When it comes to medical cannabis, Japan is way behind the curve.
Way, way behind. There is officially no legal access to medical cannabis in Japan. But some people are finding relief with hemp-derived CBD products, a market that has taken root and is rapidly growing due to a loophole in the law.
Cannabis in Japan
Cannabis actually has a long history in Japan, dating back to its pre-historic period. Fiber and seeds of hemp have been discovered in the remains of human habitats from the Jomon period (10,000 BC to 300 BC).
Throughout history, hemp was a widely cultivated crop and played a significant role in Japanese daily life. People wore clothes made of hemp, used hemp ropes in a variety of ways, crafted hemp paper, ate seeds, and made oils. Hemp fields were abundant throughout the nation.
Beyond its practical applications, hemp was also revered as sacred plant in our indigenous religion Shintoism and was (and still is) used in various ceremonies.
And cannabis was well regarded as medicine, as well. It was listed in the pharmacopoeia and prescribed to treat asthma, mitigate pain, and enhance sleep, among other uses. Cannabis tinctures and cigarettes were widely available in pharmacies and were advertised in newspapers.
Cannabis cigarettes ad in a national newspaper, 1895.
This all changed when Japan lost WWII, and the winner – the United States – forced the country to ban cannabis altogether, as a part of the Narcotic Control Act. Japanese hemp farmers – there were more than 50,000 at the time – protested. So the Japanese government negotiated with American occupation army and managed to separate cannabis from the rest of narcotics. They were also able to secure a legal exemption whereby, mature hemp stalks and seeds were permitted under the Cannabis Control Act. Enacted in 1948, this prohibitionist measure has dictated Japanese cannabis policy without revision or modification for nearly 75 years.
Think about it. In 1948, nobody in the world knew that it was THC that made you high. No one knew we had an endocannabinoid system in our body. Nobody knew the scientific basis for how cannabis can help people with a wide range of ailments, which we understand to a great extent today.
Science progressed, but we didn’t. Japan’s Cannabis Control Act was simply imposed upon us. And we Japanese, famous for our obedient nature and deference toward authority, for good or bad, obeyed.
Slow Footsteps of Change
Seven decades later, however, even our reflexive obedience is approaching its limit. News about cannabis law reform and new scientific discoveries “elsewhere in the world” reaches us every day via the internet. The globe is now smaller, the news travels faster.
In 2013, hemp-derived CBD products started to trickle into Japan. Because of the loophole in the Cannabis Control Act, CBD products are legal to import and use as long as the manufacturer declares it was produced from mature hemp stalks, and if it contains no detectable THC. Despite this absurd requirement, the CBD market has shown steady expansion, particularly after 2019, gaining momentum each year, drawing in whole host of new consumers, including children.
Green Zone Japan, an organization founded in 2017 by a Japanese M.D. and myself, helped a 6-month-old boy with Ohtahara Syndrome (early infantile epileptic encephalopathy) obtain therapeutic doses (according to the famous study led by NYU’s Dr. Orrin Devinsky) of a CBD product currently on the Japanese market. The boy’s seizures stopped!
This generated considerable interest – and hope – among Japanese families with epileptic children and their doctors, triggering a chain of events that culminated in a March 2019 announcement by the Ministry of Health, Labor and Welfare (MHLW), Japan’s equivalent of FDA, that it will “allow clinical trials of a cannabis-derived drug to be conducted.”
6-month-old Japanese epileptic boy helped by CBD.
The drug slated for clinical trials is Epidiolex, pharmaceutical CBD produced by GW Pharma in the UK and approved as a treatment for severe pediatric epilepsy in many countries, including the United States.
GW Pharma’s Japanese entity, formed for this purpose, submitted a formal application to undertake an Epidiolex study, and it has been approved by the health ministry. But the clinical trial has been slow to get off the ground.
Yes, it’s only Epidiolex, a CBD isolate, and, yes, it is only for intractable epilepsy. Nevertheless, the government’s acknowledgment of the possible therapeutic benefits of a cannabis derivative is a big first step toward the legalization of medical cannabis in Japan.
Murky Future of Medical Cannabis
So where do we go from here?
In January 2021, the Japanese health ministry announced that it was planning to review the Cannabis Control Act for a possible reform. This was expected, because if the clinical trial of Epidiolex is successful, the current law, which prohibits use of cannabis for any purpose, including medical, must be changed. A panel comprised of 12 “experts” was formed; after meeting eight times, it submitted a recommendation that identified four areas of reform. Authorization of medical cannabis is one of them. The reform is expected to be addressed during the ordinary Diet (parliament) session in 2023.
The use of whole-plant cannabis should be incorporated into the “crude drug” framework for natural herbs that Japanese people are already familiar with.
This sounds encouraging. However, things are not so simple. The term “medical cannabis” can mean many different things to different people, and it’s not clear what exactly Japanese officials are referring to when they mention the therapeutic use of cannabis.
There is a lot of confusion about this in a country where the illicit use of cannabis for recreational and/or therapeutic purposes is so limited (cannabis-related arrests in Japan were just over a paltry 5,400 in 2021). Some people simply cannot comprehend that it’s possible to use cannabis medicinally. When they hear that medical cannabis is legal in 37 states in the U.S., many Japanese think it means that doctors give cannabis to patients in hospitals. Still others are under the impression that medical cannabis refers exclusively to Epidiolex. Indeed, the majority of Japanese people are not aware of the difference between state-run “medical cannabis programs” and the unregulated nationwide hemp-derived CBD market.
Obviously, education is crucial before we can embark on a productive discussion about how to shape the future of medical cannabis in Japan. I, for one, would love to see the use of whole-plant cannabis incorporated into the “crude drug” framework for natural herbs that Japanese people are already familiar with – in addition to the pharmaceutical approach. And for that to happen, the reform of the current law is necessary.
There is a long way to go before we have a decent medical cannabis program in Japan, but the first step is now being taken.
Naoko Miki is a book translator and a co-founder of Green Zone Japan, a non-profit organization which brings up-to-date, evidence-based information on cannabis to Japanese medical professionals and the general public. She translates Project CBD articles for its Japanese language site as well. Copyright, Project CBD. May not be reprinted without permission.