Dagga psychosis worry
NO CONSULTATION: PSYCHIATRISTS BODY RAISES CONCERNS
Cannabis use during adolescence may cause lasting cognitive deficits.
Any change to 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.
This is according to Dr Abdul Kader Domingo, member of the SA Society of Psychiatrists (Sasop) special group on addictions. Sasop has expressed concern about the legalisation of cannabis for personal use.
On Tuesday, the Constitutional Court upheld an earlier ruling by Judge Dennis Davis in the Western Cape High Court that it was legal for South Africans to grow dagga for personal use.
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.
Domingo said it is estimated that one in six teenagers using cannabis will become addicted to it. “Cannabis use during the adolescent period may cause lasting cognitive deficits, even after sustained abstinence.”
He said the Global Burden of Diseases Study of 2010 estimated that two million people lived with disabilities that were attributed to cannabis.
The South African Community Epidemiology Network on Drug Use reported that during the second half of 2016, cannabis was the most common primary substance of abuse for people younger than 20 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 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,” he said.
“We agree with the executive committee of the Central Drug Authority that there is currently insufficient evidence to predict the long-term consequences of the legalisation of cannabis.”
Domingo 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,” he said.
“The decriminalisation of cannabis must be preceded by an augmented strategy with similar socially responsible strategies for it to be successful in South Africa.”
Domingo said available evidence did 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,” he explained.
“This evidence includes trials investigating pharmaceutical medications based on phytocannibinoids.
“Good-quality evidence does, however, exist regarding the frequently occurring side-effects of cannabis such as confusion, dizziness, diarrhoea, euphoria, fatigue and hallucinations.
“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 South Africa’s highest court: “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 a private space”. – ANA
A consistent dose-response relationship existed between cannabis use in adolescence and the risk of developing psychotic symptoms or schizophrenia.
World Health Organisation