SA law on medical dagga .
An amendment to SA law could make it legal for dagga to be used for medicinal purposes, but that won’t mean just anyone can grow it
WHEN she was diagnosed with stage 3 ovarian cancer two years ago her oncologist recommended chemotherapy. Bu t Jessica Johnson* wasn’t quite ready to have chemicals pumped into her body without doing some research first.
The 60-year-old Capetonian looked into the benefits of taking marijuana for medicinal use and decided to use it in conjunction with chemo.
It was one of the best decisions she could have made, Jessica says, as she had none of the usual side effects of chemo such as nausea and tiredness. For the first two rounds she drank dagga tea once a day and took about six drops of cannabis oil daily.
By the time her third round of chemo rolled around she couldn’t get a supply of dagga and felt the “horrible” side effects of her treatment. “It made me feel weak and lethargic. I cried just sweeping a room. It’s difficult to put into words but the tea definitely took the edge off.”
It helped her to sleep too, she adds. “It made a huge difference to my life.”
Jessica says she’s ecstatic about a proposed amendment to the Medicines and Related Substances Act that could make it legal to get the drug that helps her to cope with her cancer treatment. “I won’t have to sneak around anymore.”
The amendment is with President Jacob Zuma to sign but experts predict it will be some time before any actual production can take place because there still has to be consultation, public comment and a host of other legislative processes before it can go into effect.
We break down some of the details surrounding the amendment.
WHAT THE NEW LAW SAYS
You won’t suddenly simply be able to grow dagga in your backyard for commercial or recreational use. The amendment would allow people or companies to grow marijuana only for medicinal purposes and they’d need a grower’s licence from the Medicines Control Council (MCC) to do so, as well as a permit from the director-general of health to legally possess cannabis.
The amendment wasn’t aimed specifically at cannabis but rather at regulating the manufacture of scheduled substances.
Manufacturers of medicines must be licensed by the MCC, says the council’s registrar, Dr Joey Gouws. But under the current law a licence isn’t required to manufacturer scheduled substances used as the building blocks of medicines.
For example, the pharmaceutical firm that makes Panado needs a licence to do so, but the manufacturer of the paracetamol that goes into Panado doesn’t.
“The MCC realised it was only in control of half the industry,” Dr Gouws says. “We regulate the finished product but not the scheduled substances.”
This is the real reason behind the amendment, she adds, and it has nothing to do with cannabis specifically. “It’s merely coincidental that cannabis is also a scheduled substance.”
HOW WILL IT BE CONTROLLED?
You’d have to apply for a licence with the MCC if you wanted to grow dagga for
medicinal use but there are still a great many logistics that have to be sorted out.
“The MCC has formed a committee that’s looked at what the practice is overseas and is now putting together guidelines for those who want to apply,” Dr Gouws says.
“The guidelines will for example look at the type of soil used, how large the area is where the medicinal cannabis will be planted, what type of seed the manufacturer will use and which tests will be done on the plants and product produced.”
The committee was asked to consult the department of agriculture about aspects such as which soil should be used, security measures and cross-pollination.
“As soon as the guidelines are authorised by the MCC they’ll be published on our website so the public can comment on them,” Dr Gouws adds.
“We hope by the time the president signs the amendment we’ll be able to field applications from people wanting licences to grow cannabis.”
WHAT FORM WILL MEDICAL MARIJUANA TAKE?
The form it takes isn’t prescribed by legislation so it would be entirely up to manufacturers how they want to make it. The most popular forms are oil, capsules, suppositories and ointment, says James Smith* of Cannabis Therapy, a website that aims to inform people about the medicinal properties of the plant and how to choose the right oil and dose for the ailment being treated.
Smoking it won’t be considered medicinal. “People aren’t just going to be sitting in a corner of the hospital smoking dagga,” says Dr Gerbus Müller of the University of Stellenbosch’s faculty of medicine and health sciences. “The active ingredient in the dagga plant will be mixed into medicines, which must adhere to rules and regulations and be approved by regulating bodies. You’ll also get a pamphlet indicating the side effects and recommended dosage.”
WHAT MAKES DAGGA MEDICINAL?
Cannabis contains hundreds of compounds, of which cannabinoids are the best known, Dr Müller says. The cannabinoid that’s of most medicinal value – delta-9-tetrahydrocannabinol (delta-9-THC) – also happens to be the one that has the most potential to make people high. It can help to ease pain and alleviate nausea but has a host of side effects (see below).
Another cannabinoid that has medicinal value is cannabidiol (CBD), which also helps to ease nausea and has antiinflammatory properties among other things, but won’t make users high.
WHAT MEDICAL CONDITIONS CAN IT BE USED FOR?
Chronic neuropathic pain, which is often experienced by HIV patients and people with multiple sclerosis, can be treated with medical marijuana, Dr Müller says.
It can be effective in combating chronic pain related to conditions such as cancer and arthritis. And it’s been found to be helpful for nausea and vomiting caused by anti-cancer drugs, as well as loss of appetite and eating disorders in patients with HIV and advanced cancer.
It also helps to ease the side effects of medications for Parkinson’s disease and muscle spasms in people suffering from Tourette syndrome.
Dr Müller says there are indicators that cannabinoids can stimulate activity in the body that can fight cancer, especially in the case of malignant glioma tumour (usually on the brain and spine).
WHAT ABOUT SIDE EFFECTS?
Although it’s good that people would now have the option to use medical marijuana, it’s important they know about the side effects, Dr Müller says. “People should understand that if medication doesn’t have side effects then it also doesn’t have any effect at all.”
Side effects of cannabis related to the central nervous system include balance disturbance, depression, confusion, sleepiness or sleeplessness, disorientation, anxiety, amnesia, reduced intellectual function, hallucination, paranoia, lightheadedness and delayed reaction.
Side effects not related to the central nervous system include nausea, vomiting, dry mouth, racing heart, low blood pressure and diarrhoea. Dagga can also double the risk of schizophrenia in children going through puberty and aggravate epilepsy, Dr Müller says.
WHAT WILL IT COST?
At this stage it’s unclear what the price of legal locally manufactured medicinal marijuana products will be – or when it will be available at pharmacies. * Not their real names.