Clear­ing the smoke on ganja

Jamaica Gleaner - - OPINION & COMMENTARY - Chris Tufton

This is an ex­tract from the speech de­liv­ered at the launch of Med­i­canja prod­ucts in Kingston, Ja­maica, last month.

WITH THE re­cent launch of a num­ber of Med­i­canja prod­ucts, ganja is once again mak­ing news head­lines. And rightly so. It is an op­por­tune time for a na­tional dis­cus­sion on the sub­ject, as Ja­maica looks to make a name for it­self in the medic­i­nal ganja mar­ket.

The Min­istry of Health sup­ports Ja­maica’s en­try into this mar­ket. At the 70th World Health Assem­bly in Geneva last year, I made a sub­mis­sion to re­move ganja – also called ‘cannabis’ and ‘mar­i­juana’, among other names – from its cur­rent clas­si­fi­ca­tion as a Sched­ule 1 Drug (il­le­gal drug) deemed to have no medic­i­nal ben­e­fits to a sched­ule that re­flects its im­por­tant po­ten­tial for medic­i­nal use.

The re­moval of ganja from its cur­rent clas­si­fi­ca­tion is an im­por­tant step in fa­cil­i­tat­ing ef­forts by coun­tries, such as Ja­maica, to pro­mote its medic­i­nal uses while main­tain­ing a sound pub­lichealth ap­proach.

The min­istry has also es­tab­lished a Medic­i­nal Cannabis Unit, which has, to date, reg­is­tered 61 medic­i­nal cannabis prod­ucts, and is also cur­rently in­volved in the de­vel­op­ment of eth­i­cal guide­lines for cannabis re­search.

To be clear, I, as the min­is­ter of health, and the team at the min­istry are paid to be cau­tious of new dis­cov­er­ies and in­ven­tions – no mat­ter how ben­e­fi­cial they may at first ap­pear. It is crit­i­cal that we take this ap­proach be­cause while a fi­nan­cial risk may cost money, a pub­lichealth risk may cost lives.

The medic­i­nal ben­e­fits to be de­rived from ganja must, there­fore, be backed by sci­en­tific ev­i­dence; tried and tested re­search that builds on the ef­forts of the likes of the late Pro­fes­sor Manley West, who did ground­break­ing work on the ganja plant, lead­ing to the de­vel­op­ment of medicines for ail­ments, in­clud­ing glau­coma.

The re­search is also crit­i­cal if Ja­maica stands any real chance of prov­ing it­self a cred­i­ble fore­run­ner in the global medic­i­nal ganja in­dus­try, which is im­pos­si­ble to do in the ab­sence of a sound pub­lic-health ap­proach.

RE­SEARCH AND DE­VEL­OP­MENT VI­TAL

Work on medic­i­nal ganja is evolv­ing and, as a con­se­quence, there are go­ing to be ob­sta­cles; there are go­ing to be ques­tions, ne­ces­si­tat­ing the need to test, retest and val­i­date.

At the Min­istry of Health, we see our­selves as en­ablers of the process, bear­ing in mind our re­spon­si­bil­ity to ad­vance so­lu­tions to the pub­lic-health con­cerns of our peo­ple. How­ever, we must take a bal­anced ap­proach, ever mind­ful not to con­fuse the dis­cus­sion on medic­i­nal ganja with the dis­cus­sion on its recre­ational use.

I can­not overem­pha­sise the need for on­go­ing pub­lic ed­u­ca­tion. Where there are medic­i­nal ben­e­fits to be de­rived from ganja, it is also a sub­stance with psy­choac­tive prop­er­ties that have the po­ten­tial for sig­nif­i­cant and some­times long-last­ing, neg­a­tive health con­se­quences and men­tal-health com­pli­ca­tions, es­pe­cially among the young.

The re­cent Con­fer­ence of Heads of Gov­ern­ment Meet­ing of CARICOM saw the tabling of the CARICOM Re­gional Com­mis­sion on Mar­i­juana 2018 re­port. That re­port, which rep­re­sents an at­tempt by CARICOM gov­ern­ments to reg­u­larise and es­tab­lish stan­dards that would flow through­out the re­gion in terms of the ap­proach, is a pos­i­tive step.

The re­port is also quite clear that even while we cham­pion the de­vel­op­ment of the medic­i­nal ganja in­dus­try and seek to ex­ploit its po­ten­tial, we have also to ap­proach it based on a recog­ni­tion of cer­tain re­al­i­ties. These re­al­i­ties in­clude that:

There is con­clu­sive ev­i­dence that ex­ists for the neg­a­tive ef­fect on the ado­les­cent brain and on driv­ing;

Ganja use in chil­dren may af­fect mem­ory, learn­ing and at­ten­tion and may put youth at risk for early on­set of psy­chosis.

The ado­les­cent brain is not fully de­vel­oped be­fore the age of 24 years, which makes it sus­cep­ti­ble to the ef­fects of ganja.

Fur­ther, there is a con­vinc­ing body of lit­er­a­ture that re­cent use af­fects sev­eral do­mains of cog­ni­tion, such as mem­ory, at­ten­tion and learn­ing, and that these ef­fects ap­pear to per­sist even af­ter the drug is stopped.

In ad­di­tion, in re­gard to psy­chotic disor­ders, such as schizophre­nia, the emerg­ing con­sen­sus is that cannabis may ad­vance the age of psy­chosis in high-risk in­di­vid­u­als, such as those with ge­netic vul­ner­a­bil­ity.

It is not sur­pris­ing, there­fore, that when you look at coun­tries that have ad­vanced medic­i­nal ganja, among them Is­rael and now Canada, the in­dus­try is lodged in the health port­fo­lio. That premise be­gins the process of en­sur­ing that the eth­i­cal pro­to­cols of the in­dus­try are es­tab­lished, main­tained and then pro­jected.

This re­quires that we es­tab­lish our­selves in a man­ner that hits the best prac­tices early, ground­ing our ef­forts in re­search while main­tain­ing clar­ity as to the pros and the cons of the in­dus­try, thus ef­fec­tively pre­par­ing our­selves for what, I be­lieve, is not just the op­por­tu­nity ganja rep­re­sents to­day, but also the op­por­tu­nity it rep­re­sents in the years to come.

I be­lieve we have a win­ner, and we can make it work. How­ever, we must sat­isfy the var­i­ous facets of true re­search in or­der to pro­duce a value propo­si­tion that is ap­pro­pri­ately branded and can be po­si­tioned in what is sure to be an in­creas­ingly com­pet­i­tive mar­ket.

Dr Christo­pher Tufton is the min­is­ter of health. Email feed­back to col­umns@glean­erjm.com.

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