To whom it may concern
Reason for this presentation
This presentation has been compiled by Doctors for Life International out of concern regarding ramifications arising from the legalisation of Cannabis. The concern is founded on the scientific and medical fact that most drugs active in the central nervous system, including cannabis, have an impairment potential and therefore pose a road safety threat. It is essential that regulations are drafted, and parameters placed before the legislature for deliberation, to avoid a spike in intoxication-related traffic incidents and ensure that our roads remain safe.
Drug levels and their effects on different tissue types:
Cannabis blood drug levels in occasional users and chronic users (Toennes et al., 2008) showed an initial cannabis half-life of 30 minutes. The half-life of Cannabis has a complex overlay of different clearance rates, but after 8 hours, the clearance is considerably slower, particularly in heavy users of Cannabis.
Cannabis is absorbed from the lungs. It is redistributed and diluted into the entire blood pool. Simultaneously all other elimination routes start working. Kidney elimination is the fastest initial elimination route and is blood level dependant. Such elimination decreases. Liver and other routes become more important. Because heavy usage damages the liver, elimination slows and consequently drug levels are considerably higher after eight hours in heavy users than in casual, intermittent users.
Brain levels of cannabis are 2-3 times higher than blood levels (Heustis et al., 1992). This is due to accumulation in fat. The brain fatty substance is responsible for insulation around the nerve cell fibres as myelin sheaths. It may then have a profound effect on brain function. This means that blood levels may approximate, but do not accurately reflect brain levels. These levels may therefore still be high enough to cause impairment whilst the blood levels may seem safe.
When cannabis damages the liver, elimination will inevitably become slower and this affects elimination negatively, including in the brain. For most drugs that redistribute to fat, elimination is slow due to the relative lack of blood flow to fat. This accumulation is not limited to the fat in the brain but occurs in the entire body.
The effect in each patient is drug level dependant. The higher the levels, the more effect it has.
Effects of legalisation of cannabis in other countries
In an address delivered (February 2022) before the Virginia General Assembly, by Prof Bertha Madras (MD), Professor of Psychobiology, Department of Psychiatry, Harvard Medical School she stated that in states where cannabis is legal, an increase in traffic deaths was observed. Her literature review found that cannabis is the most identified drug in deadly vehicle accidents, and it doubles drivers’ chances of being involved in an accident. The reason is that cannabis impairs judgement and many other skills needed for safe driving, e. g., alertness, concentration, coordination, and reaction time. cannabis makes it difficult to judge distances and to react timeously.
After almost five years of being barred to practice medicine, the Health Professions Council of South Africa (HPCSA) finally allowed Dr Jacques de Vos’ to continue with his career. Dr De Vos was suspended from completing the gynaecology rotation of his internship at 2 Military Hospital in the beginning of 2017. He was then charged by the HPCSA with unprofessional conduct for his views that the unborn child is a human being.
Following years of delays, the HPCSA finally withdrew the charges against Dr De Vos in September 2020. 2 Military Hospital, however, still refused to sign Dr De Vos off, citing his ‘refusal to comply with basic medical ethics’ (referring to his medical views on the humanity of the unborn child). It was only after persistent intervention of organisations such as Doctors For Life, assistance of various attorneys and advocates, as well as the perseverance of Dr De Vos that the HPCSA relented on 4 April 2022 and approved his registration as a medical practitioner for purposes of his community service.
Whilst Doctors For Life (DFL) is delighted that Dr De Vos can finally proceed to practice medicine, DFL is appalled at the unfair and discriminatory manner in which he was treated. The scientific reality of the humanity of the unborn child is generally undisputed. Nevertheless, Dr De Vos was effectively punished for his scientifically sound stance, by being barred to practice medicine for almost five years without a hearing. This was a gross and inexcusable violation of his constitutional rights. Doctors For Life calls upon the South African government to urgently enact measures to ensure protection of healthcare professionals who act conscientiously in line with sound science, and not to persecute ethical practitioners such as Dr De Vos.
Embargo: Immediate release Enquiries: Doctors For Life Int.
Date: 01 February 2022 Telephone: 032 481 5550
The Review Application of Dr De Vos against the Health Professions Council of South Africa is to heard on 1 February 2022 in the Gauteng High Court, Pretoria. Dr De Vos is asking the High Court to review and set aside the HPCSA’s decision to refuse to reconvene the professional conduct hearing against him.
Dr De Vos was charged with unprofessional conduct for allegedly advising a mother that her 19-week healthy unborn baby was a human being. The proceedings against Dr De Vos by the HPCSA started in 2017. In December 2020 Dr De Vos pleaded “not guilty”. The HPCSA then refused to reconvene the hearing so that the committee could hear the case and deliver a verdict, and cited as reason that the “complainant does not want to proceed”.
Since July 2017 Dr De Vos been unable to proceed with this career as the HPCSA would not issue him with a Medical Practitioner number as the hearing had not been concluded.
The HPCSA is opposing the application. Dr De Vos is represented by Adv K Matthee SC and Adv AR Duminy (instructed by De Wet Wepener Inc c/o Maphalla Mokate Conradi) and the HPCSA is represented by Adv M Majozi (instructed by Mgeno & Mteto Inc).
Doctors For Life has been assisting Dr De Vos since the beginning of 2017 with legal representation as well as renowned expert witnesses in the fields of embryology, human anatomy and psychology.
For more information contact Doctors For Life at [email protected]