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Official websites use. Share sensitive information only on official, secure websites. Correspondence: Dr. E-mail: drdhanashakya yahoo. Nepal is a geographically, ecologically, bio-culturally and ethnically diverse country. Cannabis has been a flora, used in various forms and ways and its effect has been variably a matter of concern in Nepal. Perception to its use has also been changing with time with the dynamics of various factors and trends around and in the world. The views of its proponents at times appear with relatively more powerful influence among people though the views of the opponents seem less, and relatively less influential. Proponents advocate for its legalization with highlights of its different uses and benefits whereas opponents, mainly mental health professionals point out sporadically its adverse consequences, mainly in psychological health. The purpose of this review is to explore the existing literature regarding cannabis use and abuse in Nepal. We summarize and discuss about cannabis in various aspects in the Nepalese context. The overarching objective is to reflect upon the ongoing debate regarding its harm and benefits, thereby upon the issue of its legalization in Nepal. Keywords: cannabis , cannabis abuse , cannabis use , Nepal. Cannabis is the most widely abused illicit drug globally. Ethno-medicine is practiced in Nepal for generations 4 , 5 and Cannabis has been used for treating diarrhea, constipation and snake-bites in remote communities. Its use and attitude have, however, transformed across generations. In the pretext of ongoing worldwide discussion about decriminalization and legalization, this narrative review tries to give an overview of Nepal's available published evidence regarding its use and abuse. The following keywords were used in different combinations for the search: 'cannabis', 'medicinal', 'cannabidiol', 'THC', 'benefits', 'use', 'indication', 'abuse' and 'harm'. The included articles were evaluated by the reviewers to extract relevant information regarding the subject matter. The least potent form among different potencies in the Indian subcontinent is marijuana and Bhang. Marijuana is consumed mainly as smoking cigarettes joints and edible form as bhang during the Holi festival. Over million people, approximately 3. West and Central Africa come first with Nepal is known for rich mega-biodiversity possessing a variety of plants with medicinal values. Bioactive phytochemical constituents e. Phenolic compounds possess different biological functions, e. Saponin compound has been reported to cause tonic and stimulating effects. Among four selected medicinal plants Ageratum Conyzoides, Eclipta Prostrata, Cannabis Sativa and Woodfordia Fructicosa ; the highest amount of phenols, saponin, and essential oil are found in C. Even in rice fields of Nepal, several medicinal plants occur as weeds grass and broadleaf due to favorable geographical conditions. These weeds have economic importance due to medicinal, nutritional, industrial use, and as fodder for animals. Cannabis Sativa is among the broadleaf weeds. As a part of primary health care, traditional practitioners are still using these weeds in curing diseases and proper utilization of medicinal weeds is pointed out as the best strategy of weed management. After the imposition of law for punishment for possessing and using the drug, local traders still practice illegal trading in Nepal. Proponents of legalization advocate it as a strong mechanism to stop the illegal trade of medicinal plants and ultimately to increase revenue generation. The production and use of cannabis products in India and Nepal were well documented during the 19 th century by British colonial officials. Farmers were free to produce hashish. Nepalese youth gradually started following the hippies' lifestyle and its recreational use grew rapidly. In July , the government of Nepal revoked all licenses to cultivate, buy and sell cannabis, and in September , the Narcotic Drugs Control Act made cannabis illegal in Nepal. The Oldest Vedic Scripture mentions cannabis as a sacred plant due to its close association with Lord Shiva. Spiritually, it is used by Sadhus for meditation and to show their devotion towards Lord Shiva. In social context, people use cannabis at the time of gatherings, festivals, and mourning time to reduce anxiety and stress. Traditional medicine Ayurveda uses cannabis to treat ailments like food poisoning, digestion problems, gout and rheumatism and as a pain-relieving agent. It is used also to stimulate appetite and treat sleep problems. People use it for smoking and drinking as bhang ground leaves and flowers from female plants. Recent years are witnessing a movement in Nepal to legalize its commercial production, pointing to its potential to become a lucrative cash crop and create employment opportunities. On March 2, , a private bill named, 'Marijuana Cultivation Regulation and Management in Nepal' was registered by a member of parliament Sher Bahadur Tamang at the parliament secretariat of the House of Representatives demanding the legalization of marijuana cultivation in the country. Illicit substances including opioids and cannabis are also highly prevalent after alcohol and tobacco in Nepal. This was followed by the use of injection buprenorphine and a mixture of various psychoactive compounds opiate, benzodiazepine and antihistamines. Intervention must be implemented at the root level to reduce the burden of multiple substances in newbies. The mode of use was smoking cannabis mixed with tobacco multiple times a day. Cannabis use is a highly comorbid condition with other substance use. Nepal, once famous as a hippie destination, still serves cannabis lovers around the globe. Voices of legalization pour aloud about the potential benefit of legalizing at least for cannabis research in Nepal considering the fact that this country has been a unique natural laboratory because of its diverse bioactive compounds due to extreme ecological alterations in short physical distance and its potential for benefit from at least efforts to study its harm and benefit. Regulated licensed growing facilities and household plant quotas given in specific parts of the country are pointed out to help reduce poverty. Most of these studies have heterogeneous subjects of various programs, years or schools. Although medical students are supposed to be and were relatively more aware about the negative consequences of psychoactive substances, cannabis use was fairly common among them. The physical dependence and other consequences of cannabis among its users were not largely investigated thoroughly. Prospective or retrospective studies are necessary to understand the actual effect of cannabis on the health, study and other important aspects of the students. The mean age of onset of psychosis for cannabinoids users was younger; The majority of medical students using cannabis gave the reason as pleasure-seeking and experimentation purpose. A study done among dental students reported pleasure-seeking and difficulty in handling pressure as the cause for the use of substances. Marijuana is also a popular drug during OST as almost all reported that OST and marijuana in combination reduce the craving for other drugs and at the same time produces the high effect. However, few individuals reported marijuana as a cause of relapse due to increased craving for other drugs. So, the evidence-based fact is inconclusive about using cannabis among OST clients and warrants further study. A cross-sectional study was carried out in 42 patients consecutively admitted in the psychiatric ward of Kathmandu Medical College Teaching Hospital and Punarjeevan Hospital. The Majority of them This research did not show any difference in anxiety levels between case and control, whereas alcohol and cigarette use was higher among cannabis users. Among 80 first-episode psychosis patients in TUTH, 38 Harmful use was present in Cannabis was the most commonly used illicit drug. The cannabis-induced psychotic disorder was found in 7 patients. There was a clear relationship with heavy use in which one patient developed within 24 hours of heavy bhang use. They presented with rapid onset behavioral changes like laughing or crying episodes, eating non-edibles, tearing clothes, biting people, and delusions of being controlled and hypnotized. Improvement was seen within weeks of stopping cannabis and with a small dose of antipsychotics. Substance dependence was a significant factor in the non-adherent group; 8 out of 11 cannabis dependence cases were from the nonadherent group. A descriptive study conducted in the de-addiction unit at the Centre for Mental Health Chautari Nepal Health Foundation in Rupandehi district of province-5, Nepal looked into the prevalence of psychoactive substance disorders. Out of psychoactive substance users, Many substance abusers Out of them, 63 patients remained in the methadone maintenance treatment MMT program. One of the significant factors associated with the dropout from the MMT program was poly-substance use in which cannabis was present along with alcohol, heroin, injectables, other opioids and benzodiazepines. The study was undertaken long back by BP Sharma , the first psychiatrist of Nepal, to look into the effect of cannabis use for a long time regularly among individuals, compared with control matched on age and education. The study found cannabis users had poor work records, interpersonal relationships, lack of interest in sexual activity, and overall loss of initiative and efficiency. A narrative review on endocrine effects of cannabis in different organ systems based on animal and human studies showed conflicting and contradictory results; some studies showing the lowering level of almost all hormones except cortisol and some studies showing no change in the level of effect. There is also the development of tolerance with repeated administration. Acute and transient effect is seen but long term effect is not conclusive, e. So, the definite cohort is warranted to establish its true effect. These socio-cultural factors contribute towards the use of marijuana which ultimately may turn an individual to be a hard drug user. Their belief system of addiction of substance tobacco, alcohol, cannabis, heroin and other substance assessed with Addiction Belief Scale showed majority of medical students believing predominantly the biological model of illness. Less educated and Naga sect Sadhus were more likely to view cannabis as a boon of Lord Shiva and provide it to devotees. Providing evidence-based information about cannabis and clarifying misbelief about Lord Shiva and cannabis to Sadhus have been pointed out as one of the strategies of harm reduction in people using substances. For subtypes of persistent headache or post craniotomy pain, cannabinoid derivatives have been mentioned as a potential candidate research molecule for formulating future Post Craniotomy Pain PCP management algorithm though Amitriptyline, Gabapentinoids, Carbamazepine or Sodium Valproate, steroid injection, and Botox injection are already available and commonly used medications. The main aim is to enable non-specialists in primary healthcare to detect and treat priority MNS disorders and make appropriate referrals to a higher system of care. Different subheadings starting from introduction to different substance use, assessment, management, and follow-up along with emergency presentation are discussed. Cannabis use in Nepal is intertwined with religious, cultural, economic since ancient times and later political perspectives. Amendment of the Narcotics Drug Control Act in Nepal prohibits the sale, cultivation and use of cannabis. Nepal has also been swept by the wave of hot debate ongoing in the world about decriminalization and legalization of cannabis. With a vote of 27 in favor, Nepal also voted in December to remove cannabis from schedule-IV of the convention opening the avenue for its therapeutic use. A private bill was also registered at the House of Representatives in Nepal for the legalization of marijuana, mainly for medical use and export. Voices are outpouring in media to decriminalize cannabis use as the democratic generation doesnot want interference from the government with an individual's choice of what goes into their body as long as it does not harm others. Regarding medicinal use, only a few studies show some benefits in certain conditions pain, nausea, vomiting, spasticity ; mostly inconclusive. On the other hand, the current understanding of cannabis use in any form medicinal or recreational showed more evidence for harms than therapeutic benefits in the majority of health conditions mainly from the perspective of mental health effects and serious conditions e. As a library, NLM provides access to scientific literature. Find articles by Dhana Ratna Shakya. Find articles by Sandesh Raj Upadhaya. Find articles by Milan Thapa. Issue date Sep. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

Cannabis Use and Abuse in Nepal: A Review of Studies

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Nepal is small beautiful country, yet culturally and socially very diverse. The total population is less than 30 million but diverse in religion, caste, culture and ethnicity. We can find the assortment in each and every aspect that is dissolved in the society, so most coming from outside notice the melting pot of culture, and belief systems and practices. Each community has its own identical beliefs and practices that influence the society. This article, is about the Hashish culture that is prevalent in the Nepalese society from prehistoric times to the current twenty-first century. Cannabis is flowering plant believed to be indigenous plant of central Asia. Mainstream science always doubted the properties of this plant but users believe that it has medicinal value. It has been mentioned in ancient Vedic text books, as well as Chinese. Ancient and religious uses of hashish also dates back to prehistoric time in western countries at around BCE but industrial uses of hemp just started in the 20th century. Marijuana is an annual, dioecious flowering herb that grows in the moist and sunny places on the altitude ranges generally from m above the sea level. Cannabis, Ganja, hemp, marijuana, hashish, etc. The scientific name of the plant is Cannabis Sativa. Some other famous names of this plant is weed, herb, pot, grass, bud, and the mixture of greenish-grey part of the plant is consumed. Apart from medicinal purposes and as recreational drugs to reduce anxiety, pain, and increase creativeness, the plant can also be used for industrial scale also referred to as hemp. Hemp fiber, hemp oils, hemp juice, etc. Today, number of developed western countries has legalized the cultivation of cannabis for medicinal use whereas cultivating, trading and smuggling of cannabis and its various products are illegal in Nepal since It is said that the wild-grown hashish in the mountains of Nepal is the best among the hashish found in the world. As it grows wildly almost anywhere, trekkers trekking in Nepal can easily get to taste it if interested! But trading and carrying is completely illegal and a huge punishment but just smoking for taste is a not big deal! It is no secret that marijuana plants produce chemicals called cannabinoids that generate mental and physical effects after consumption. Many religious Hinduism books mention that Lord Shiva highly gratify marijuana so his followers take marijuana as the prasad blessing and consume it without any hesitation. Most Nepalese youths and senior citizens use it as a blessing of Shiva on the birthday of Lord Shiva, grandly celebrated as a festival called Shivaratri. On the day of Shivaratri, more than a million people of Nepal visit the Pashupatinath temple to worship Lord Shiva and try various products of Marijuana as a Prasad Blessing of Lord Shiva. The belief is that the Lord Shiva will be pleased on doing so. Another festival, known as Holi festival of colors — the use of Bhang is popular in the southern part of Nepal Terai Region. Bhang is an especial milk shake made with boiling cannabis and adding other flavor full ingredients. Nepal was known to be heaven for Marijuana lovers in the late 60s and early 70s as marijuana, hashish, etc. The government of Nepal illegalized the use of Cannabis in AD because people started migrating to Nepal because of the legal production and trade of Marijuana. Likewise, Hippies are prominently those who are highly credited as the beginners of Nepal tourism. Similarly, world-famous hip-hop singer Bob Marley visited Nepal for a trek to Muktinath in the s in the Mustang area of Annapurna Region. Near the holy Muktinath temple, a species of cannabis known as purple haze leaf turns slightly purple during flowering is found which is considered to be one of the best species of cannabis. Purple haze is said to be originated in Columbia but many people believe Mustang, Nepal is the original destination of its origin. Even though Hashish is illegal in Nepal, Nepalese people not only tolerate the use of Hashish but also accept the use of cannabis and its products as cannabis is part of their religious and daily life practice. Nepalese farmers use Marijuana leaf to treat their ill cattle and consume by themselves as medicinal herbs. Bhang achar Pickles is one of the most delicious pickles made in almost all Nepali households. Tourists can try Bhang Achar Pickles prepared by the grinding of marijuana seeds if they wish to try, if interested they shall consult with their guide or Nepali friend for this, and for sure they will be willing to help. Bhang lassi is another delicious food prepared by the marijuana seeds and also available in some of the famous restaurants of Kathmandu and Pokhara. Simply, we can say that marijuana is found everywhere in Nepal and it is a part of Nepali culture. The government of Nepal has restricted the trade, cultivation and production of hashish so no tourists and locals are allowed to transport cannabis from one place to another. Sadhus in the Pashupatinath Temple. Also Read Festivals Tours of Nepal. Suggested Trek. Company About Us Blog Reviews. Associated with:. Payment methods possible. All rights reserved. Facebook Twitter Instagram Pinterest.

Pokhara buy ganja