Pubdate: Thu, 28 May 2015
Source: Business Day (South Africa)
Copyright: 2015 Business Day.
Author: Marika Sboros


Despite intense lobbying, the jury is out on if medicinal cannabis 
should be allowed

WHICHEVER way you look at it, dagga is medicine. Even if you smoke it 
just to get "high", it doesn't only alter your consciousness and 
cognitive functional - it has other pharmacologic effects on body and mind.

There is intense lobbying for the legalisation of the common South 
African weed and equally vehement groups that want its possession and 
use to remain a criminal offence.

The "dagga couple", as the media have dubbed Lanseria activists 
Julian Stobbs and Myrtle Clark, have been joined by doctors, 
psychologists, lawyers and other interested parties campaigning for 
the legalisation of dagga for medical and recreational use.

But there are other committed health and legal professionals who say 
the risks of dagga far outweigh the benefits, and that legalisation 
is not an option for a variety of religious, cultural and economic reasons.

Stobbs and Clark became "reluctant activists" after the police 
arrived at their Johannesburg home at 2am in late 2010, "trying to 
bash the door down". They were arrested for "growing a little dagga 
for our own use" and given three choices, says Stobbs: "Pay our way 
out of it, take our punishment, or fight it."

They hired a lawyer and have been fighting seven government 
departments and "unlawful laws" ever since, helping others to do the 
same. They are preparing to take their cause to the Constitutional 
Court if necessary.

Stobbs and Clark have smoked dagga every day for the past 50 years 
without adverse effects, they say. Stobbs says he smokes dagga to 
"get that shift you need at the end of the day - when you know you 
haven't done everything you need to do. It helps me switch off, calm 
down, put my lights out... when my mind is whirling. Some people call 
that a sedative."

Dagga, a green or gray mixture of dried, shredded flowers and leaves 
of the Cannabis sativa hemp plant, has active ingredients - compounds 
known as cannabinoids, the most well-known of which is THC (delta-9 

Research supports the efficacy and safety of cannabis compounds for 
illnesses ranging from cancer to neurological disease, eye disease, 
asthma and pain control. It is also used to reduce nausea and 
vomiting during cancer treatment, and to treat cachexia, a wasting 
syndrome present in people with cancer, HIV/Aids and tuberculosis.

LAST year, the Cancer Association of SA produced a position statement 
on dagga prepared by its head of health, Prof Michael Herbst.

Apart from "possible endocrine disrupting effects" and selective 
cognitive and memory impairment, it says risks include airway injury, 
lung inflammation, bronchitic conditions and rare forms of cancer in 
those whose mothers smoked it during pregnancy. It says dagga is 
addictive and often a "gateway" drug, leading to harder drugs.

That's scaremongering, says Cape Town GP Dr Keith Scott, since most 
adverse symptoms associated with dagga are short-term side effects 
experienced after smoking or ingesting it. He says it is "absurd" 
that dagga is still illegal in SA. While legalising it for medical 
use would be a "step in the right direction", it wouldn't solve the 
other psycho-socioeconomic and crime problems caused by drug 
criminalisation - which are in effect public health issues.

A two-day roundtable conference last month organised by the 
Department of Social Development in partnership with the Central Drug 
Authority, aimed to increase debate about the safety of medicinal use 
of dagga, and develop recommendations on policy.

The roundtable became farcical at times, Scott says, as vehement 
opponents of legalisation, including Doctors For Life, introduced 
"redherring" arguments such as the dangers of pilots flying aircraft 
while high on dagga.

Scott doesn't believe the event contributed much to a real 
understanding of the issues. "Dagga has been demonised," he says. 
"People assume it is far more dangerous than alcohol and tobacco, but 
it is far, far safer, and definitely safer than harder drugs such as 
heroin and morphine."

There are few documented cases worldwide where dagga has killed 
someone, while tobacco kills 6-million people annually, and alcohol 
3-million people, says Scott.

There is also no evidence linking dagga with an increased risk of 
schizophrenia in adults, Scott says, and studies are under way using 
cannabis to treat schizophrenia.

Regular dagga use from childhood or adolescence could possibly 
increase the risk of schizophrenia and other long-term brain 
dysfunction, "but, like alcohol and tobacco, no one is suggesting 
children should be taking dagga or any other drug", Scott says.

He says cannabis is no more a gateway drug than tobacco and alcohol, 
and is far less toxic. "No drug is free from harm," Scott says, "but 
any harm must be seen in perspective".

Bedfordview clinical psychologist Quentin Ferreira says though there 
are mental-health risks, cannabis is "relatively safe compared to 
other drugs, including legal ones" for adults not generally 
predisposed to psychosis or schizophrenia.

"The youth using dagga is problematic," he says, because the brain 
finishes developing only in the early 20s, and adding chemicals 
changes the way the brain works. It can also make young people 
vulnerable to addiction.

IF THERE is an underlying or genetic predisposition to psychosis or 
schizophrenia, any drug use can bring on the onset faster and worsen 
these conditions by mimicking symptoms, he says.

Addiction is "much more complicated than most people think", says 
Ferreira, who has worked at Sterkfontein Hospital, the South African 
National Council on Drugs and Alcohol Abuse, and clinics in Ekurhuleni.

"People get addicted to all sorts of things, including shopping, sex 
and gambling," he says.

"You wouldn't say a pack of cards causes addiction in gambler," Ferreira says.

He says addiction is "an acute interaction between the substance, 
biological and psychological factors of the person and the environment".

Many countries allow the use of cannabis for medical purposes 
including Canada, Finland, Germany, Israel, Uruguay, Italy, the 
Netherlands, Portugal, Austria and Spain. In the US, 26 of its 50 
states and the District of Columbia have enacted legislation to 
legalise or decriminalise cannabis for medical and/or recreational use.

In SA, medical practitioners are legally denied the right to 
prescribe cannabis or commercially produced cannabinoids approved in 
the US for the treatment of cancer-related side effects. Among these 
are dronabinol (imported and sold under the trade name Marinol in SA) 
and nabilone.

"Many people in SA decide to take cannabis for various ailments such 
as cancer, arthritis, multiple sclerosis and other diseases," says 
Scott. "Under the present discriminatory and arbitrary laws, patients 
are breaking the law by doing so."

He knows of many doctors monitoring seriously ill patients who are 
treating themselves with the plant.

One reason given for opposition to the medical use of dagga is that 
cannabinoids don't have sufficient doubleblind, clinical studies 
required for full registration.

But such studies are economically unviable, says Scott. "Profits in 
the pharmaceutical industry come from patents and cannabis, a plant 
that's in the public domain, can't be patented."

The criminalisation of cannabis over the past century has also made 
research extremely difficult.

BUT international pharmaceutical companies are exploring ways to cash 
in on the legalisation of cannabis as they stand to make trillions of 
dollars from selling products.

Scott says drugs are mired in politics and outdated international 
treaties formed in the wake of criminalisation, collectively known as 
the war on drugs. "The war has been lost and has exacerbated drug 
problems worldwide," he says.

Change to the law on medical use of dagga in SA received a boost 
after a plea to Parliament last year by the late Inkatha Freedom 
Party MP Mario Oriani-Ambrosini, who tabled the Medical Innovation 
Bill and admitted to using dagga medicinally for terminal lung 
cancer. Oriani-Ambrosini committed suicide in August and progress on 
the bill stalled temporarily.

If there is to be change, the dagga couple's pending court cases, not 
the Medical Innovation Bill, will drive SA to more just drug laws, 
says Scott. "The Constitutional Court will probably compare dagga 
laws to those pertaining to tobacco and alcohol, and, hopefully, find 
the former unconstitutional," he says.

"Laws that criminalise the use of one substance while allowing the 
use of far more toxic drugs are not only irrational, they are grossly 
unfair and discriminatory."
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MAP posted-by: Jay Bergstrom