/time/health/article/0,8599,1931247,00.html (last accessed Oct. 27, 2015)
2
Kayla Webley, Brief History: Medical Marijuana, Time, 2010, available at
http://content.time.com/time/magazine/article/0,9171,1995849,00.html (last accessed Oct. 27, 2015)
3
Patrick Stack, A Brief History of Medical Marijuana, Time, (2009), available at
http://content.time.com/time/health/article/0,8599,1931247,00.html (last accessed Oct. 27, 2015)
4
Kayla Webley, Brief History: Medical Marijuana, Time, 2010, available at
http://content.time.com/time/magazine/article/0,9171,1995849,00.html (last accessed Oct. 27, 2015)
5
Ibid.
6
Compassionate Use of Medical Cannabis Act, House Bill No. 4477, 16th Congress. (2014)
7
Frontline, Marijuana Timeline, (2014), available at
http://www.pbs.org/wgbh/pages/frontline/shows/dope/etc/cron.html (last accessed Oct. 27, 2015)
Federal Bureau of Narcotics (FBN) was created in 1930 to regulate the drug usage.
During hearings on marijuana, claims were made about marijuana’s ability to cause men
of color to become violent and solicit sex from white women. 8 This imagery became the
backdrop for the Marijuana Tax Act of 1937 which effectively banned its use and sales.
While the Act was ruled unconstitutional years later, it was replaced with the Controlled
Substances Act in the 1970’s which established Schedules for ranking substances
according to their dangerousness and potential for addiction. Cannabis was placed in
the most restrictive category, Schedule I, supposedly as a place holder while then
President Nixon commissioned a report to give a final recommendation.9 In 1996,
California became the first state to approve the use of marijuana for medical purposes,
ending its 59 year reign as an illicit substance with no medical value. Prior to 1937,
cannabis had enjoyed a 5000 year history as a therapeutic agent across many cultures.10

Particular States with Medical Marijuana Laws

Cannabis has many currently accepted medical uses in the US, having been
recommended by thousands of licensed physicians and more than 500,000 patients in
21 states with medical marijuana laws. Like the twenty states and the District of
Columbia in the United States, Israel, Canada, the Netherlands and the Czech Republic
have enacted medical cannabis laws that remove criminal sanctions for the medical use
of cannabis, define eligibility for such use, and allow some means of access, in most
cases, through a dispensary. Other states in the European Union, such as Finland,
Portugal, Spain and Luxembourg, in recognition of the medical value of cannabis, have
developed various forms of de facto decriminalization, whereby possession and use of
cannabis, rarely lead to criminal prosecution.11

Legal issues of Medical Marijuana in the Philippines

The legalization of regulated use of marijuana for medicinal purposes as

embodied in House Bill 4477, which was proposed by Isabela Representative Rodolfo

8
We are the Drug Policy Alliance, How Did Marijuana Become Illegal in the First Place, (2015), available at
http://www.drugpolicy.org/blog/how-did-marijuana-become-illegal-first-place (last accessed Oct. 17, 2015)
9
Ibid.
10
Ibid.
11
Compassionate Use of Medical Cannabis Act, House Bill No. 4477, Explanatory Note, 16th Congress. (2014)
Albano III, has already gained support from lawmakers with six House members co-
authoring the measure. It was a proposal for patients “with debilitating disease, severe
pain, intense seizures and persistent muscle spasms.” Albano also called attention to
research that cited medical cannabis as an effective treatment for seizures 12 in children.
He was persuaded by the fact that the efficacy of the current pharmaceutical drugs gets
parents become financially incapable and frustrated. If the bill becomes a law, he
stressed that the Department of Health and the Food and Drug Administration would
closely regulate cannabis for medical use alone. This legislation does not address or
support recreational use of cannabis.13

Legalization Positive Effects

Legalizing such medicinal drug would surely have pros and cons. As discussed, it
is approved by research studies that medical cannabis has positive effects insofar as
health and medical treatment is concerned. Financially, on the other hand, it is safe to
say that citizens would decrease the burden of purchasing costly medicines that are not
as effective as medical marijuana. As one House supporter of the bill whose son died
from what she termed “a debilitating disease” shared, her family wished there had been
an effective and less expensive alternative to morphine to help his son in pain.14

The legalization has already been approved by the head of the Catholic Bishops
Conference of the Philippines and stated such use of marijuana would fall under church
rules and may even be approved by government without passing a law. Senior church
leaders in the conservative Philippines also affirmed their support of the use of
marijuana to ease the pain of the terminally ill, but not for recreational reasons. 15

Oppositions

However, despite these affirmations, the controversial measure is still contested

by some medical groups on grounds of their "moral and ethical responsibility" to ensure

12
Medical marijuana eliminates seizures in Texas 9-year-old girl
13
Mark Vesler, Lawmakers of the Philippines consider Medical Cannabis, Whaxy, (2015), available at
https://www.whaxy.com/news/medical-marijuana-philippines (last accessed Oct. 27, 2015)
14
Ibid.
15
Agence France-Presse, PH bishops OK marijuana use for the terminally ill, Rappler, (2015), available at
http://www.rappler.com/nation/62634-philippine-bishops-marijuana-terminally-ill (last accessed Oct. 27, 2015)
their patients' safety in spite of the "confirmed beneficial and therapeutic uses" of
marijuana to treat chronic diseases cited in the said bill.16 Medical groups contend that
HB 4477 does not address the compassionate use of medical marijuana among select
patients with potential indications.17 Instead of new legislation, they proposed the
creation of a task force that will review existing policies and systems, and explore other
options regarding medical marijuana. For instance, they said the country's Dangerous
Drugs Board can do the following: (1) allow the reclassification of marijuana as a
schedule II drug; (2) allow the regulated importation of oral cannabis extracts and/or
synthetic analogues with proven efficacy for specific conditions not responsive to
standard forms of treatment; (3) allow the importation of the plant for research
purposes; or (4) regulate the prescriptions and use of marijuana and its analogues.18

They also suggested that the National Integrated Research Program on Medicinal
Plants and/or the Philippine Institute of Traditional and Alternative Health Care
conduct research on marijuana. Meanwhile, they believe government should put more
funds into making specialists who can diagnose specific illness and exhaust up-to-date
treatment options accessible to Filipinos.19

Addressing the Abusive Substance Use

Nevertheless, the issue, according to some doctors and parents, is no longer

about the medical benefits of marijuana; but how it can be implemented and regulated
in the Philippines. Dr. Jorge Ignacio, chairman of the University of the Philippines-
Philippine General Hospital Cancer Institute, suggested that one way to do that is by
conducting a controlled clinical research where participating patients are carefully
screened and registered.20 Through this, the fear of substance abuse will alleviate.

16
Katerina Francisco, Medical marijuana advocates: Hold tests to end 'doomsday' fears, Rappler, (2015), available
at http://www.rappler.com/nation/103094-medical-marijuana-advocates-clinical-research-call-legalization (last
accessed Oct. 27, 2015)
17
Jee Y. Geronimo, PH doctors want task force on medical marijuana, Rappler, (2015) available at
http://www.rappler.com/nation/70776-doctors-task-force-medical-marijuana (last accessed Oct. 27, 2015)
18
Ibid.
19
Ibid.
20
Katerina Francisco, Medical marijuana advocates: Hold tests to end 'doomsday' fears, Rappler, (2015) available
at http://www.rappler.com/nation/103094-medical-marijuana-advocates-clinical-research-call-legalization (last
accessed Oct. 27, 2015)
Regulations and Safeguards

Some provisions in the proposed measure that will serve as safeguards against
possible abuse are emphasized. Once it has been enacted, HB 4477 will establish a
Medical Cannabis Regulatory Authority, a compassionate center, and safety compliance
facilities. Such facilities are tasked to conduct more research on the medicinal uses and
benefits of marijuana. The legislators specifically laid down the steps once HB 4477 is
enacted:

Once enacted, the law will establish under the Department of Health a Medical
Cannabis Regulatory Authority that will regulate the medical use of cannabis in the
country. The agency will issue registered identification cards to qualified patients as well
as maintain a registry of cannabis patients' caregivers who will assist registered qualified
patients. The bill also proposes a Medical Cannabis Compassionate Center and Medical
Cannabis Safety Compliance Facilities. Both should not be located within 1,000 feet of
the property line of a pre-existing school, college, or university, and should implement
security measures to prevent unauthorized entry as well as theft of cannabis. The bill
specified who will be exempted from civil and criminal liability for the use of, or for
activities related to, medical cannabis. Under the bill, medical cannabis and its
paraphernalia possessed, owned, or used in connection with its medical use should not
be seized or confiscated unless the dosage exceeds what is prescribed by a qualified
physician. It also prohibits discrimination against both the registered qualified patient
and the designated caregiver. A Joint Congressional Oversight Committee for Medical
Use of Cannabis will be established to oversee the implementation of the bill once it is
enacted.21

The Philippines can further improve the said bill in adopting some provisions
from some of the countries which already have medical marijuana laws such as
Proposition 215 of California, and Medical Marijuana Act of Oregon.

Dangerous Drugs Act of 2002 vs. House Bill 4477

21
Jee Geronimo, Bill on medical use of marijuana filed in Congress, Rappler, (2015), available at
http://www.rappler.com/nation/59118-compassionate-use-medical-cannabis-bill (last accessed Oct. 27, 2015)
 Skeptics who question the possible overstepping of HB 4477 on the Dangerous
Drugs Act of 2002 can only be answered by the provisions it both stated therein. In the
Philippines, the “Dangerous Drugs Act of 2002” recognized the medical use of drugs
classified as dangerous drugs including marijuana when it said in Section 2:

“The government shall, however aim to achieve a balance in the national

drug control program so that people with legitimate medical needs are not
prevented from being treated with adequate amounts of appropriate
medications, which include the use of dangerous drugs.”22

It went further in Section 16 when it provided that:

“xxx in the case of medical laboratories and medical research centers

which cultivate or culture marijuana, opium poppy and other plants, or
materials of such dangerous drugs for medical experiments and research
purposes, or for the creation of new types of medicine, the Board shall
prescribe the necessary implementing guidelines for the proper
cultivation, culture, handling, experimentation and disposal of such plants
and materials.”23

As the purpose and intent of HB 4477 is to provide accessible, affordable, safe

medical cannabis to qualifying patients with debilitating medical condition, it is in
harmony with the Republic Act No. 10606, specifically Section 2 which states:

“xxx the policy of the state to adopt an integrated and comprehensive

approach to health development which shall endeavor to make essential
goods, health and other social services available to all the people at
affordable cost.”24

Conclusion

Matters on the House Bill 4477 or the legalization of the use of medical
marijuana, will rest upon our citizens, particularly on the part of lawmakers insofar as

22
Dangerous Drugs Act of 2002, Section 2, (2002).
23
Ibid., Section 16
24
RA No. 10606, National Health Insurance of 1995, as amended, (2012)
how they will sustain the order of the country as soon as it has been implemented; and
on the part of the citizens, not only the patients but the people of the Philippines as a
whole. Positive effects may surely be felt and seen on the health, as how it has improved
their health, and pocket, as how it has relieved the financial burden in purchasing
medicine, of the people. But as society becomes susceptible of chaos because of risk of
substance abuse, it should be highly regulated by the government with the cooperation
of the people.

It is also true that medical marijuana has been a hotly debated topic and it is one
of the most widely supported issues. Due to this, the government and the citizens should
be adaptive to change. As we live in a world where change is inevitable, the House Bill
4477 should continuously be improved and enhanced for the protection of the
government and the rights of the people.