There has been increasing discussion in public circles on the tenets of legalization of marijuana in Ghana in the wake of the call for a national debate by Mr Akrasi Sarpong, the head of the Narcotics Control Board of Ghana. The call for a national debate is believed to be borne out of his frustration and that of his outfit in controlling the drug problem effectively.
Unfortunately, most of the discussions in the public have all been based on moral justification and exaggeration of the effects of the marijuana plant with scientific evidence thrown out of the window. This is however not surprising since most public policies are devoid of the scientific evidence.
In our effort as a country to solve the myriad of challenges confronting us, it is the hope of some that, public policy in all facets of our society should aim at the scientific evidence and not ideology. Ghana’s current discussion on the issue with marijuana, ‘to legalize or not to’, is however not new since most countries and jurisdictions that has either legalized or decriminalized use and possession also went through such debates in the past which were sometimes characterized by misinformation and exaggeration of the harms associated with use.
The evidence available indicates that, such public campaigns on the use of drugs aimed at distorting the facts have never yielded the required results. It is for this reasons that I put together this write up to lay the facts bare so all readers will be well informed which will invariably, lead to a sound public health policy for the good of the public.
The world over, psychoactive substances are receiving increasing public attention especially when they are defined broadly to include alcohol, tobacco, illicit drugs and certain types of pharmacological agents that have high dependence potential.
The effects that these substances have on individuals and society depends on a number of factors including the pharmacological properties of each drug, the way the drugs are ingested, their cultural meanings in everyday life, reasons for using them and the harms associated with their misuse. Unfortunately, public discussions of drug policies have too often failed to consider these complexities.
Simplistic views that all drugs are the same and all are equally dangerous not only limit our understanding of drug-related problems but also impede our ability to develop meaningful policy responses. Advances in psychiatry, psychology, neurobiology, cultural anthropology, epidemiology and a variety of other disciplines have substantially increased the understanding of experts in the addiction field on psychoactive drugs, their actions and misuse.
WHAT IS MARIJUANA?
Cannabis is a plant (botanical) known popularly as marijuana, which is a derivative of Cannabis Sativa and has medicinal as well as psychoactive qualities. ‘Marijuana’ is a slang term for the dried leaves and flowers of the varieties of the cannabis plant that are rich (1-20+ %) delta-9-tetrahydrocannabinol, or “THC”- the primary psychoactive cannabinoid found in the cannabis plant. It is variously called Hashish, ‘THC’, ‘bhang’, ‘wee’, ‘weed’, ’abosa tawa’, etc.
A brief Historical Perspective
Cannabis, popularly called marijuana, has a long history of medical use worldwide. Records of it use dates back to 2700 B.C. when the Chinese use marijuana for maladies ranging from rheumatism to constipation. There were similar reports of Indians, Africans, ancient Greeks and medieval Europeans using the substance to treat fevers, dysentery and malaria.
In the history of US marijuana use, physicians documented the therapeutic properties of the drug as early as 1840, and the drug was included in the US Pharmacopoeia, the official list of recognized medical drugs from 1850 through 1942. It was reported that, lack of appetite was one of the indications for marijuana prescription.
To appreciate the complex nature of drug use as well as the public policy issues associated with the different psychoactive substances, three (3) necessary distinctions must be made. First is whether a particular drug is natural or synthetic. Until the 19th Century, almost all psychoactive substances were used in their natural forms.
With the advent of modern chemistry, the active components of these natural products could be identified, and this knowledge led to the production of potent extracts, such as morphine and cocaine. Subsequently, it become possible to create synthetic forms of many psychoactive substances such as heroin and crack cocaine and to produce new or more potent substances such as Lysergic Acid Diethylamide (LSD), Diazepines and the Opioids.
As in the case of distilled spirits, the ability to produce highly concentrated forms of natural substances greatly increased their portability and thus, dependence potential.
Another important distinction about psychoactive substances relates to the way in which they are ingested. There are four (4) main ways by which to ingest drugs: (1) through the mouth in the form of natural substances (e.g. coca leafs of the people of Bolivia), or synthetic products (e.g. some pain medications); (2) insufflated across mucous membranes such as when cocaine powder is snorted; (3) through inhalation, such as crack vapour and cannabis; and (4) through injection as with heroin. It must be emphasized that, drugs that can be injected into the veins which goes directly into the bloodstream provide rapid delivery which greatly increases their abuse potential, dependence and harm. The recent addition to the mode of ingestion is chewing.
The third distinction is whether or not a particular psychoactive substance has an accepted use in medicine. Many substances such as sedatives and opioids were developed for medicinal purposes but are now restricted in most countries for use only under a prescription system.
Some remain available as accepted medicines, but with controls (e.g. morphine, amphetamines and barbiturates); others are no longer regarded as medicines despite their original development. Substances with medicinal benefits have subsequently been used in amounts larger than recommended on the medication label. In such instances, their use may present the risk of physical, psychological and even legal problems which is a major concern for drug policy makers.
Despite the medicinal value of some psychoactive substances and the social and recreational uses of others or both, government policies ban many such substances and impose penalties on the user. Throughout human history, but particularly since the late 19th century, national governments have regulated or prohibited the use, manufacture and sale of various psychoactive substances with heroin, cocaine and cannabis among the most notable drugs.
At the international level, treaties developed within the framework of the UN and WHO coordinate the control of different psychoactive substances. The International control conventions notably the 1961 and 1971conventions to which Ghana is a signatory state, were designed to prevent diversion of pharmaceutical drug into illegal markets, combat drug trafficking and to tailor controls to the pharmacological properties and dependence potential of each drug.
The main principle was to reduce the availability of these substances which brought in its wake, ‘the war on drugs’ attitude towards managing the escalating drug menace through enforcement over the years.
The classification of substances within the international conventions reflects historical circumstances and cultural factors as well as scientific evidence. For this particular reason, international treaties may not always be consistent with current expert opinion and the scientific evidence regarding the danger or harm associated with a particular substance.
For instance, many experts in the addiction field consider tobacco and alcohol to pose greater risk of harm than cannabis, yet these substances are legal while cannabis is illegal in most jurisdictions. In fact, alcohol and tobacco are believed to be enjoying privileged statuses in society for various reasons.
I however wish to emphasize that, most drugs especially the permissible or legal drugs have also had their fair share of prohibition in history. In the sixteenth century, it is reported that the Egyptian government banned coffee. In the seventeenth century, the Czar of Russia and the Sultan of the Ottoman Empire executed tobacco smokers. In the eighteenth century, England tried to halt gin consumption and China penalized opium sellers with strangulation.
Coffee and for that matter, chocolate which are now seen as not harmful were viewed with suspicion when they first became available in Europe and the near East.
They were associated with laziness, sexual licence and political intrigue. In the seventeenth century, just visiting a coffeehouse was a capital offence in what are presently Egypt, Saudi Arabia, and Turkey. Currently, all coffeehouses that provide marijuana (which has been subjected to quality control measures with labels) for sale are now important centres of sociability and business as well as the discussion of very important national issues.
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