Campaign to legalise use of medical cannabis gathers momentum in the country known for draconian approach to drugs.

Kuala Lumpur, Malaysia – Drugs have long attracted the harshest penalties here.

Under the Dangerous Drugs Act, anyone found with 200 grams of cannabis, 40 grams of cocaine, and 15 grams of heroin or morphine risks being charged with drug trafficking – a crime that carries the death penalty.

The burden of proof doesn’t even fall on the prosecution.

It is the accused who must show the drugs are not theirs.

As a result, the majority of people behind bars in Malaysia are there because of drugs.

Nearly three-quarters of the 1,281 people on death row at the end of October have been convicted of drug crimes. And just over half of the more than 65,000 prisoners in the country’s jails.

But with the government now in the process of abolishing the death penalty, the country’s punitive approach to drugs is also under review.

“The bulk of prisoners are drug-related offenders and this is where we have to re-look the definition of drugs – dangerous drugs, especially – with the development of certain drugs that can be used for medicinal purposes like marijuana or morphine that can be used in cancer treatment,” Malaysia’s de facto Law Minister Liew Vui Kheong told Al Jazeera in an interview.

Around the world, there has been a discernible shift in policies towards drugs, particularly in relation to the medicinal use of cannabis.

In October, Canada legalised the recreational use of cannabis arguing it would reduce the profits of organised crime and ensure regulation of a drug that millions of Canadians were already using. It had allowed the use of the plant for medicinal reasons since 2001.

Argentina, meanwhile, provides medical cannabis for free and 30 states in the US have also approved the drug for medical reasons.

Even in Asia, where drug policies have long been among the world’s most draconian, exemplified by Philippine President Rodrigo Duterte’s bloody “war on drugs”, Thailand is taking steps to legalise the use of cannabis for research and medicinal purposes.

In Malaysia, two recent cases of men facing the death penalty for selling medical cannabis have given the debate renewed urgency.

Muhammad Lukman, 29, was sentenced to death at the end of August, three years after he was arrested in possession of three litres of cannabis oil, 279 grams of compressed cannabis, and 1.4kg of a substance containing tetrahydro cannabidiol (THC), the psychoactive element of cannabis.

In court his lawyer argued he was an alternative healer who helped ease the pain of those with cancer and other conditions, even giving away the drugs for free to those from poor backgrounds.

A petition to free him has more than 70,000 signatures and support from MPs in the ruling coalition.

‘Prohibition era’

Amiruddin Nadarajan Abdullah, popularly known as Dr Ganja (the local name for marijuana), is facing 36 charges including the death penalty on similar grounds.

Amiruddin began using cannabis to cope with the pain from kidney problems and a tumour in his back.

“The war on drugs has failed,” said Intan Mustika, cofounder of the Malaysia Society of Awareness, which has been campaigning for the legalisation of cannabis for medicinal use since 2011. “We are living in a prohibition era, in Asian countries especially. We need a different approach.”

A young cannabis plant showing signs of flowering in a back garden in Los Angeles [Richard Vogel/AP]

The same year that MASA was founded, an audit of Malaysia’s criminal justice system found that drug crimes dominated the caseload at all levels with few alternatives to imprisonment or pre-release schemes.

“People will continue to use drugs, for a variety of reasons, no matter how strict the laws are,” Ruth Dreifuss, former president of Switzerland and chair of the Global Commission on Drug Policy, told Al Jazeera.

“So when a government cracks down harshly not only on drug trafficking but also use and possession, this inevitably leads to mass incarceration and prison overcrowding.”

Fifa Rahman spent six years advocating for decriminalisation as a policy officer at the Malaysian Aids Council.

She left Malaysia in 2016 thinking her work had gone to waste.

“People didn’t see there were rational reasons for decriminalisation,” she told Al Jazeera on the phone from Leeds where she is now studying for a doctorate. “People thought it was a crazy idea.”

Despite its generally punitive approach to drugs, Malaysia has run harm reduction programmes for drug-users since 2005 as part of its attempt to curb the spread of HIV and protect public health.

According to Harm Reduction International, the country is one of only a handful of upper-middle-income countries that have made a “sizeable national government investment” in harm reduction, spending $5.4m in 2015, according to the Global AIDS Response Progress Report.

But May’s change in government, as well as a realisation of the costs of incarceration, have given additional momentum to non-punitive approaches.

MASA’s Intan, who has hypokalemia, a potassium deficiency that causes muscle cramps and spasms, said she has been jailed a “few times” for drug use, but that cannabis helped ease the pain of her illness when conventional medicines couldn’t.

“All the time in hospital it looked like there was nothing that would work for me,” the 40-year-old said. “I would rather be illegally healed than legally die.”

‘Punished for desperation’

Crucial for the success of any policy change will be support from the police who are concerned about the increasing amount of synthetic drugs, like methamphetamines, that are being seized.

The Narcotics Criminal Investigation Department told local media it seized drugs worth a record $83.5m between January and November this year, the highest since the unit was established 22 years ago.

A data-based review of any decriminalisation within five years might help reassure police and public security groups, Fifa said. She adds that her research showed most of those jailed in Malaysia for drug crimes were poor people.

“I don’t think that prison is the best approach,” she said. “These are generally people who did not get the best opportunities in life and are being punished for their desperation.”

Malaysia spends about $10 a day on each of the 65,222 inmates in the country’s jails, according to Liew. That figure includes food, clothing and personal items provided to the prisoners, as well as the salaries of the guards and other staff.

Changes to the legislation surrounding drugs would mean that some prisoners would no longer have to serve a sentence, he added, with the money instead being used to develop education programmes for young people around the misuse and abuse of drugs.

MASA is working on research designed to show the medical benefits of cannabis, and have met senior politicians in their campaign to get the drug legalised for medical purposes.

“I think most Malaysians are quite open to the idea that ganja is medicine,” Intan said. “It’s not something people don’t recognise. It’s been used way back by our ancestors.”