Cannabis

1
Cannabis

• Ziad Al-Najim
• March 2004

2
Contents

• Cannabis facts
• Effects
• Therapeutic use
• Re-classification
• School drug testing

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Cannabis sativaDelta-9-tetrahydrocannabinol (THC)
4
Facts

• Mid 1800s in UK, medicinal use until banned in
  1925
• 400 chemicals, 60 carcinogens
• Commonest illicit substance in UK (42 of 16-24yr
  tried it)
• Dependence lt alcohol and tobacco

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Effects

• Mainly via THC
• Chilled out/happy
• introspective drug
• Mild hallucinogen
• Low concentration Slow reaction S-T
  memory loss Cancer/lung dis (more
  tar) Psychiatric, subfertility

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Psychiatric Effects

• Adolescent cannabis use is a risk factor for
  developing adult schizophrenia, showed NZ study,
  BMJ Nov 02
• Prevalence of anxiety and depression increased
  with increasing cannabis use. Adolescent
  depression or anxiety does not predict cannabis
  use, found Australian cohort study, BMJ Nov 02

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Effects

• RCGP, 27th January 2004
• Calls for health risks of cannabis to be
  debated. No views on legalisation, but It is a
  credit to the pro-cannabis debate that the
  legalisation issue has proved such an effective
  smoke screen to health risks associated with
  the drug

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Therapeutic Use

• MS, pain control, glaucoma, arthritis
• Still illegal
• Under research
• Home Office granted a licence to GW
  Pharmaceuticals

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Therapeutic Use

• Qualitative systemic review of RCTs on the pain
  relieving effects of cannabinoid BMJ July 2001
• 9 trials, 222 patients
• Same effect as 60mg codeine for post-op pain and
  spasticity. Side effects limited use

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Therapeutic Use

• Cannabinoids for control of chemotherapy induced
  nausea vomiting, quantitative systemic review
  BMJ July 2001
• 30 RCT, 1400 patients
• Better in first 24hr but more side effects

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The Canada Situation

• Growing and use is legal for personal use in the
  terminally or seriously ill
• Only when conventional treatment doesnt work,
  and doctor approves
• Not supported by CMA because no scientific
  evidence

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Re-classification

• Classes
• A cocaine, heroine, ecstacy
• B speed
• C Cannabis, valium, anabolic steroids

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Why?

• Advisory Council on the Misuse of Drugs
  recommendation to Home Secretary in 2002
• Gov accepted bec
• Law should reflect that cannabis is not as
  harmful
• Help convey effective and credible message to
  young people about dangers of misusing drugs
• Help police focus greater resources on priority
  areas like dealing in Class A drugs

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What difference?
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Re-classification

• Common and socially tolerated, but the law
  criminalises it
• Millions of well-adjusted otherwise law abiding
  will no longer come to conflict with police
• Doesnt signify that cannabis is safer but sends
  wrong message
• Law infringes on human rights?

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Legalise or not?
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The Netherlands Experience

• Legal licensed outlets for personal use for 25yrs
• Supplies from criminal markets
• Fewer cannabis users and fewer hard drug addicts
  than UK
• Drug related crime and enforcement costs are
  significantly lower

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Conclusion

• Might well send wrong message re safety of
  cannabis
• Reflects more realistically how the law deals
  with cannabis
• Re-classification adds little to the argument of
  legalising cannabis

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School Random Drug Testing

• 22nd Feb 2004, Prime Minister says
• Head teachers will have powers to introduce
  random drug testing

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• Survey 13 of 15yr tried drugs
• Government promised to halve the number of young
  people using illegal drugs by 2008
• Designed to reassure parents

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• Guidance will be issued in March
• Government wants more police patrols inside
  schools with sniffer dogs available

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• Not compulsory, but to help Heads start a
  programme (power to treat, exclude or report to
  police)
• The issue of consent was not addressed
• Unclear what action would be taken against any
  child testing positive
• Not welcome by most teaching unions

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Conclusion

• A headline-grabbing initiative during time of
  crisis?
• Key for drug policy is to be digestible to young
  people and non-confrontational, rather than using
  criminal law against children

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Discussion

• Sample MEQ/oral
• Should cannabis be prescribable?
• Many would disagree, what do you think their
  concerns are?
• Would BMA support legalisation?