By Marika Sboros
I would never accuse members of South Africa’s Central Drug Authority (CDA) of smoking cannabis – or “dagga” as it is more popularly known. However, the CDA’s views on drug-law reform suggest they are smoking something.
In the June edition of the SAMJ (South African Medical Journal), executive member Dr Dan Stein had interesting things to say. For starters, the CDA now favours “decriminalisation rather than the legalisation of cannabis” for personal use. It has vigorously opposed that previously. Now it accepts that alcohol causes more harm globally than cannabis causes.
Those can seem like two big steps forward – or not. Cape Town GP Dr Keith Scott would say: “Not”. In a recent issue of the SAMJ, Scott lights up the debate on the drug’s benefits versus risks.
Scott has a special interest in reforming drug laws to reflect drug use. He sees drug use as a public health rather than a criminal concern. The CDA frustrates and irritates him in equal measure in that regard.
The big irony, he says, is that alcohol is still legal in South Africa while cannabis is not. Many countries have decriminalised cannabis – or marijuana, weed or reefer as it is also known, for personal use.
Uruguay led the way in 2013 when it made cannabis legal. Many countries have legalised it for medical use. Canada has significantly liberalised its laws on cannabis. None has descended into anarchy and criminality.
So why doesn’t the South African government follow suit? After all, cannabis grows wild in that country. It is freely available on the black market. People have used it for centuries, if not millennia, for medical purposes. There is growing evidence for benefits.
In May this year, UK researchers issued a paper for the country’s All-Party Parliamentary Group looking into drug reform. It is titled Cannabis: The Evidence for Medical Use, over 176 pages, with 43 on references. In it, the Newcastle University authors make a case for legalisation.
They say that cannabis use is generally safe, with mild, well-tolerated short-term effects. They say that there is good evidence for efficacy of medical marijuana in
- Pain – chronic and neuropathic;
- Spasticity – mainly in multiple sclerosis but also other neurological disorders;
- Nausea and vomiting – particularly with chemotherapy use; and
They say that there is moderate evidence that cannabis eases symptoms of Parkinson’s and sleep disorders. It can also stimulate appetite in HIV-positive and cancer patients.
The researchers found a small dependency rate with cannabis at around 9%. They say that experts should take this seriously but that it compares well to around 32% in tobacco use and 15% with alcohol.
Click here to read: HIGH TIMES FOR MARIJUANA AS MEDICINE
The researchers address evidence for a causal link between cannabis use and schizophrenia. They say that there is probably a link with cannabis use at an early age. The link may also apply if there is a genetic predisposition to psychosis. Thus, they recommend caution when prescribing cannabis in these cases.
In the SAMJ, Scott describes the CDA’s stand on decriminalisation as a welcome if belated move. It shows the government’s response to “shifting sands” of local and global public opinion and drug policies.
However, he says the CDA uses “confirmation bias” (selective presentation of evidence) to justify keeping cannabis illegal. If it used the same standards as with alcohol and tobacco, it would have to ban those two drugs as well.
It would also have an unintended consequence. People would be able to self-medicate with it legally will doctors wouldn’t be allowed to prescribe it.
This could be an “unintentional, illogical policy clash”, Scott says.
Scott attacks the CDA’s use of “stale arguments” to oppose medicinal use.
“We know all medicines have many undesirable effects. These include potentially lethal over-the-counter drugs such as aspirin and paracetamol. Cannabis is no exception, but it is far less harmful than alcohol and tobacco,” Scott says.
Research shows that cannabis is less toxic than alcohol that is associated with cancer, cardiovascular disease and other diseases. Alcohol is also directly responsible for over three million deaths annually. By comparison, deaths attributed to cannabis are “insignificant”.
In the SAMJ, the CDA agrees that various substances “differ in their associated costs and harms”. It agrees that an approach that “emphasises harm reduction and human rights is also key”.
In an editorial in the SAMJ, acting editor Dr Bridget Farham refers to her late father, a solicitor in England. He had a predominantly criminal practice and encountered substance abuse in all its forms throughout his career, she says.
He “always believed” that the authorities should legalise so-called drugs of abuse, including cannabis. Her father believed they should regulate cannabis in the same way as they regulated alcohol and tobacco.
Like most sensible people, he could see that the “war on drugs” hadn’t worked, she says. He saw the untold misery it caused to the many while massively enriching the few.
He believed that criminalising use and supply made criminals of people who might otherwise have led normal lives.
Her father’s opinion was “revolutionary for his time”. Few of his contemporaries shared that view. Farham “always agreed with him”.
If Scott had known Farham’s father, he would also have agreed with him.
Scott hopes that the CDA’s “increasingly progressive attitude to drug issues” will bring changes. Among those are that the medical profession will have a dominant role in CDA policy-making, in parliament and in other decision-making forums.
“Drug use should be primarily a public health issue, not a criminal one,” Scott says.
Since illicit drug use is victimless, it should be no more a crime than the use of tobacco or alcohol is a crime, he says.
The CDA has latched on to the important concept of harm reduction belatedly. However, it considers only to the direct adverse effect of drugs on users. It is unwilling even to discuss the massive harms that the UN-sponsored War on Drugs itself causes, he says
Harm reduction requires that the CDA deals with the considerable harms that the criminal justice system causes. The CDA can seem progressive in saying hat alcohol is as big a problem as that of other drugs. However, Scott says what they don’t say may be even more important.
“They don’t say that being a legal drug, alcohol causes harms that result entirely from the substance itself. They don’t say that the laws that regulate alcohol’s production, sale and use also cause harm.
“Compare that with those who take illicit drugs. The harms they suffer are due not only to the direct effects of those drugs. They are also due to violence, criminal activity, corrupt officials, unjust jailing, contaminated products and social upheaval,” Scott says.
The CDA calls for more action to reduce the harms that alcohol causes but never calls for an outright ban. That’s because alcohol is “a culturally sanctioned drug”, he says. And anyway, prohibition attempts in the US proved that banning a drug just doesn’t work.
Whenever the CDA confronts alcohol in illicit drug policy discussion, “rational thought trumps political interests every time”. However, what he finds most unforgivable is “the scare mongering”.
The CDA has added the bogeyman of “Big Cannabis” into their fear-mongering mix. It ignores the real problem – the trillion-dollar-a-year global drug trade run by “Big Organised Crime”.