I believe drugs have destroyed many lives but wrong government policies have destroyed more lives. Kofi Annan
Marijuana is a dry, shredded green and brown mixture of flowers, stems and seeds obtained from the female hemp plant known as Cannabis Sativa. Marijuana belongs to the hallucinogens class of drugs which can be taken either orally or smoked. Jerrold Meyer and Linda Quenzer (2019) in Psychopharmacology: Drugs, the Brain, and Behaviour, claimed marijuana consist of more than 70 unique compounds while others have even suggested more than 400 chemical components which can be explored for multitudes of purposes.
The major psychoactive (mind-altering) chemical in marijuana is the delta-9, scientifically known as tetrahydrocannabinol (THC). Marijuana generally comes in three forms: herbal cannabis, hashish and hashish oil. It has several names depending on it location and notable among these are: ‘cannabis’, ‘Indian hemp’, ‘weed’, ‘wee’, ‘ganja’, ‘pot’, ‘stone’, ‘igbo’, ‘hashish’, ‘abonsa tawa’, inter alia.
Globally, marijuana in all its forms is a controlled drug and so is its cultivation, production, manufacturing, distribution, trafficking or consumption per the Single Convention on Narcotic Drugs of 1961 as amended by the 1972 Protocol (Schedules I and IV). In Ghana, its unauthorized use, possession, cultivation, export or import, among others is a criminal offence under the Narcotics Drugs (Control, Enforcement and Sanctions) Law, 1990 (PNDCL 236).
The marijuana plant can be employed for a myriad of purposes ranging from recreational to medicinal as well as for commercial and industrial uses. Nonetheless, the high rate of marijuana abuse and its associated negative consequences especially among the youth has also called for concern and action by key stakeholders on the way forward.
The most widely used narcotics drug worldwide continues to be marijuana, with an estimated 188 million people have used the drug in the previous year. The active users are ages of 15-64 of which about 45 million, 54 million and 57 million are in Africa, Asia and North America respectively. In Europe, five out of six countries that provided data on marijuana prevalence in 2017 also reported an increase in its usage. The overall global annual users of marijuana have increased by 30% over the period 1998 to 2017 (UNODC, 2019). And in Ghana, it is no secret that marijuana use for recreation has been on the ascendancy for some time now coupled with the use of other addictive drugs like tramadol, inter alia.
The recreational use of marijuana is prohibited in most countries of the world although a few have legalized with quite a number of them decriminalizing it usage, amidst an increasing call for its outright legalization. In December 2013, Uruguay became the first country in the world to legalize marijuana in all spheres (cultivation, production, distribution, possession and use). Subsequently, Bolivia and Peru also legalized not only marijuana but coca as well (the raw plant for producing cocaine). Other countries which have also legalized recreational marijuana include the Netherlands, Portugal, Spain, Poland, Czech Republic, Canada, some states in the US and South Africa in recent time.
Proponents of marijuana use such as Hogan et al (1970) conducted surveys comparing marijuana users with non-users in a college. They found out that users are more sociable, have a broader range of interests, more adventurous and more concerned with the feelings of others. Non-users, on the other hand, were found to be too deferential to external authority, narrow in their interests and over-controlled. Mary Lynn Marthe (2002) also claimed that those adolescents who experimented with drugs (primarily marijuana) were the “best-adjusted” compared to abstainers.
Marijuana as a herbal plant has been used as medicine since time immemorial. Samuel C. D. Hanu, a psychiatrist nurse at the Accra Psychiatric Hospital and a student of International Programme in Addiction Studies (IPAS) in an article titled “Legalization of Marijuana in Ghana: The Issues”, posits that the use of marijuana as medicine dates back to 2700 BC when the Chinese used it to cure maladies ranging from rheumatism to constipation.
He adds that 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, for example, physicians documented the therapeutic properties of the marijuana as early as 1840 to the extent that it was included in the US Pharmacopoeia, the official list of recognized medical drugs from 1850 to 1942.
Moreso, the Medical Service Workers Compensation Board in 2012 opines that smoking marijuana is reported to reduce intraocular pressure in glaucoma and to ameliorate pain, nausea, multiple sclerosis, spasticity and asthma. The Liberal Party of Canada Standing Policy Committee, a pro-legalization political party, in January 2013 claimed that Canadian doctors prescribe marijuana to more than 20,000 people to treat conditions ranging from Alzheimer’s, premenstrual syndrome, seizures and migraines to glaucoma, MS, OCD, ADD and HIV/AIDS.
Currently, there are about 30 countries that have legalised medical marijuana. In the US, for instance, the National Conference of State legislatures reported that as at March 2019, 33 states including the District of Columbia have legalized marijuana for medical purposes.
The marijuana plant species is one of the fastest-growing plant in the world. It can be processed into a variety of commercial and industrial purposes such as paper, textiles, shoes, clothing, cosmetics products, biodegradable plastics, paints, building materials, biofuel, animal feed and food. In 2009, a report by the RAND Corporation for the European Commission concluded that the global retail expenditures on marijuana ranged from €40-120 billion based on a global market of about 200 million consumers. The said report also estimated a €2.769 billion for the marijuana retail market in Canada and the World Drug Report, 2019 also claims that in the states of California, Colorado and Oregon alone the total sales of different marijuana products were estimated at $4.2 billion from January to November 2018.
In spite of the several positive uses of marijuana and its derivatives, there has been a significant increase in marijuana-related emergency room visits, hospital admissions and traffic deaths as well as instances of people driving under the influence of marijuana in the State of Colorado and other jurisdictions per the 2018 World Drug Report.
Marijuana on the Brain
When the drug ingest in the body, the THC acts upon specific molecular targets on the brain cells called cannabinoid receptors. These receptors are ordinarily activated by chemicals similar to THC called endocannabinoids such as anandamide. These naturally occurring in the body are part of a neural communication network called the endocannabinoid system. This system according to US National Institute on Drug Abuse (NIDA) plays an important role in normal brain development and function that influence pleasure, memory, thinking, concentration, sensory and time perception as well as coordinated movement.
Marijuana over activates the endocannabinoid system, causing the “high” and other effects that users experience. These include distorted perceptions, impaired coordination, difficulty with thinking and problem solving as well as disrupted learning and memory. It also mentions that those who use marijuana heavily in their teens lose 8 points in their Intelligence Quotient (IQ) when they are between age 13 and age 38 and that those lost cognitive abilities were not restored in those who even quit smoking marijuana as adults (NIDA, 2012).
Again, Health Canada (2014) also posits that marijuana use leads to loss of memory and creates learning problems. Dr Romina Mizrahi, also claims a well-replicated epidemiological study indicates a 2-4 fold of incidences of schizophrenia in early marijuana users as well as an increase in psychosis associated with marijuana use before age 15. Furthermore, it is estimated in the US that persons with mental illness are responsible for about 80% of all marijuana consumed.
Marijuana in the Heart
Marijuana raises heart rate by 20-100% shortly after smoking. This effect can last up to three hours. In one study, it was estimated that marijuana users have a 4.8-fold increase in the risk of a heart attack in the first hour after smoking the drug. This may be due to increased heart rate as well as the effects of marijuana on heart rhythms, causing palpitations and arrhythmias. This risk may be greater in older individuals or in those with cardiac vulnerabilities (NIDA, 2012). The World Federation against Drugs (2015) also claims that marijuana use can cause fatal damages to the heart and arteries.
Effects of Marijuana on the Lungs
Marijuana smoking, for instance, leads to the inhaling of carcinogens and carbon monoxide which creates health risks similar to or more than smoking tobacco. This leads to bronchitis, daily coughing, phlegm production, acute chest illness and other lung-related illnesses. Dr Kahan also pointed out that a forty-year study published in 2013 showed that frequent marijuana smoking is associated with two-fold increase in developing lung cancer. Other studies have also shown that many marijuana smokers absent themselves from work due to respiratory illness (NIDA, 2012).
Marijuana Use and Car Accidents
Marijuana has been found to be the most prevalent illicit drug detected in drivers in Canada, US, Europe and Oceania. Koerth-Baker (2014) examined that recent epidemiological studies have proven marijuana users who drive while under its influence are at an increased risk of motor vehicle crashes. The International Narcotics Control Board (2013) also indicates that habitual marijuana use is linked to a 9.5-fold greater risk of driving accidents. As a result, many countries/states which have legalised recreational marijuana include a prohibition on driving after its use.
Marijuana and Crime
According to the US National Crime Prevention Council (2006), the marijuana sold today is far stronger than it was two or three decades ago and for that matter more dangerous. The illicit marijuana markets continue to exist in many of the states that have legalized the non-medical use of the drug. This is especially evident in the US states of Colorado and Washington, which were among the first jurisdictions to allow such measures. Again, the US Office on Drug Control Policy claims that marijuana and violent crimes go hand in hand.
In other words, marijuana traffickers use violence and commit all sought of crimes in order to get the drug into the US market, among other places. It has also been asserted that most people who use other hard narcotic drugs such cocaine or heroin have first used marijuana therefore, serving as a gateway drug. Some studies have also indicated that substance misuse including marijuana is associated with suicide attempts and high risk-taking criminal acts such as rape, armed robbery and general violence.
Does Legalization Reduce Drug Prevalence?
Advocates of marijuana legalization argue that when the drug is legalized and regulated it leads to a decrease in its use as well as its negative consequences. For instance, the International Centre for Science in Drug Policy posits that the legal status inter alia has at most a marginal impact on the prevalence of its use, hence will not lead to a higher level of marijuana use. Nevertheless, the 2019 World Drug Report indicates that in North America, specifically Canada and some states in the US, where marijuana has been legalized have shown a drastic surge in its prevalence for the past years.
Thus, in the US, the number of past-year users of marijuana rose by some 60% between 2007 and 2017, while the number of daily or nearly daily users of marijuana more than doubled over the period. In Colorado, in particular, the quantity of marijuana used by annual users saw a sharp increase over the period 2014–2017, that is, 56% in four years. Again, in Canada, marijuana use from 2004 to 2012 was about 9% per annum but increased to a gargantuan 40% between 2013 to 2017 due to the decrease in perception about marijuana disorders and the national debate about its legalization.
More so, in Europe among the six countries that provided data on cannabis use in 2017 namely: France, Italy, Spain, Czech Republic, Netherlands and Switzerland, five reported an increase since the last survey. In Uruguay, the project Monitor Cannabis Uruguay implemented a drug use survey in 2017 which showed that annual prevalence of marijuana was 15% among the adult population aged 15–64 as compared to 9.3% in some previous survey in 2014.
Calls for Decriminalization
Another measure which has been advocated for as a middle way between legalisation and criminalisation is the issue of decriminalization. Such proponents include the late Kofi Annan, former UN Secretary-General, the former Nigerian President Olusegun Obasanjo, Yaw Akrasi Sarpong, former Executive Secretary of the Narcotics Control Board of Ghana, among other prominent statesmen. Decriminalization is the removal of punishments such as incarceration and other harsh penalties for marijuana offences such as usage and possession.
It is not synonymous to legalization because the offences still remain prohibited. It is meant to afford drug users and a person with drug use disorders the option of entering into voluntarily evidence-based drug treatment services at recognized rehab centres as an alternative to a prison sentence. Hence, public health and harm reduction approach to the war on drugs. The UNODC reports that drug use and drug use disorders are highly prevalent among people who are incarcerated which comes with its health hazard of transmission of infectious diseases like hepatitis B & C, HIV/AIDS, etc.
The evolving trends relating to recreational, medical and commercial-industrial marijuana use and the rapidly expanding global marijuana market has spurred understanding of the need for more research and consistent data in this regard. In Ghana, firstly, there is the urgent need for evidence-based data collection, analysis and research on the various marijuana species prevalent in the country. Additionally, the different marijuana products, their potency, personal health effects and use, public health impact including medicinal marijuana should be deeply researched to identify the facts behind them.
Lastly, the swift passage of the new Narcotic Control Commission Bill, 2019 coupled with a comprehensive drug policy on the fight against substance abuse and illicit drug trafficking would go a long way in addressing the marijuana problem confronting the nation. The aforementioned measures should be conditions precedent before any agitation for legalisation can be thought of and not jump onto the bandwagon and clarion call for legalization in order to save the moral fibre of the Ghanaian society since not all that glitters is gold. And as Billy Graham succinctly puts it: “If you lose wealth, nothing is lost. If you lose health, something is lost. If you lose character, all is lost.”
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