Cape Town - Any change to the legislation regulating cannabis use should have been undertaken in consultation with all the relevant stakeholders and should have also taken into consideration the availability and accessibility of drug addiction prevention and treatment resources in South Africa.
The criticism has been made by Dr Abdul Kader Domingo, member of the South African Society of Psychiatrists (SASOP) Special Group on Addictions, which has expressed concern about the legalisation of cannabis for personal use.
On Tuesday, the Constitutional Court upheld an earlier ruling by Western Cape High Court Judge Dennis Davis that it was legal for South Africans to grow dagga for personal use.
“Any change to the legislation regulating cannabis use should have been undertaken in consultation with all the relevant stakeholders, be based on good quality scientific evidence and take into consideration the availability and accessibility of current drug addiction prevention and treatment resources in South Africa,” said Dr Domingo.
SASOP said it noted with concern a growing public perception of cannabis as a "harmless" plant, and that few measures have been instituted to address this.
Dr Domingo said it is estimated that one in six teenagers using cannabis will become addicted to it.
Human brain development and maturation is a process that is guided by the body’s endogenous cannabinoid system and occurs until the early 20’s.
Exposure to phytocannabinoids (cannabinoids obtained from the cannabis plant) during this vulnerable period may disrupt the process of brain maturation and affect aspects of memory, attention, processing speed and overall intelligence.
"Cannabis use during the adolescent period may cause lasting cognitive deficits, even after sustained abstinence,” said Dr Domingo in a statement.
He said the Global Burden of Diseases Study of 2010 estimated that two million years lived with a disability was attributed to cannabis.
The South African Community Epidemiology Network on Drug Use (SACENDU) reported that, during the second half of 2016, cannabis was the most common primary substance of abuse for persons younger than 20 years presenting to treatment facilities in all areas across South Africa, except for the Free State, Northern Cape and North West.
Domingo said that a review article by the World Health Organisation in 2016 concluded that evidence pointed to a modest contributory causal role for cannabis in schizophrenia and that a consistent dose-response relationship existed between cannabis use in adolescence and the risk of developing psychotic symptoms or schizophrenia.
“SASOP concurs with the executive committee of the Central Drug Authority (CDA) of South Africa that the approaches to combat the use and abuse of psychoactive substances should include harm reduction (interventions aimed at reducing the harmful consequences associated with substance use), supply reduction and demand reduction/preventative strategies.
“We agree with the executive committee of the CDA that there is currently insufficient evidence to predict the long-term consequences of the legalisation of cannabis,” he said.
“The ease of accessing an intoxicating substance may have an underestimated impact on the initiation, frequency and amount of use, and the subsequent risk of developing a substance use disorder. Legalisation should therefore not have been considered at this point,” said Domingo
He said the decriminalisation of cannabis removed the criminal penalty related to the use of cannabis, which allows for a distinction between a drug dealer and an individual experimenting with or addicted to a drug.
“While SASOP supports the human rights of all individuals, we argue that a decision to protect those addicted to substances should not be viewed as a simple binary decision based on criminal penalties.”
In 2001, Portugal augmented the decriminalisation of illicit substances with drug dissuasion commissions, increased the number of facilities offering detoxification and therapeutic admissions, increased the number of drug education campaigns and refocused policing efforts on large-scale trafficking operations.
“The decriminalisation of cannabis must be preceded by an augmented with similar socially responsible strategies for it to be successful in South Africa.”
Domingo said available evidence does not support the strong positive public opinion and anecdotal reports favouring medicinal cannabis.
“The exceptions are the moderate quality evidence of medicinal cannabis for treating chronic pain, spasticity due to Multiple Sclerosis and weight loss associated with HIV.
"This evidence includes trials investigating pharmaceutical medications based on phytocannabinoids. Good quality evidence does, however, exist regarding the frequently occurring side effects of cannabis such as confusion, dizziness, diarrhoea, euphoria, fatigue and hallucinations,” said Domingo.
“Any potential benefit obtained from cannabis must, therefore, be weighed against its risk of causing addiction, psychosis, cognitive impairments and a 2.6 times greater likelihood of motor vehicle accidents.
"SASOP further notes with concern the growing evidence linking cannabis use with an increased risk of an acute myocardial infarction as well as an ischaemic stroke.”
However, these concerns seem to have gone up in smoke after Deputy Chief Justice Raymond Zondo's judgment in SA's highest court said: "The right to privacy is not confined to a home or private dwelling. It will not be a criminal offence for an adult person to use or be in possession of cannabis in private space".
African News Agency (ANA)