There is intense lobbying for the legalisation of the common South African weed and equally vehement groups that want its possession and use to remain a criminal offence.
The "dagga couple", as the media have dubbed Lanseria activists Julian Stobbs and Myrtle Clark, have been joined by doctors, psychologists, lawyers and other interested parties campaigning for the legalisation of dagga for medical and recreational use.
But there are other committed health and legal professionals who say the risks of dagga far outweigh the benefits, and that legalisation is not an option for a variety of religious, cultural and economic reasons.
Stobbs and Clark became "reluctant activists" after the police arrived at their Johannesburg home at 2am in late 2010, "trying to bash the door down". They were arrested for "growing a little dagga for our own use" and given three choices, says Stobbs: "Pay our way out of it, take our punishment, or fight it."
They hired a lawyer and have been fighting seven government departments and "unlawful laws" ever since, helping others to do the same. They are preparing to take their cause to the Constitutional Court if necessary.
Stobbs and Clark have smoked dagga every day for the past 50 years without adverse effects, they say. Stobbs says he smokes dagga to "get that shift you need at the end of the day - when you know you haven't done everything you need to do. It helps me switch off, calm down, put my lights out... when my mind is whirling. Some people call that a sedative."
Dagga, a green or gray mixture of dried, shredded flowers and leaves of the Cannabis sativa hemp plant, has active ingredients - compounds known as cannabinoids, the most well-known of which is THC (delta-9 Tetrahydrocannabinol).
Research supports the efficacy and safety of cannabis compounds for illnesses ranging from cancer to neurological disease, eye disease, asthma and pain control. It is also used to reduce nausea and vomiting during cancer treatment, and to treat cachexia, a wasting syndrome present in people with cancer, HIV/Aids and tuberculosis.
Last year, the Cancer Association of SA produced a position statement on dagga prepared by its head of health, Prof Michael Herbst.
Apart from "possible endocrine disrupting effects" and selective cognitive and memory impairment, it says risks include airway injury, lung inflammation, bronchitic conditions and rare forms of cancer in those whose mothers smoked it during pregnancy. It says dagga is addictive and often a "gateway" drug, leading to harder drugs.
That's scaremongering, says Cape Town GP Dr Keith Scott, since most adverse symptoms associated with dagga are short-term side effects experienced after smoking or ingesting it. He says it is "absurd" that dagga is still illegal in SA. While legalising it for medical use would be a "step in the right direction", it wouldn't solve the other psycho-socioeconomic and crime problems caused by drug criminalisation - which are in effect public health issues.
A two-day roundtable conference last month organised by the Department of Social Development in partnership with the Central Drug Authority, aimed to increase debate about the safety of medicinal use of dagga, and develop recommendations on policy.
The roundtable became farcical at times, Scott says, as vehement opponents of legalisation, including Doctors For Life, introduced "redherring" arguments such as the dangers of pilots flying aircraft while high on dagga.
Scott doesn't believe the event contributed much to a real understanding of the issues. "Dagga has been demonised," he says. "People assume it is far more dangerous than alcohol and tobacco, but it is far, far safer, and definitely safer than harder drugs such as heroin and morphine."
There are few documented cases worldwide where dagga has killed someone, while tobacco kills 6-million people annually, and alcohol 3-million people, says Scott.
There is also no evidence linking dagga with an increased risk of schizophrenia in adults, Scott says, and studies are under way using cannabis to treat schizophrenia.
Regular dagga use from childhood or adolescence could possibly increase the risk of schizophrenia and other long-term brain dysfunction, "but, like alcohol and tobacco, no one is suggesting children should be taking dagga or any other drug", Scott says.
He says cannabis is no more a gateway drug than tobacco and alcohol, and is far less toxic. "No drug is free from harm," Scott says, "but any harm must be seen in perspective".
Bedfordview clinical psychologist Quentin Ferreira says though there are mental-health risks, cannabis is "relatively safe compared to other drugs, including legal ones" for adults not generally predisposed to psychosis or schizophrenia.
"The youth using dagga is problematic," he says, because the brain finishes developing only in the early 20s, and adding chemicals changes the way the brain works. It can also make young people vulnerable to addiction.
If there is an underlying or genetic predisposition to psychosis or schizophrenia, any drug use can bring on the onset faster and worsen these conditions by mimicking symptoms, he says.
Addiction is "much more complicated than most people think", says Ferreira, who has worked at Sterkfontein Hospital, the South African National Council on Drugs and Alcohol Abuse, and clinics in Ekurhuleni.
"People get addicted to all sorts of things, including shopping, sex and gambling," he says.
"You wouldn't say a pack of cards causes addiction in gambler," Ferreira says.
He says addiction is "an acute interaction between the substance, biological and psychological factors of the person and the environment".
Many countries allow the use of cannabis for medical purposes including Canada, Finland, Germany, Israel, Uruguay, Italy, the Netherlands, Portugal, Austria and Spain. In the US, 26 of its 50 states and the District of Columbia have enacted legislation to legalise or decriminalise cannabis for medical and/or recreational use.
In SA, medical practitioners are legally denied the right to prescribe cannabis or commercially produced cannabinoids approved in the US for the treatment of cancer-related side effects. Among these are dronabinol (imported and sold under the trade name Marinol in SA) and nabilone.
"Many people in SA decide to take cannabis for various ailments such as cancer, arthritis, multiple sclerosis and other diseases," says Scott. "Under the present discriminatory and arbitrary laws, patients are breaking the law by doing so."
He knows of many doctors monitoring seriously ill patients who are treating themselves with the plant.
One reason given for opposition to the medical use of dagga is that cannabinoids don't have sufficient doubleblind, clinical studies required for full registration.
But such studies are economically unviable, says Scott. "Profits in the pharmaceutical industry come from patents and cannabis, a plant that's in the public domain, can't be patented."
The criminalisation of cannabis over the past century has also made research extremely difficult.
But international pharmaceutical companies are exploring ways to cash in on the legalisation of cannabis as they stand to make trillions of dollars from selling products.
Scott says drugs are mired in politics and outdated international treaties formed in the wake of criminalisation, collectively known as the war on drugs. "The war has been lost and has exacerbated drug problems worldwide," he says.
Change to the law on medical use of dagga in SA received a boost after a plea to Parliament last year by the late Inkatha Freedom Party MP Mario Oriani-Ambrosini, who tabled the Medical Innovation Bill and admitted to using dagga medicinally for terminal lung cancer. Oriani-Ambrosini committed suicide in August and progress on the bill stalled temporarily.
If there is to be change, the dagga couple's pending court cases, not the Medical Innovation Bill, will drive SA to more just drug laws, says Scott. "The Constitutional Court will probably compare dagga laws to those pertaining to tobacco and alcohol, and, hopefully, find the former unconstitutional," he says.
"Laws that criminalise the use of one substance while allowing the use of far more toxic drugs are not only irrational, they are grossly unfair and discriminatory."
Source: Business Day via I-Net Bridge
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