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More MS news articles for September 2003

Dagga: demon drug or Nature's medicine?

September 25, 2003
By Marika Sboros
The Cape Argus

Controversy about the risks versus benefits of dagga is evergreen and continues to divide camps.
Also known as grass, zol, pot, marijuana or the botanically correct cannabis sativa, it is a common weed, classified as a drug because of its mind or consciousness-altering and other properties.

Earlier this year, New Zealand's parliamentary committee recommended liberalising the country's marijuana laws, saying moderate use was associated with "few health risks", and research "did not appear to substantiate a link between cannabis and psychosis".

It also said the supposed negative mental health impacts of the drug appeared to have been "overstated". That came after a three-year inquiry into the drug's effects on the human body and to determine an appropriate legal status for it.

Canada and Britain have similarly recommended the reclassification and/or decriminalisation of marijuana. Along with the Netherlands, they allow cannabis for medicinal use in certain cases, including chemotherapy treatment, and for terminal cancer and multiple sclerosis patients.
In South Africa, dagga is never far from the spotlight

In South Africa, dagga is never far from the spotlight, as Rastafarian Gareth Prince continues his battle to overturn a ruling by the SA Law Society barring him from becoming a lawyer (because of his use of the drug required by his religion), and Aids activists call for more research.

HIV-positive David Patient, for example, has been quoted as calling dagga a "God-made herbal compound" with "amazing benefits" that helped him cope with the effects of highly toxic drugs to treat HIV/Aids.

Cannabis for recreational use remains illegal in South Africa. Sanctions range from a mere caution, to a fine or jail term depending on how much you happen to have in your possession, whether you have previous convictions and your personal circumstances.

Its medical use in this country is limited to an extract of one of its 60 active cannabinoids, THC, available in pill form, used to treat nausea from chemotherapy.

Few doctors favour it much though. They say there are more conventional compounds that do the job just as well or even better.
Why then such a divergence of opinion?

Last year, a media report suggested there was a groundswell of support among doctors and psychiatrists for cannabis as medicine. That was after the editor of the SA Medical Journal, Professor Daniel Ncayiyana, wrote an editorial calling for it to be decriminalised and permitted in small quantities for personal consumption.

Gauteng GP Dr Norman Mabasa, as spokesman for the SA Medical Association (Sama), was also quoted at the time as saying there was "no doubt" that dagga acted as an anti-depressant, and the association "wouldn't have any problem with the Medicines Control Council recommending dagga as a medicine".

If all that was true then, it doesn't appear to be so now. The groundswell appears to have ebbed to a very low tide - if opinions of doctors I spoke to are anything to
go by.

Former UCT surgery professor John Terreblanche is the current chairman of the Sama's health policy committee. He says Sama is "totally opposed" to recreational use of cannabis, and is not "providing support" for its use as medicine, as there is currently no evidence to warrant doing so.

However, he does say that this position could change as it is continually being evaluated.

Sama's newly elected vice-chairperson, UCT psychiatric professor Denise White, says most psychiatrists in this country are trying to discourage rather than encourage the use of cannabis, because they see its devastating mental effects.

KwaZulu-Natal psychiatrist Dr Shakir Salduker is on the executive committee of the SA Association of Psychiatrists and says cannabis does have analgesic (painkilling) properties, and it is an anti-emetic, making it useful to treat nausea and vomiting. However, any benefits are more than offset by serious risks. He says between 50% to 70% of patients in psychiatric wards in the province have cannabis-induced psychosis.

It is shown to aggravate rather than alleviate depression, and he believes it is as dangerous and addictive as crack cocaine and heroin.

Salduker says prolonged cannabis use causes "amotivation syndrome", making users underachieve and become demotivated in many areas of their lives. This, along with the fact that it is shown to be a "gateway" to harder drugs, makes it particularly dangerous.

Vereeniging psychiatrist Dr Ike Nzo agrees. He says cannabis is dangerous and highly addictive, and he would never advise patients to use it - or anyone else, for that matter.

Johannesburg endocrinologist Dr Tessa van der Merwe says cannabis can cause cardiovascular abnormalities, including arrythmia (abnormal heartbeat), and structural changes in the heart.

Why then such a divergence of opinion?

One theory is that effects of the drug vary widely - and wildly - depending on where it is grown. Local varieties such as "Durban poison" (grown in KwaZulu-Natal) and Transkei specimens are said to be particularly potent. This may be related to soil content, though there is no evidence on this.

The Medical Research Council at Tygerberg Hospital in Cape Town plans to investigate this aspect of cannabis soon.

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