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.
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.
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.
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.
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.
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.