Medical Cannabis in Malaysia: Supply and Demand on Facebook

Main Article Content

Ekmil Krisnawati Erlen Joni
Shahrul Mizan Ismail
Rohaida Nordin

Abstract

The internet has become a key hub for communication and information, including drug-related information. Evidence from other nations suggests that medical cannabis is also available online. Yet little is known about medical cannabis dealing on online services in Malaysia. This study examines the current supply and demand of medical cannabis on Malaysian Facebook Pages. Researchers searched for cannabis Facebook Pages in Malay and English between April and June 2022, using the keywords associated with cannabis and marijuana in popular search engines. The Facebook content, including the posts and users’ responses to supply and demand information for medical cannabis, were screened and analysed. Subsequently, the contents of the Facebook Pages were categorised into five themes: (1) demand for medical cannabis; (2) testimony; (3) supply information; (4) adverse health effects of medical cannabis; and (5) product types and routes of administration. The findings indicate that medical cannabis is available online and searchable via popular search engines, despite being illegal in Malaysia. A total of 46 Facebook Pages related to cannabis were identified in this study, where 13 pages sell medical cannabis directly, and 3 sell both medical and recreational cannabis. In addition to private messages via Facebook Messenger, most pages share contact details. The information on the sampled Facebook Pages reflected the growing demand and illegal sales of medical cannabis in Malaysia via online platforms since 2012. Thus, there is an urgent need for proper regulations and laws to control medical cannabis usage besides protecting patients against potentially harmful medical cannabis online.


 

Article Details

How to Cite
Ekmil Krisnawati Erlen Joni, Shahrul Mizan Ismail, and Rohaida Nordin. 2024. “Medical Cannabis in Malaysia: Supply and Demand on Facebook”. Kajian Malaysia 42 (1): 139‒165. https://doi.org/10.21315/km2024.42.1.7.
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References

Abuhasira, R., L. Shbiro and Y. Landschaft. 2018. Medical use of cannabis and cannabinoids containing products – regulations in Europe and North America. European Journal of Internal Medicine 49(March): 2–6. https://doi.org/10.1016/j.ejim.2018.01.001

Alzeer, J., K.A. Hadeed, H. Basar, F. Al-Razem, M.A. Abdel-Wahhab, and Y. Alhamdan. 2020. Cannabis and its permissibility status. Cannabis and Cannabinoid Research X(X): 1–6. https://doi.org/10.1089/can.2020.0017

Beaulieu, P., A. Boulanger, J. Desroches and A.J. Clark. 2016. Medical cannabis: Considerations for the anesthesiologist and pain physician. Canadian Journal of Anaesthesia 63(5): 608–624. https://doi.org/10.1007/s12630-016-0598-x

Bottorff, J.L., L.J. Bissell, L.G. Balneaves, J.L. Oliffe, H.B. Kang, N.R. Capler, J.A. Buxton and R.K. OBrien. 2011. Health effects of using cannabis for therapeutic purposes: A gender analysis of users’ perspectives. Substance Use and Misuse 46(6): 769–780. https://doi.org/10.3109/10826084.2010.537732

Braun, I. M., M.M. Nayak, A. Revette, A.A.Wright, P.R. Chai, M. Yusufov, W.F. Pirl and J.A. Tulsky. 2020. Cancer patients experiences with medicinal cannabis–related care. Cancer 127(1): 67–73. https://doi.org/10.1002/cncr.33202

Caulley, L., B. Caplan and E. Ross. 2018. Medical marijuana for chronic pain. The New England Journal of Medicine 379(16): 1575–1577. https://doi.org/10.1056/NEJMclde1808149

Cavazos-Rehg, P.A., S.J. Sowles, M.J. Krauss, V. Agbonavbare, R. Grucza and L. Bierut. 2016. A content analysis of tweets about high-potency marijuana. Drug and Alcohol Dependence 166: 100–108. https://doi.org/10.1016/j.drugalcdep.2016.06.034

Coconuts KL. 2018. Lawyer for death row inmate guilty of selling cannabis oil says prosecution lacked proper procedure. https://coconuts.co/kl/news/lawyer-death-row-inmate-guilty-selling-cannabis-oil-says-prosecution-lacked-proper-procedure/ (accessed 3 June 2022).

Demant, J., S.A. Bakken, A. Oksanen and H. Gunnlaugsson. 2019. Drug dealing on Facebook, Snapchat and Instagram: A qualitative analysis of novel drug markets in the Nordic countries. Drug and Alcohol Review 38(4): 377–385. https://doi.org/10.1111/dar.12932

Devinsky, O., J.H. Cross, L. Laux, E. Marsh, I. Miller, R. Nabbout, I.E. Scheffer, E.A. Thiele and S. Wright. 2017. Trial of Cannabidiol for drug-resistant seizures in the Dravet Syndrome. New England Journal of Medicine 376(21): 2011–2020. https://doi.org/10.1056/NEJMoa1611618

Dos Santos, R.G., F.S. Guimarães, J.A.S. Crippa, J.E. Hallak, G.N. Rossi, J.M. Rocha and A.W. Zuardi. 2020. Serious adverse effects of cannabidiol (CBD): A review of randomised controlled trials. Expert Opinion on Drug Metabolism and Toxicology 16(6) : 517–526. https://doi.org/10.1080/17425255.2020.1754793

Dryburgh, L.M., N.S. Bolan, C.P. Grof, P. Galettis, J. Schneider, C.J. Lucas and J.H. Martin. 2018. Cannabis contaminants: Sources, distribution, human toxicity and pharmacologic effects. British Journal of Clinical Pharmacology 84: 2468–2476. https://doi.org/10.1111/bcp.13695

Erridge, S., O. Salazar, M. Kawka, C. Holvey, R. Coomber, A. Usmani, M. Sajad, S. Beri, J. Hoare, S. Khan and M.W. Weatherall. 2021. An initial analysis of the UK medical cannabis registry: Outcomes analysis of first 129 patients. Neuropsychopharmacology Reports 41(3): 362–370. https://doi.org/10.1002/npr2.12183

Evans D.G. 2020. Medical fraud, mislabeling, contamination: All common in CBD products. Missouri Medicine 117(5): 393–399.

Fitzcharles, M.A., O.Z. Niaki, W. Hauser, G. Hazlewood and Canadian Rheumatology Association. 2019. Position statement: A pragmatic approach for medical cannabis and patients with rheumatic diseases. The Journal of Rheumatology 46(5): 532–538. https://doi.org/10.3899/jrheum.181120

Free Malaysia Today. 2018. Group urges “patients” to step forward in support of “Dr Ganja”. 22 January. https://www.freemalaysiatoday.com/category/nation/2018/01/22/group-urges-patients-to-step-forward-in-support-of-dr-ganja/?fmt=1 (accessed 18 June 2022).

Hadirah Syahrain Supian and Noor Munirah Isa. 2019. Public opinion on medical cannabis controversy: A content analysis of selected medical cannabis Facebook Pages in Malaysia. Paper poresented at Proceeding of ICITS 2019, 5th International Conference on Information Technology and Society, Selangor. 20 August.

Hanson, C.L., S.H. Burton, C. Giraud-Carrier, J.H. West, M.D. Barnes and B. Hansen. 2013. Tweaking and tweeting: Exploring Twitter for nonmedical use of a psychostimulant drug (Adderall) among college students. Journal of Medical Internet Research 15(4): e2503. https://doi.org/10.2196/jmir.2503

Haroutounian, S., Y. Ratz, Y. Ginosar, K. Furmanov, F. Saifi, R. Meidan and E. Davidson. 2016. The effect of medicinal cannabis on pain and quality-of-life outcomes in chronic pain: A Prospective prospective open-label study. Clinical Journal of Pain 32(12): 1036–1043. https://doi.org/10.1097/AJP.0000000000000364

Hazekamp, A. 2018. The trouble with CBD oil. Medical Cannabis and Cannabinoids 1(1): 65–72. https://doi.org/10.1159/000489287

Hazekamp, A. and S. Epifanova. 2017. Grote variatie in samenstelling cannabisolie Noopt Tot Regels. Pharmaceutisch Weekblad 152(44): 16–18.

Hillebrand, J., D. Olszewski and R. Sedefov. 2010. Legal highs on the internet. Substance Use and Misuse 45(3): 330–40. https://doi.org/10.3109/10826080903443628

Huestis, M.A., R. Solimini, S. Pichini, R. Pacifici, J. Carlier and F.P. Busardò. 2019. Cannabidiol adverse effects and toxicity. Current Neuropharmacology 17(10): 974–989. https://doi.org/10.2174/1570159x17666190603171901

Kemp, S. 2022. Digital 2022: Malaysia data report. https://datareportal.com/reports/digital-2022-malaysia (accessed 14 April 2022).

Kudahl, B., M.E. Berg, C.M. Posselt, M. Nordentoft and C. Hjorthøj. 2021. Medical cannabis and cannabis-based medicine show both potential efficacy and potential harms: Cross-sectional comparison with controls on self-rated and interviewer-rated outcomes within the Danish Pilot Program on medical cannabis. Complementary Therapies in Clinical Practice 45: 101476. https://doi.org/10.1016/j.ctcp.2021.101476

Lachenmeier, D.W. and P. Diel. 2019. A warning against the negligent use of cannabidiol in professional and amateur athletes. Sports 7(12): 251. https://doi.org/10.3390/sports7120251

McPartland, J.M. and K.J. McKern. 2017. Contaminants of concern in cannabis: Microbes, heavy metals and pesticides. In Cannabis sativa L. – Botany and biotechnology, eds. S. Chandra, H. Lata and M. ElSohly, 457–474. Cham: Springer. https://doi.org/10.1007/978-3-319-54564-6_22

Mercurio, A., E.R. Aston, K.R. Claborn, K. Waye and R.K. Rosen. 2019. Marijuana as a substitute for prescription medications: A qualitative study. Substance Use and Misuse 54(11): 1894–1902. https://doi.org/10.1080/10826084.2019.1618336

Montoya, Z., M. Conroy, B.D. Vanden Heuvel, C.S. Pauli and S.H. Park. 2020. Cannabis contaminants limit pharmacological use of cannabidiol. Frontiers in Pharmacology 54(11): 1894–1902. https://doi.org/10.3389/fphar.2020.571832

NPRA (National Pharmaceutical Regulatory Agency). 2018. Drug registration guidance document (Drgd). https://members.wto.org/crnattachments/2018/TBT/ MYS/18_5565_02_e.pdf (accessed 9 May 2022).

Nurmikko, T.J., M.G. Serpell, B. Hoggart, P.J. Toomey, B.J. Morlion and D. Haines. 2007. Sativex successfully treats neuropathic pain characterised by Allodynia: A randomised, double-blind, Placebo-controlled clinical trial. Pain 133(1–3): 210–220. https://doi.org/10.1016/j.pain.2007.08.028

Ogborne, A.C., R.G. Smart, T. Weber and C. Birchmore-Timney. 2000. Who is using cannabis as a medicine and why: An exploratory study. Journal of Psychoactive Drugs 32(4): 435–443. https://doi.org/10.1080/02791072.2000.10400245

Pinyopornpanish, K., W. Jiraporncharoen, K. Thaikla, K. Yoonut and C. Angkurawaranon. 2018. Sedative and analgesic drugs online: A content analysis of the supply and demand information available in Thailand. Substance Use and Misuse 53(4): 641–647. https://doi.org/10.1080/10826084.2017.1355386

Pisanti, S., A.M. Malfitano, E. Ciaglia, A. Lamberti, R. Ranieri, G. Cuomo, M. Abate, G. Faggiana, M.C. Proto, D. Fiore and C. Laezza. 2017. Cannabidiol: State of the art and new challenges for therapeutic applications. Pharmacology and Therapeutics 175: 133–150. https://doi.org/10.1016/j.pharmthera.2017.02.041

Pritchett, C.E., H. Flynn, Y. Wang and J.E. Polston. 2022. Medical cannabis patients report improvements in health functioning and reductions in opiate use. Substance Use & Misuse 57(13): 1883–1892. https://doi.org/10.1080/10826084.2022.2107673

Qatanani, A., M. Umar and A.I. Padela. 2021. Bioethical insights from the fiqh council of North America’s recent ruling on medical cannabis. International Journal of Drug Policy 97: 103360. https://doi.org/10.1016/j.drugpo.2021.103360

Rapisarda, A., K. Lim and J. Lee. 2017. Does cannabis consumption negatively affect cognition? A review of the scientific evidence. ASEAN Journal of Psychiatry 18(2): 82–93.

Russo, E.B. 2007. History of cannabis and its preparations in Saga, Science, and Sobriquet. Chemistry and Biodiversity 4(8): 1614–1648. https://doi.org/10.1002/ cbdv.200790144

Safakish, R., G. Ko, V. Salimpour, B. Hendin, I. Sohanpal, G. Loheswaran and S.Y.R. Yoon. 2020. Medical cannabis for the management of pain and quality of life in chronic pain patients: A prospective observational study. Pain Medicine (United States) 21(11): 3073–3086. https://doi.org/10.1093/PM/PNAA163

Seltenrich, N. 2019. Cannabis contaminants: Regulating solvents, microbes, and metals in legal weed. Environmental Health Perspectives 127(8): 082001. https://doi.org/10.1289/EHP5785

Shutler, L., L.S. Nelson, I. Portelli, C. Blachford and J. Perrone. 2015. Drug use in the Twittersphere: A qualitative contextual analysis of tweets about prescription drugs. Journal of Addictive Diseases 34(4): 303–310. https://doi.org/10.1080/10550887.2015.1074505

Singh, Y. and C. Bali. 2013. Cannabis extract treatment for terminal acute Lymphoblastic Leukemia with a Philadelphia chromosome mutation. Case Reports in Oncology 6(3): 585–592. https://doi.org/10.1159/000356446

Spindle, T.R., D.J. Sholler, E.J. Cone, T.P. Murphy, M. ElSohly, R.E. Winecker, R.R. Flegel, M.O. Bonn-Miller and R. Vandrey. 2022. Cannabinoid content and label accuracy of hemp-derived topical products available online and at national retail stores. JAMA Network Open 5(7): e2223019. https://doi.org/10.1001/jamanetworkopen.2022.23019

Statista Research Department. 2022. Social media users as a percentage of the total population Malaysia 2021. https://www.statista.com/statistics/883712/malaysia-social-media-penetration/ (accessed 9 May 22).

Thaikla, K., K. Pinyopornpanish, W. Jiraporncharoen and C. Angkurawaranon. 2018. Cannabis and kratom online information in Thailand: Facebook trends 2015–2016. Substance Abuse: Treatment, Prevention, and Policy 13: 1–8. https://doi.org/10.1186/s13011-018-0155-4

Thomas, B.F. and M.A. ElSohly. 2016. The botany of Cannabis sativa L. In The analytical chemistry of cannabis: Quality assessment, assurance, and regulation of medicinal marijuana and cannabinoid preparations, 1–26. https://doi.org/10.1016/b978-0-12-804646-3.00001-1

Thompson, L., F.P. Rivara and J.M. Whitehill. 2015. Prevalence of marijuana-related traffic on Twitter, 2012–2013: A content analysis. Cyberpsychology, Behavior, and Social Networking 18(6): 311–319. https://doi.org/10.1089/cyber.2014.0620

Vandrey, R., J.C. Raber, M.E. Raber, B. Douglass, C. Miller and M.O. Bonn-Miller. 2015. Cannabinoid dose and label accuracy in edible medical cannabis products. JAMA 313(24): 2491–2493. https://doi.org/10.1001/jama.2015.6613

Watts, S., M. McElroy, Z. Migicovsky, H. Maassen, R. van Velzen and S. Myles. 2021. Cannabis labelling is associated with genetic variation in terpene synthase genes. Nature Plants 7(10): 1330–1334. https://doi.org/10.1038/s41477-021-01003-y