SINGAPORE – A second person in Singapore has been approved to use cannabis-derived medicines.
The “young patient” with treatment-resistant epilepsy was allowed to use a cannabinoid drug, commonly known as medicinal cannabis, after an application made after December 2019, the Home Office (MHA) said in response to inquiries from the Straits Times.
The approval was granted “because all available and suitable therapeutic options have been exhausted”.
ST reported on December 1, 2019 that authorities had for the first time approved the use of cannabis-derived drugs to treat a girl with drug-resistant epilepsy.
Regarding the second patient, the MHA said, “Given the extremely debilitating progressive condition, the patient’s physician applied to the Health Sciences Authority (HSA) for a cannabinoid drug installation as treatment could meet unmet medical need.”
The application was reviewed and approved by the HSA, the Central Narcotics Bureau, the Department of Health and the MHA.
Citing patient confidentiality, the MHA made no updates on the condition of the first patient after cannabinoid treatment. For the same reason, no information was given on the sex and age of the second patient.
Cannabinoids refer to chemical compounds found in the cannabis plant, the two best known of which are cannabidiol (CBD) and tetrahydrocannabinol (THC).
Both compounds have the potential to help with certain medical conditions, but have different effects on the body. THC is the psychoactive component in the plant that induces the cannabis-related high, while CBD is non-psychoactive and has been classified by the World Health Organization (WHO) as having no public health risk and no potential for abuse.
The MHA did not confirm whether the treatment used in both cases was the prescription drug Epidiolex, which is currently the first and only pharmaceutical-grade cannabinoid drug to be approved by the U.S. Food and Drug Administration (FDA).
The drug, which contains the non-hallucinogenic CBD, is used to treat children with Lennox-Gastaut syndrome and Dravet syndrome, both of which are severe forms of epilepsy that start in early childhood.
The drug works by blocking or slowing down brain signals that decrease the excitability of cells that cause seizures.
Epidiolex is approved for use in medical or clinical studies in the European Union as well as other countries such as South Korea and Japan. Worldwide, the global medical cannabis market has also grown as more countries allow its use.
A United Nations commission voted last December to classify cannabis as less dangerous for medicinal purposes. It was previously listed on Appendix IV of the 1961 Single Convention on Narcotic Drugs, along with heroin and other opioids considered harmful to health.
The Singapore government expressed disappointment with the United Nations move when the MHA issued a statement in December saying it could fuel the misconception, particularly among young people, that cannabis was less harmful than before, despite strong evidence.
The MHA reiterated that Singapore will continue to enforce tough laws against the trade, possession, use, and import and export of illicit drugs, including cannabis, to protect the health and well-being of people.
Meanwhile, efforts in the republic to produce synthetic cannabinoids for medicinal purposes have proven fruitful.
“Significant progress has been made,” said Professor Yew Wen Shan, an enzymologist at the National University of Singapore who leads a team studying the components of cannabis to find ways to make them sustainable for medicinal use.
Over the past three years, Prof. Yew and his team have discovered how to biosynthetically produce at least five lesser-known cannabinoids and are now investigating whether they can be used medicinally. You can now make these cannabinoids on a laboratory scale of no more than five liters.
Growing the cannabis plant is illegal in Singapore, so Prof. Yew’s team has biologically manipulated yeast and other microorganisms to make cannabinoids – like CBD – in the same way a cannabis plant could produce.
The team has filed three international patents for the synthetic cannabinoids they make.
Prof. Yew began working on his project in 2018 as part of the $ 25 million synthetic biology research and development program supported by the National Research Foundation.
“This is all part of an effort to improve public health as (the biosynthetically manufactured cannabinoids) could be used as sustainable therapeutics,” he said, noting however that this process is a “long way” of 20 years from laboratory research until used as medication.