Medical Cannabis in Lebanon: History & Therapeutic, Ethical, and Social Challenges. A Narrative Review

Legalizing cannabis for both medical and recreational purposes is currently a worldwide trend. Lebanon, a Middle Eastern country, recently became the first Arabic state to legalize the cultivation of medical and industrial cannabis amid a huge economic crisis and the COVID 19 pandemic. However, the state of the art regarding the Lebanese cannabis is still poorly defined. Hence, our aim is to highlight medical and social concerns, and to clearly define the ethical framework for medical cannabis prescription and usage. Studies showed cannabis therapeutic potentials in treating numerous diseases such as epilepsy (high level of evidence), multiple sclerosis (moderate level of evidence), PTSD (low level of evidence), as well as in alleviating symptoms related to other conditions, for instance weight loss in HIV patients and chemotherapy induced nausea and vomiting (high level of evidence in both cases). Nonetheless, legalizing a drug known worldwide for its abuse potential could hinder several ethical principles. Whenever prescribing medical cannabis, the physician should respect patient’s autonomy, assess the risk benefit ratio of his actions, and act by justice. Moreover, authorizing cannabis usage for medical purposes could give rise to stigmatization, and further increase the burden on a society already struggling with the issues of self-medication, unemployment, and drugs diversion phenomena. By legalizing medical cannabis, Lebanon has entered a new chapter that warrants assessments, regulations, and readiness in order to insure a safe and successful experience.