Following the recent high-spirited reactions to the legalisation of private cultivation, possession and use of Cannabis in South Africa, it is apparent that we need to weed out issues regarding the substance, particularly related to mental health.
Firstly, we need to dispel the belief that the legalisation of Cannabis means that it is a harmless substance. The legality of substances says little about harms: tobacco and alcohol are legal but they still cause significant harm to users and society.
The harm of Cannabis is even greater amongst individuals with a mental illness or a predisposition for having a mental illness. There is evidence showing that Cannabis use precipitates and perpetuates schizophrenia and psychotic disorders. Thus, just like some people are lactose-intolerant some people can be said to be ‘Cannabis -intolerant’.
Even amongst those who can use Cannabis without significant mental health problems, Cannabis intoxication leads to impaired motor coordination and disturbance in the perception of time and distance.
Now, imagine someone intoxicated on Cannabis and driving! There is already evidence of increased risk of motor vehicle accidents amongst Cannabis users. So, those driving to-fro South Africa for a joint should bear that in mind.
Secondly, we do not yet have scientifically reliable recommendations about how much Cannabis is too much. There is reasonable consensus that drinking 4-5 standard drinks (Standard drink = 10g-14g of pure alcohol) of alcohol in one sitting (2hrs) is the threshold for harmful alcohol use and it leads to a blood alcohol concentration above the legal limit.
We are yet to determine that with Cannabis. Coming up with a standard measure of Cannabis is made more difficult by varying potencies of THC (the psychoactive constituent of Cannabis ) as a result of different cultivating and curing practices.
Interestingly, over the years, the concentration of THC in Cannabis has risen from about 4% to about 12% in some countries. This means Cannabis is becoming
Thirdly, it is important to know that Cannabis is commonly mixed or ‘laced’ with other substances. For example, in South Africa, the mixing of Mandrax (Methaqualone) with Cannabis is not infrequent, it is habit-forming, and the effects can be deadly.
Lastly, Cannabis is frequently romanticised as a ‘holy herb’ that cures a string of ailments. Based on the available research, the Institute of Medicine in the USA has only found conclusive evidence of the therapeutic effects Cannabis in the following respect:
l For treatment of chronic pain in adults;
l For treatment of chemotherapy-induced nausea and vomiting; and
l For reducing muscle stiffness and rigidity in multiple sclerosis.
No doubt the evidence is still building, and perhaps ‘promising’. However, we need to be wary of scientifically unsubstantiated testimonies of the healing properties of Cannabis. Unfortunately, in countries where Cannabis is illegal, like Botswana, research into the therapeutic effects of Cannabis will remain non-existent.
Going forward, this may be an opportunity for our government to implement a proactive and empirical approach towards whether or not we legaliseCannabis . We need to conduct the necessary bioscientific and psychosocial research to increase our understanding of Cannabis , its potential uses beyond recreational, and its effects on the human body (harms and benefits).
*Maphisa Maphisa (B.Psych, UB; M.A Clin.Psych, Rhodes) is a clinical psychologist and lecturer in the Department of Psychology, University of Botswana. The ideas expressed here are solely his and not of his employer. The article is not intended to be a substitute for professional psychological and medical advice. firstname.lastname@example.org