• The Sumithrayo Drug Demand Reduction Prog. (Mel Medura) Honorary Director Jomo Uduman observes that the produce could enter the local mkt. and will be very difficult to contain
• Laws and policies in SL lag behind the science of addiction and the lived realities of families

The recent Government decision to permit the commercial cultivation of cannabis has sparked significant debate. While aimed at creating a regulated, export cannabis industry, concerns have arisen about the potential leakage of cultivated cannabis into the illegal market and the possibility of indirectly promoting cannabis consumption, raising questions about its impact on local use and public health.

According to The Sumithrayo Drug Demand Reduction Programme (Mel Medura)’s Honorary Director Jomo Uduman, as this conversation unfolds, it is important to strike a balance between economic opportunities and protecting the public from the consequences of cannabis. He discussed the related issues during an interview with The Daily Morning.

Following are excerpts from the interview:

The recent decision by the Government to allow the commercial cultivation of cannabis has led to various discussions, including whether the cultivated cannabis could leak into the local illegal cannabis market and whether it could indirectly promote cannabis use. What is your opinion on this situation?

The Poisons, Opium and Dangerous Drugs Ordinance, No. 43 of 1935 (principal enactment, No. 17 of 1929) has made it illegal to grow or possess cannabis, while the Ayurveda Act, No. 31 of 1961 allows Ayurvedic physicians to obtain opium and cannabis for the manufacture of their medicinal preparations. Reports indicate that seven foreign investors are selected to participate in a Board of Investment-backed project to allow cannabis cultivation strictly limited to medical-grade export markets and not for local sale, on the condition that the cultivation site must also be enclosed by a secure fence to prevent the release of crops into the illegal market during cultivation. 

It would have been better if the Government also had a healthy discussion on the pros and cons of this venture with stakeholders like Mel Medura, the Alcohol and Drug Information Centre (ADIC), the National Dangerous Drugs Control Board (NDDCB), the College of Psychiatrists (SLCP) and psychologists, all of whom are concerned whether the produce will enter the local market surreptitiously, which will be very difficult to contain, and which can, of course, promote the availability and use of cannabis in Sri Lanka.

What do you think about the addiction aspect of cannabis – what are the commonly observed symptoms and trends?

At Mel Medura, around 6-8% of our callers come in struggling with cannabis use. The progression to Cannabis Use Disorder (CUD) often follows this pattern: Experimental use, occasional or recreational use, regular use, and then heavy use, which can lead to CUD. There are biological, psychological, and environmental predispositions that can drive a person towards use and then continue using it. 

The characteristics of CUD are quite similar to other substances which are, compulsive use (cravings), going out of control, continued use in spite of knowing the consequences, acquiring tolerance, experiencing withdrawals (when not able to use), and relapsing when on the road to recovery. The mild, medium and extreme effects of CUD may include red eyes, dry mouth and throat, a feeling of being anxious, feeling paranoid and agitated, irritated respiratory system (from smoking), increase in appetite, drowsiness or restlessness, delusions, and hallucinations. Psychosis can also develop especially during the withdrawal stage. 

Treatment at Mel Medura involves a combination of motivational interviewing and cognitive behaviour therapy (CBT), and depends on the severity of the disorder and is individualised. A gradual reduction in use is first cultivated with motivational change talk, and then, when in abstinence, a relapse prevention guide is shared and followed up with the caller. 

Sri Lanka is now seeing the emergence of Kush (synthetic cannabis) which is not made from the cannabis plant at all. Instead, it is created in illegal labs overseas by spraying or soaking dried plant material (like herbs, tea leaves, or even grass) with synthetic chemicals that mimic tetrahydrocannabinol (the psychoactive substance in cannabis). The symptoms are vastly different from smoking organic cannabis because its effects are unpredictable and far more harmful, and risky, luring unsuspecting users into dependency and serious health consequences. The dissemination of correct information on Kush by the media is therefore very important.

Mel Medura data also reflect that 70% of other drug users state that cannabis was their ‘gateway drug’ and that they still use it to mitigate the distress of experiencing withdrawal symptoms.

What sort of rehabilitation processes are employed to deal with cannabis addiction, and what are your recommendations to improve them?

Apart from drop-in centres like Mel Medura and ADIC, residential and community programs for all substance use dependencies are run or overseen by the NDDCB – e.g. the Thalangama Prevention, Treatment and Rehabilitation Centre and a 24/seven helpline (1927) for counselling and referrals. CUD care at Government hospitals are via psychiatry services with assessment, counselling, and the management of co-occurring conditions.

Improving them means making the services consistently accessible island-wide, because there is a huge gap in accessing and the availability of such services. There must also be rapid screening for synthetic cannabinoid harms in emergency rooms, brief interventions, psychoeducation in distinguishing kush versus cannabis, and surveillance to detect clusters. Then, we must develop structured aftercare and relapse prevention with peer recovery groups and vocational support.

There are various misconceptions about cannabis, such as that it is not addictive and that its health impacts are very low. How do you propose to tackle these misconceptions?

Misconceptions about cannabis can be one of the biggest barriers to prevention and early help-seeking. From a centre like Mel Medura, we can offer some practical approaches. These combine education, engagement, and lived experience to correct the myths without sounding moralistic or alarmist. The key is balance – avoid fear-mongering, which youth reject. Instead, give honest, relatable, and localised facts. Partner with universities, schools, and religious and community leaders to spread consistent, non-stigmatising messages to show that seeking help is not shameful. Create simple ‘myth vs. fact’ modules for group sessions, social media posts, and school and community outreach.

What is your assessment of the indirect impacts of cannabis use by individuals – particularly its effects on families and society?

What I am saying relates not only to CUD but all substance use disorders. Families experience emotional stress. Parents, partners, and children often feel helpless, anxious, or betrayed. Conflicts and arguments can occur over money, trust, and lifestyle choices, and these can become frequent. 

Healthcare costs include increased expenses due to mental health treatment, hospital visits, or accidents. The neglect of responsibilities pertain to household duties, parenting, or caring roles that may be overlooked, leaving other family members overburdened. The economic burden happens when money diverted to drugs reduces resources for essentials such as food, education, or healthcare. 

The productivity loss takes place due to missed work, poor academic performance, or job instability, which affects the long-term family income. The impact on children involves psychological harm (growing up in a home with substance misuse increases the risks of anxiety, depression, and behavioural problems), the cycle of use (children exposed to parental drug use are more vulnerable to adopting the same habits), and social and community consequences. 

The breakdown of trust happens when communities may experience fear, stigma, or the loss of safety when drug use is visible. With regard to crime and legal issues, while substance use itself may not always lead to violence, dependency can push individuals toward petty crimes, trafficking, or unsafe environments. Weakened social capital happens as more individuals disengage from education, work, or civic life, and society, in turn, loses productive members. Cultural and generational effects are normalisation (if substance use is perceived as harmless, younger generations may start using earlier, in turn magnifying long-term consequences) and inter-generational trauma (families affected by addiction may carry unresolved stress, shame, and poverty into the next generation).

In short, while substance use is often seen as an ‘individual choice’, its ripple effects destabilise families, strain resources, weaken communities, and can perpetuate cycles of disadvantage.

How do you think the regulatory processes, laws, and policies pertaining to cannabis and other substances can be improved?

Laws and policies in Sri Lanka (and globally) often lag behind the science of addiction and the lived realities of families. Balancing punitive and public health approaches is required. The current gap is that Sri Lanka relies heavily on punitive responses (arrest and compulsory rehabilitation) which often overcrowd prisons and stigmatise users, while dealers profit. For improvement, shift toward a ‘health-first’ approach where possession for personal use leads to screening, counselling, and treatment referrals, not imprisonment. This aligns with World Health Organisation recommendations. 

The evidence-based classification of substances is also required. The current gap is that cannabis, cocaine, heroin, methamphetamine and other synthetics are treated under the same broad criminal framework, though their harms differ. For improvement, adopt a harm-based classification system (as done in some European Union countries) so that policies and penalties reflect the relative risk of each drug. This avoids both underestimating (e.g., synthetic cannabis/kush) and over-criminalising. 

There is also a need to regulate treatment and rehabilitation centres. The current gap is that many private rehab centres operate without oversight, using unscientific or even abusive methods. For improvement, create a national accreditation system with minimum standards (evidence-based therapies, trained staff, aftercare). Focus on prevention and early intervention. 

The current gap is that drug education in schools is limited and often fear-based. For improvement, roll out age-appropriate prevention programs in schools and universities focusing on resilience, emotional intelligence, decision-making, life skills and mental health. Train teachers and peer leaders in early identification and referral. Then, there is a need to strengthen harm reduction measures. 

The current gap is that harm reduction (e.g., needle exchange, opioid substitution therapy) is very limited. For improvement, introduce harm reduction programmes with proper monitoring to prevent human immunodeficiency virus, hepatitis, and overdose deaths. Launch helplines, drop-in centres, and mobile outreach for at-risk groups. Research and surveillance are vital. 

The current gap is the limited reliable data on all substances including cannabis/kush patterns in Sri Lanka. For improvement, establish a national drug observatory (like in Europe) to track usage trends, health outcomes, and the effectiveness of interventions, in turn informing better policy. De-stigmatisation and human rights (HR) protection are also needed. 

The current gap is that substance use is often treated purely as a moral failing or a criminal act. For improvement, incorporate HR language into the drug policy, ensuring dignity and choice in treatment and launch public campaigns to reduce the stigma, encouraging help-seeking before crises.

In short, move from punishment to prevention, care, and regulation, with clear distinctions between users and traffickers and the stronger oversight of treatment systems.

(If you or anyone you know is struggling with the use of alcohol, tobacco and other drugs including behaviour dependency disorders, please contact The Sumithrayo Drug Demand Reduction Programme [Mel Medura] at 60/7, Horton Place, Colombo 7, (0112693460/0112694665/0714307799), melmedura@sltnet.lk. This service is free of charge)