Pubdate: Thu, 21 Apr 2016
Source: Business Day (South Africa)
Copyright: 2016 Business Day.
Author: Tom Nevin


THE stalled Medical Innovation Bill, which seeks legality for dagga 
as a medical therapeutic adjunct and greater freedom for its 
recreational use, will need significant surgery if it is to become law.

The bill, tabled by the late Mario Ambrosini in 2014, went through 
Parliament unopposed, but has been wheel-spinning ever since. It is 
hopelessly bogged down - primarily over the liberalisation of dagga 
for commercial and recreational use.

Charles Parry, director of the alcohol, tobacco and other drug 
research unit at the South African Medical Research Council, says 
that before medicinal dagga can be made more widely available - for 
conditions, such as chronic pain, in which the evidence of benefit is 
strongest - policy makers will need to consider issues such as safe 
supply and regulation.

Arvitha Doodnath, a legal researcher at the Helen Suzman Foundation, 
maintains that "marijuana is not the serious threat that most 
governments want us to believe. There are legalised drugs that cause 
more harm than marijuana, such as alcohol and tobacco."

She quotes one estimate that more than 158-million people worldwide 
use dagga, but concedes that there are social and physical side 
effects, particularly among adolescents and pregnant women.

"But the science shows that marijuana can be mixed in various 
quantities to achieve a certain desired result. Legalising and 
regulation is preferable to a black market," Doodnath says.

Central Drug Authority deputy chairman David Bayever describes the 
bill as confusing, "as it proposes medicinal use and other uses, such 
as commercialisation of the plant, which we believe would add to more 
social problems that the country is facing".

Gerbus Muller, clinical pharmacologist and toxicologist and a former 
lecturer at the University of Stellenbosch's faculty of medicine and 
health sciences, believes it would be "catastrophic" to make dagga 
unregulated and freely available in its raw form, as suggested in the bill.

Traditional medicine is big business, says Muller, who estimates that 
about half of all the medicines used in SA are traditional or 
alternative medicines, including dagga.

Svetoslav Bulatov, a medical doctor and homeopath, is opposed to all 
mind-altering drugs as a treatment for illness. "We don't need dagga 
in any form as a therapy. I am not in favour of any herbal 
mind-altering substances like ibogaine, ayahuasca, peyote, salvia, 
betel nut, jimson-weed, coca leaves."

Bulatov believes dagga is a dangerous and addictive drug and a 
gateway to narcotics abuse. He says he is all for research into 
natural remedies, but such investigation must be guileless. He 
worries that the hype around dagga as a wonder treatment for dread 
diseases, such as cancer and diabetes, masks the "real reason" for 
the rush to legalise it. Parry says the South African Medical 
Research Council acknowledges the increasing evidence of the value of 
medical dagga in providing palliative care for various conditions, 
but the issue should be separated from the legalisation of dagga.

The bill proposes that, in keeping with world standards, one or more 
research hospitals should be established so that medical innovation 
can be promoted and can effect change on the legalisation of the 
medical, commercial, and industrial use of dagga.

Bulatov says reasonable steps have been taken to filter out the 
narcotic effects in isolating the chemicals that hold health benefits 
and capturing them in pill, syrup, and injectable form, primarily the 
Cannabidiol in the plant.

"But you can never retrieve such components in a completely 
uncorrupted form," he says. "There will be always traces of the 
unwanted chemical in any extract.

"As small as that contamination might be, it still represents 
narcotic contamination. The same applies to marijuana especially 
cultivated to have none of the TCH stimulant or very little of it." 
Some traditional healers use dagga to diagnose diseases. In his book, 
Medical Plants and Traditional Medicines in Africa, Abayomi Sofowora 
recorded that "after taking the drug, the patient talks freely and 
while in this uninhibited state, he reveals the story of his life, as 
well as his sickness".

In some cultures, dagga sends the healer into a trance, which allows 
them to commune and intercede with the patient's ancestors, who are 
often thought to be the source of the problems.

Medical marijuana has been approved by the US Food and Drug 
Administration (FDA) for the treatment of nausea and vomiting in 
patients undergoing chemotherapy and to stimulate appetite in 
patients with HIV. It is also used to treat Tourette's Syndrome; loss 
of appetite in cancer patients; spasticity in patients with multiple 
sclerosis; postoperative nausea and vomiting; and the skin condition 
pruritus, although it does not have FDA approval for these conditions.

Earlier this month, the Australian parliament legalised the growing 
of dagga for medicinal purposes, with the government calling it "the 
missing piece in a patient's journey".

Australian Health Minister Sussan Ley said the law allowed dagga 
cultivation through a national licensing and permit scheme, opening 
the way to a safe, legal and sustainable supply of domestically 
produced product. In SA, a watered-down version of the Medical 
Innovation Bill could possibly become law, which would allow some 
easing of the ring-fencing that constrains the use of medical dagga.

The elephant in the surgery room is the apparently insurmountable 
incompatibility between modern biomedicine and traditional medicine. 
Both parties understand the need for a closer relationship, but they 
do not seem to know how to get there.
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MAP posted-by: Jay Bergstrom