RTI Analysis Indian Journal of Clinical Practice, Vol. 30, No. 6, November 2019 Bhang or Marijuana is Legal in Ayurvedic Prescription

KK Aggarwal*, IrA Gupta†

A drug can be available in Ayurvedic preparations but be permitted for research including trials of various varieties not approved in modern medicine. of cannabis (20)." Marijuana is another name for cannabis obtained from "Section 14 of the NDPS Act empowers the Government to, the Cannabis plant, Cannabis sativa. It is mainly used as by general or special order, permit cultivation of cannabis charas, hashish, ganja and bhang. exclusively for horticultural and industrial purposes (23)." The Narcotic Drugs and Psychotropic Substances The medical use of marijuana is much debated in (NDPS) Act, 1985 has defined cannabis as below: modern medicine. Medical marijuana refers to using "(iii) "cannabis (hemp)" means- the whole, unprocessed marijuana plant or its basic extracts. It is not yet approved by the US Food and (a) charas, that is, the separated resin, in whatever Drug Administration (FDA) as a safe and effective drug form, whether crude or purified, obtained from for any indication, although many states in the United the cannabis plant and also includes concentrated States have legalized marijuana for medical purposes. preparation and resin known as hashish oil or liquid However, FDA has approved one medication, which hashish; contains the purified substance cannabidiol for the (b) ganja, that is, the flowering or fruiting tops of the treatment of seizures associated with Lennox-Gastaut cannabis plant (excluding the seeds and leaves syndrome or Dravet syndrome in patients 2 years of age when not accompanied by the tops), by whatever and older. https://www.fda.gov/news-events/public- name they may be known or designated; and health-focus/fda-and-marijuana (c) any mixture, with or without any neutral material, Medicinal cannabinoids, including medicinal cannabis of any of the above forms of cannabis or any drink and pharmaceutical cannabinoids and their synthetic prepared therefrom." derivatives, such as tetrahydrocannabinol (THC) and Bhang is prepared from the leaves (and seeds) of the cannabidiol (CBD), have been suggested to have a cannabis plant. Hence, it is not covered under the therapeutic role in certain mental disorders. However, a NDPS Act, 1985, which bans the production and sale recent review and meta-analysis analyzing the available of cannabis resin and flowers, but permits use of leaves evidence to ascertain the effectiveness and safety of all and seeds. types of medicinal cannabinoids in treating symptoms of various mental disorders concluded that there is Mixing of bhang with any part of flowering tops or the scarce evidence to suggest that cannabinoids improve resin produced from the cannabis plants; however, is depressive disorders and symptoms, anxiety disorders, a punishable offence under relevant provisions of the attention-deficit hyperactivity disorder, Tourette NDPS Act, 1985. syndrome, post-traumatic stress disorder or psychosis The National Policy on Narcotic Drugs and Psychotropic (Lancet Psychiatry. 2019 Oct 25. pii: S2215-0366(19)30401- Substances allows cultivation of cannabis, with permit, 8. doi: 10.1016/S2215-0366(19)30401-8). for purposes of research and not for medical purposes. "Cultivation of cannabis will not be permitted given its A Right to Information (RTI) application was filed limited proven uses for medical purposes. Cultivation shall to know about the items included in marijuana and whether it can be used for medicinal purposes in India (see Appendices 1 and 2). As of today, marijuana is not approved as a drug by the *Group Editor-in-Chief, IJCP Group Central Drugs Standard Control Organization (CDSCO). †Advocate and Legal Advisor, HCFI But it is used regularly in Ayurveda.

562 IJCP Sutra: "Mosquitoes can lay eggs in money plant pots or in water tanks on the terrace if they are not properly covered." Indian Journal of Clinical Practice, Vol. 30, No. 6, November 2019 RTI Analysis

Bhang (Cannabis sativa) is included in Ayurvedic It is prescribed in a dose of 125-250 mg of the drug in Pharmacopoeia Part-I, Volume-I and National powder form. Institute of Drug Abuse (https://www.drugabuse. As per Ayurvedic Pharmacopoeia Part-I, Volume-I, bhang gov/publications/research-reports/marijuana/what- is Vijaya and consists of dried leaves of cultivated or wild marijuana). The Ayurvedic formulations are Jatiphaladi plants of Cannabis sativa Linn. (Fam Cannabaceae). churna and Madanananda modaka. In Ayurveda, it has different names are Bhanga, Madani, Its therapeutic uses are for: Bhan, Sidhi, Indian Hemp, Bhaang, Bhang, Bhangigida,

ÂÂ Agnimandya (in which food is not properly digested Ganjagida, Pang, Bangi, Kanchavu, Ganja, Ganjei and due to the diminished power of Jatharagni) Qinaab. Table summarizes the information in the replies received ÂÂ Atisara (acute diarrhea) in response to the RTI (see Appendices 3 and 4). ÂÂ Grahaniroga (irritable bowel syndrome) Till marijuana is made legal in modern medicine, ÂÂ Klaibya (erectile dysfunction) doctors can co-consult Ayurvedic practitioners and let ÂÂ Anidra (insomnia). the patient avail the benefits.

RTI Reply in Marijuana (Bhang) S.N. RTI dated 12.08.2019 Reply by AYUSH dated 18.09.2019 Reply by CDSCO dated 20.09.2019 1. What all items are included in As per Ayurvedic Pharmacopoeia Part-I, Volume-I CDSCO regulates safety, marijuana? Provide the details. reflecting details about the Bhang (Cannabis sativa) efficacy and quality of the and National Institute of Drug Abuse (URL:-https:// drugs, medical devices www.drugabuse.gov/publications/research- and cosmetics under the reports/marijuana/what-marijuana). provisions of Drugs and Cosmetics Act, 1940 & Rules, made there under. Marijauna has not been approved as drug by CDSCO. 2. Can marijuana be used for medicinal Yes purpose? 3. If answer to query no. 1 is “Yes”, Important Formulations then please provide the details of the Jatiphaladi churna, Madanananda modaka. medicinal purpose for marijuana can be used. Therapeutic Uses Agnimandya, Atisara, Grahaniroga, Klaibya, Anidra Dose: 125-250 mg of the drug in powder form 4. If answer to query no. 1 is “No”, then Misuse and illegal use of marijuana can be reported please provide the details of the to Central Bureau of Narcotics, 19, The Mall, Morar, authority to which the misuse and illegal Gwalior - 474006, Madhya Pradesh, India use of marijuana can be reported. 5. Is there any expert committee looking No into the use of marijuana in the country? 6. Is bhang or cannabis leaves used in As per Ayurvedic Pharmacopoeia Part-I, Volume-I Ayurveda or any other stream of AYUSH bhang is: for any medical purpose? Vijaya consists of dried leaves of cultivated or wild plants of Cannabis sativa Linn. (Fam Cannabaceae); an annual erect, dioecious herb, 1-2 m high, found almost throughout the year; practically naturalized in the Sub-Himalayan tracts in India and abundantly found in waste lands from Punjab eastwards to Bengal and extending Southwards.

IJCP Sutra: "If the water pots for birds kept on terraces are not cleaned every week, then mosquitoes can lay eggs in them." 563 RTI Analysis Indian Journal of Clinical Practice, Vol. 30, No. 6, November 2019

Synonyms: Sansk. : Bhanga, Madani Assam. : Bhan, Bhang Beng. : Bhang, Sidhi Eng. : Indian Hemp Guj. : Bhang Hindi : Bhaang, Bhanga Kan. : Bhangigida, Ganjagida Kash. : Pang, Bangi Mal. : Kanchavu Mar. : Bhang, Ganja Ori : Bhanga, Ganjei Punj. : Bhang Tam. : Ganja Tel. : Ganjayi Urdu : Qinaab, Bhang 7. If answer to query no. 7 is “Yes”, then Important Formulations provide the list of medicines where it is Jatiphaladi churna, Madanananda modaka. used. Therapeutic Uses Agnimandya, Atisara, Grahaniroga, Klaibya, Anidra Dose: 125-250 mg of the drug in powder form

564 IJCP Sutra: "Using mosquito nets/repellents in the night may not prevent malaria because these mosquitoes bite during the day time." Indian Journal of Clinical Practice, Vol. 30, No. 6, November 2019 RTI Analysis

Appendix 1

IJCP Sutra: "Gout is uncommon in women." 565 RTI Analysis Indian Journal of Clinical Practice, Vol. 30, No. 6, November 2019

Appendix 2

566 IJCP Sutra: "Wearing full sleeves shirt and trousers can prevent mosquito bites. Mosquito repellent can also be helpful during the day." Indian Journal of Clinical Practice, Vol. 30, No. 6, November 2019 RTI Analysis

Appendix 3

IJCP Sutra: "Avoid stress, excessive humidity, heat and tight clothes and use moisturizers, 567 sun block and wear the right type of clothes, which absorb sweat and keep the body cool." RTI Analysis Indian Journal of Clinical Practice, Vol. 30, No. 6, November 2019

568 IJCP Sutra: "Using sunscreen and taking vitamin C tablets helps in preventing flare ups in some patients." Indian Journal of Clinical Practice, Vol. 30, No. 6, November 2019 RTI Analysis

Appendix 4

IJCP Sutra: "Patients should also maintain good hygiene to prevent flare ups." 569