Cannabis for Private Purposes Bill: Public Hearings (Press Release)

Cannabis Committee

Doctors for Life International (DFL) submitted their stance to the Parliamentary Portfolio Committee on Justice and Correctional Services, expressing their opposition to the inclusion of hemp commercialisation in the contentious cannabis bill. Despite receiving resistance from some stakeholders who dismissed DFL’s right to be heard, Dr WL Sieling delivered an outstanding presentation, grounded in medical science.

During the discussion, Dr Sieling warned that the passage of the United States Agriculture Improvement Act of 2018 legalised hemp cultivation for commercial purposes. However, this legalisation inadvertently created a legal loophole that certain American businesses exploited to market and sell Delta-8 THC. Delta-8 THC is an isomer of Delta-9 THC with comparable adverse effects.

In addition to newly discovered THC isomers like delta-8 THC, there is an increasing concern surrounding hemp derived CBD. Consumer products containing CBD are being falsely marketed, making claims about their supposed health benefits and overall wellness effects. A recent article authored by researchers from the United States Food and Drug Administration (FDA) provides insight into the potential risks of CBD, including developmental and reproductive toxicity, hepatotoxicity, and interference with essential metabolic pathways and liver enzyme functions. The toxicological profile of CBD raises concerns regarding its safety, particularly when consumed by the general population over an extended period.

The South African Government’s optimism about hemp as a source of job creation and revenue may also be misguided. The United States Department of Agriculture’s latest National Hemp Report indicates significant declines in the value and cultivation of hemp crops across various metrics. The report states that the value of hemp production in the United States decreased by 71 percent compared to 2021. This decline reflects a market correction, as the exaggerated publicity surrounding hemp as a miraculous cure-all substance begins to fade away.

The video to DFL’s submission before the committee can be viewed here:

Legalising cannabis fails to address health risks: UN drugs control board (Press Release)

United Nations International Narcotics Control Board

The United Nations International Narcotics Control Board (INCB) warns in its most recent annual report, that cannabis legalisation causes “negative health effects and psychotic disorders” among some recreational users. It also warned legalisation contravenes the UN 1961 Single Convention on Narcotic Drugs.

“In all jurisdictions where cannabis has been legalised, data show that cannabis-related health problems have increased,” the INCB said. It pointed out that between 2000 and 2018, “global medical admissions related to cannabis dependence and withdrawal increased 800%. Admissions for cannabis-related psychotic disorders have increased 400% worldwide.” Statistical evidence from Colorado (United States) shows that fatal traffic accidents with drivers under the influence of cannabis nearly doubled from 2013 to 2020.

Regarding the recreational use of cannabis, the UN panel expressed concern that the “growing” industry was fuelling the shift to even greater use of the drug, by advertising their products “particularly to young people, in ways that lower the perception of risk”.

In the United States, it has been shown that adolescents and young adults consume significantly more cannabis in federal states where cannabis has been legalised compared to other states where recreational use remains illegal.

New cannabis-based products, including “edibles”, or vaping products marketed in eye-catching packaging have increased the trend, the report’s authors continued, warning that these tactics have contributed to a “trivialisation” of the impacts of cannabis use in the public eye, especially among a younger demographic. “This is a major cause for concern, because the harms associated with using high-potency cannabis products are being played down,” said INCB President Jagjit Pavadia.

The main objective stated by Governments for legalising cannabis has been to reduce criminal activities and increase public health and safety. In its report, the INCB highlights that this objective has not been achieved.

Generating tax income has been listed as another important goal by Governments which promoted legalizing cannabis. The INCB finds that, although tax income from cannabis sales has increased year over year in Canada and the United States, tax revenue has been lower than expected, making up only 1 per cent of the budget in legalising states.

Doctors for Life International notes that these tax benefits are further nullified when considering the added burden and expenses on the heath sector e.g., mental health care, traffic accidents.

The President of the INCB, Jagjit Pavadia said: “Evidence suggests that cannabis legalization has not been successful in dissuading young people from using cannabis, and illicit markets persist.” Data show that illegal cannabis supply continues at high levels in all legalising jurisdictions, reaching 40 per cent in Canada, nearly 50 per cent in Uruguay and even 75 per cent in California.

Cannabis Use Disorder (CUD) in individuals using cannabis for medical purposes (Media Release)

Cannabis disorder

The most common conditions for which individuals obtain medical cannabis are pain, insomnia, anxiety, and depressed mood, but evidence for the efficacy of cannabis to treat these symptoms has been mixed.

A follow-up study of a 12-week randomised clinical trial of medical cannabis users, found an association between frequent cannabis use and increased Cannabis Use Disorder (CUD) risk, with no significant improvement in pain, anxiety, insomnia, or depression symptom severity. These findings call into question the use of cannabis as an effective tool in relieving clinical symptoms.

The study was conducted by a team of researchers from Harvard University, one of the world’s most respected medical research institutes. Harvard Medical School consistently ranks as the number one medical school around the globe.

Cannabis use disorder (CUD), also known as cannabis addiction, is defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and ICD-10 as the continued use of cannabis despite clinically significant impairment. Those who used cannabis 3 or more days per week were 269% more likely to develop CUD.

The study found an association between greater cannabis use and greater pain, indicating that cannabis is not adequately treating pain symptoms. This viewpoint is supported by a recent position paper from the International Association for the Study of Pain (IASP) that found, after a comprehensive review of research on the use of cannabinoids to treat pain, there was a lack of sufficient evidence to endorse the general use of cannabinoids for the treatment of pain.

The lack of improvement in symptoms of anxiety after 12 months of cannabis use adds to a growing body of literature that does not endorse cannabis as a treatment for these conditions. The lack of benefit from cannabis indicates that individuals with chronic conditions should consider evidence-based treatments.

United States marijuana legalisation and opioid mortality epidemic during 2010–2020 and pandemic implications

According to the Journal of the National Medical Association opioid mortality trends in the United States, a world leader in both opioid mortality and cannabis use disorder, do not support the hypothesis that marijuana availability reduces opioid mortality. During the past decade, the country’s opioid mortality trends in marijuana legalising and non-legalising jurisdictions suggest the opposite. The United States opioid mortality rate was compared in states and District of Columbia that had implemented marijuana legalisation with states that had not. Instead of supporting the marijuana protection hypothesis, ecologic associations at the national level suggest that marijuana legalisation has contributed to the U.S.’s opioid epidemic.


Potential public health consequences of liberalising cannabis legislation (South Africa)

Laws that increase access to cannabis will have public health consequences including respiratory health, traffic-related injuries, and the mental health of vulnerable populations.Evidence highlights safety concerns that cannabis causes damage to the developing brain. Cannabis use can damage the brain to such an extent, that even after years of abstinence the damage is still present and it is not yet clear whether these effects are reversible. In particular, cannabis use during pregnancy increases the risk of adverse outcomes for women and their neonates.

Scientific research may not have kept pace with the speed at which cannabis laws are being liberalised. Consideration needs to be given to these public health concerns as South Africa moves towards ratifying the Cannabis for Private Purposes Bill.


Cannabis use amongst substance use disorder patients with ADHD (South Africa)

According to a recent study published in the South African Journal of Psychiatry, Attendion Deficit Hyperactivity Disorder (ADHD) is more common amongst patients who use cannabis than amongst patients seeking other substance abuse treatments. ADHD is a common childhood neurodevelopmental disorder characterised by early onset of impairing levels of hyperactivity, inattention, and impulsiveness. The study provides evidence of significant cannabis use, especially in females with ADHD, in treatment-seeking facilities in South Africa. It is widely reported that several mental health disorders are overrepresented amongst substance abuse populations. According to the study, South Africa needs to strengthen prevention and intervention activities against alcohol and cannabis use, especially in identified risk groups, like ADHD.


Cannabis exposures reported to the Poison Information Helpline (South Africa)

South Africa decriminalised the use of cannabis for private use in a Constitutional court ruling during September 2018.

An observational study, of cannabis exposures reported to the Poison Information Helpline in the Western Cape. the University of Witwatersrand found that coinciding with the court ruling there was a threefold increase in cases reported to the Poison Information Helpline.

Accidental ingestion of edible cannabis products was a common occurrence in patients aged 12 years and younger, leading to neurological symptoms.

In general, there has been an increase in reports made to health care facilities of cannabis intoxication and other adverse effects in countries where cannabis has been legalised.

Cannabis use is not without consequences, health care practitioners should take note of the various adverse effects associated with its use.


New South African Studies on cannabis/dagga (Press Release)

Cannabis studies

New South African Studies done on cannabis/dagga since the legalisation for private use by the Constitutional Courts ruling in 2018

A recent study published in the South African Medical Journal found Cannabis use during adolescence affects the endocannabinoid system, which is particularly susceptible to the harmful effects of cannabis as it undergoes profound developmental changes.

The study states that adolescent cannabis use causes structural, functional, and histological alterations in the frontoparietal, cerebellar and other regions of the brain with some evidence suggesting that cannabis related neurocognitive impairments persist into adulthood, even after prolonged abstinence. Adolescent cannabis use should be actively discouraged, and pregnant women should be advised to avoid cannabis use.

Thirdly According to another study published in the South African Journal of Psychiatry, ADHD is common amongst cannabis users seeking substance abuse treatment and advises that cannabis prevention activities be strengthened.

Also, an observational study by the University of Witwatersrand on cannabis exposures reported to the Poisons Information Helpline of the Western Cape (PIHWC) noted there was a threefold increase in cases reported during the period June 2018 to June 2019 compared to the period June 2015 to June 2016. This coincides with the South Africa Constitutional Court ruling in favour of decriminalising cannabis for private cultivation and consumption.

Accidental ingestion of edible cannabis products was a common occurrence in patients aged 12 years and younger.

The introduction of the Cannabis for Private Purposes Bill in 2020 further clarified how consumers can legally use cannabis.

The expectation of many is that changing legislation will lead to the increased use of cannabis products.

In general, there has been an increase in reports made to health care facilities of acute cannabis intoxication and other adverse effects in countries when cannabis was legalised.

The same study warned that Cannabis use is not without consequences, and it is important for all health care practitioners involved in acute patient care to be aware of the various adverse effects associated with its use.

Prolonged cannabis use during adolescence also disrupts the neuromaturation processes of the brain that occur during this period, with synaptic pruning and white matter development particularly affected. Adolescent cannabis use is also associated with cognitive deficits and interference in logical thinking processes.

Cannabis use during pregnancy increases the risk of adverse outcomes for women and their neonates, to the extent that the American College of Obstetricians and Gynaecologists advised physicians to discourage use of cannabis during preconception, pregnancy, and lactation.

Cannabis use during pregnancy and breastfeeding alters the development of multiple brain regions and may result in lasting functional consequences, including impaired higher-order executive functioning (i.e., impulse control, visual memory, and attention). As a result, attention deficit hyperactivity disorder (ADHD) during childhood affects academic performance and social adjustment.

Prenatal cannabis exposure is associated with an increased risk of foetal growth retardation and childhood behavioural disturbances. Infants exposed to cannabis in utero tend to have lower birthweights and are more likely to need placement in the neonatal intensive care unit compared with infants without exposure. Cannabis may be toxic to human chromosomes, with chromosomal changes caused by in utero cannabis exposure contributing to the lower fertility and higher miscarriage rates known to occur among women who use cannabis.

Doctors For Life International would like to caution the South African government on whether they want to continue to experiment with the approximately 60 million people of South Africa as it moves towards ratifying the Cannabis for Private Purposes Bill introduced to Parliament in October 2020.

Decriminalisation of cannabis, UN delves into impacts of cannabis legalisation (Europe)

Highlighted in the 2022 World Drug Report by the U.N. Office on Drugs and Crime, cannabis remains the most widely used drug worldwide, with roughly 209 million people having used cannabis in 2020, a 23% increase from the 170 million people in 2010. As cannabis use and THC potencies increase, there has been a “notable increase” in related treatment admissions and psychiatric comorbidities. Cannabis was the most common substance reported in emergency rooms, where it was present in 26% of acute drug toxicity cases. In a study involving patients presenting first episode psychosis, cannabis use was associated with a three times greater likelihood of psychotic disorder. Daily use of high-potency cannabis increased the risk of psychotic disorder more than fourfold.


Decriminalisation of cannabis, high court rejects bid for work reinstatement (South Africa)

An employee who was fired after repeatedly testing positive for cannabis, in breach of company rules, has failed in their bid to be reinstated. The company had a zero-tolerance policy towards alcohol and drugs requiring employees to undergo regular tests. After failing several weekly tests the employee was charged with breaching the company’s Alcohol and Substance Abuse Policy and was fired. Johannesburg Labour Court Acting Judge Makosho Ntsoane held that the employee was at all times aware of the policy which had been applied consistently to all employees. He said in light of the dangerous environment, the company was entitled to its zero-tolerance policy and the Constitutional Court judgment on cannabis did not offer protection to employees who breach company policies.