Medical cannabis and cannabidiol: A new harvest for Malawi

In February 2020 parliament passed the Cannabis Regulation Bill (2020) which regulates the cultivation and production of industrial hemp and medical cannabis. The country will only fully benefit from this development if the medical and scientific community can take the lead in enabling the country to exploit the plant's potential to help address some of our economic and public health challenges. This special communication provides some basic information on cannabis and discusses its history and medical uses. Cannabidiol (CBD) has emerged as one of the most important cannabis-derived phytochemicals and has formed the basis for the growth of the medical cannabis industry. The scientific data on the mechanisms of the effects of CBD on the human neuroendocrine-immune network is reviewed and the first effective cannabis-based FDA-approved treatment for epilepsy discussed. Some clinical research that is being done on the antipsychotic and neuroprotective properties of CBD is also reviewed. A case is made for the potential of CBD as a neuroprotective adjunctive therapy for the prevention of neuropsychological sequelae associated with complicated malaria. The safety profile of CBD is reviewed and finally, the potential importance of the re-medicalization of cannabis-based therapies for the broader field of phytomedicine is pointed out

Drug use among youth and adults in a population-based survey in South Africa

Objective: Illicit drug use is a growing public health problem. The aim of the study was to assess the prevalence of drug use and the sociodemographic and health characteristics that influence it among young and adult South Africans. Methods: Data based on the South African national population-based survey in 2012 for 26453 individuals (52.0% women and 48.0% men) aged 15 years and older were analysed. Past 3-month drug use was assessed with the 'Alcohol, Smoking and Substance use Involvement Screening Test (ASSIST)'. Bivariate and multivariable logistic regression was conducted to assess the association between sociodemographic factors, health variables and any past 3-month drug use. Results: Overall, any past 3-month drug use was 4.4%, 7.9% among men and 1.3% among women. The proportion of past 3-month cannabis use was 4.0%, followed by sedatives or sleeping pills 0.4%, amphetamine-type stimulants 0.3%, cocaine 0.3%, opiates 0.3%, inhalants 0.2% and hallucinogens 0.1%. Among the nine South African provinces, any past 3-month drug use was the highest in the Western Cape (7.1%), followed by the Free State (6.3%) and Northern Cape (5.2%). In adjusted, multivariable, logistic regression analysis among both men and women, younger age, being mixed race and hazardous or harmful alcohol use were associated with any past 3-month drug use. In addition, having been a victim of violent crime and sexual risk behaviour among men and having psychological distress among women were associated with any past 3-month drug use. Conclusion: An increase of any past 3-month drug use from 3.7% in 2008 to 4.4% in 2012 was observed in South Africa. Prevention and intervention activities targeting drug use, in particular in identified risk groups, need to be strengthened in South Africa

Comparaison de deux techniques de dépistage urinaire du 11-nor-9-carboxy-delta 9­tetrahydrocanabinol (THC-COOH): Immunochimie (EMIT) versus chromatographie en phase gazeuse couplée à la spectrométrie de masse (CPG-SM)

Introduction: La consommation du cannabis est un fléau social dont les effets psychiques dominent sa toxicité. Une analyse toxicologique fiable avec une technique performante s'avère indispensable pourun diagnostic rapide et correct de la toxicomanie en particulier chez les jeunes.Objectif: Comparer les performances de l'immuno-analyse (EMIT) et la chromatographie en phase gazeuse couplée à la spectrométrie de masse (CPG-SM); utilisées pour le dépistage urinaire du11-nor-9-carboxy-delta 9-tetrahydrocanabinol (THC-COOH).Matériel & Méthodes: 42échantillons urinaires provenant des consultants du centre de psychiatrie ont été soumis à un dépistage du THC-COOH par EMIT et CPG-SM.Résultats: L'analyse des urines par EMIT a révélé 12 cas positifs (29%) et 30 négatifs (71%), par contre celle par CPG-SM a donné 13 cas positifs (31%) et 29 négatifs (69%). L'étude comparative entre les deux techniques a montré 5 faux positifs (11,91%) et 6 faux négatifs (14,28%).Discussion: 7 cas positifs (16,67%) et 24 négatifs (57,14%) par les deux techniques analytiques, 6 cas négatifs par EMIT et positifs par CPG-SM (14,28%) et 5 cas positifs par EMIT et négatifs par CPG-SM (11,91%).La sensibilité à 53% s'explique par le cut-off de l'EMIT à 50 ng/mL. EMIT présente une spécificitéde17% liée aux réactions croisées.Conclusion: L'importance des réactions croisées avec EMIT illustre la nécessité d'une démarche de confirmation d'un résultat positif au THC-COOH par CPG-SM car elle est plus spécifique et plus sensible. Les performances des techniques utilisées dans les laboratoires de toxicologie doivent être parfaitement maîtrisées en vue d'une interprétation correcte

Cannabis use predicts shorter duration of untreated psychosis and lower levels of negative symptoms in first-episode psychosis: a South African study

Objective: Cannabis use/abuse is a common co-morbid problem in patients experiencing a first episode of psychotic illness (FEP). The relationship between the clinical presentation of FEP and cannabis abuse is complex and warrants further investigation; especially within the South African context. Method: We tested associations between recent/current cannabis use and duration of untreated psychosis (DUP); age of onset (AO); PANSS-rated (Positive and Negative Syndrome Scale) positive; negative and general psychopathology symptoms and depressive symptoms (Calgary Depression Scale for Schizophrenia) in a sample of 54 patients with FEP. Results: Mean DUP was 34.4 weeks; while mean AO was 24.7 years. Co-morbid cannabis use occurred in 35of the sample and was significantly associated with shorter DUP (Mann-Whitney U; p=0.026). While not significant; there was also a trend association between cannabis use and lower negative symptoms (Mann-Whitney U; p=0.051). Conclusion: Current/recent cannabis use was associated with clinical features of psychosis onset that previously have been associated with better outcome. Medium and long-term outcome for cannabis users however; is likely to depend on whether or not cannabis use is ongoing

Illicit drug use in South Africa: Findings from a 2008 national population-based survey

Objective. The aim of this secondary analysis of the South African National HIV; Incidence; Behaviour and Communication (SABSSM) 2008 survey is to provide current data on illicit drug use that could assist in the development and implementation of effective substance abuse policies and intervention programmes aimed at these populations in South Africa.Method. A multistage random population sample of 15 828 people age ?15 (56.3 women) was included in the survey. Illicit drug use was assessed by 2 sections of the Alcohol; Smoking and Substance use Involvement Screening Test (ASSIST). Frequency analyses for different age groups; geolocality; educational level; income; and population group were calculated; as were odds ratios for these variables regarding combined illicit drug use.Results. Current cannabis use was reported by 3.3 of the population sample - 6.1 of the men and 1.2 of the women - and the use of combined all-other illicit drugs (cocaine; amphetamines; inhalants; sedatives; hallucinogens; opiates) was reported by 1.8 of the participants. Coloured men (14.3) were most likely; and Indian or Asian women (0.6) least likely; to be cannabis users. Illicit drug use (combined) among men was associated with the 20 - 34 year age group and the coloured and white population groups; and among women in the younger age groups; the coloured and white population groups; and low and higher income.Conclusion. An increase of cannabis and other illicit drug prevalence rates was observed from 2005 (2.1) to 2008 (3.3) in the population sample. Multilevel interventions are required to target illicit drug users; in addition to creating awareness in the general population of the problems associated with illicit drug use. There is a need to address illicit drug use in national and provincial policy planning and intervention efforts and; in terms of treatment; a need to ensure that treatment practitioners are adequately trained to address illicit drug use. Future prospective studies are necessary to assess the impact of illicit drug use

Cannabis publication analysis using density-equalising mapping and research output benchmarking

Background. Cannabis has been a topic of political and medical controversy in many countries over the past century. Although many publications on this topic are available, there is currently no comprehensive evaluation of global research activities in the field. Objective. This study was conducted in order to provide a quantitative and qualitative analysis of the worldwide research output on cannabis. Methods. In a quantitative approach, items concerning cannabis published between 1900 and 2008 were retrieved from the ISI Web of Science databases developed by the Thompson Institute of Scientific Information and analysed using scientometric methods. In a second step, research fields of growing interest were identified. Results. We found that publications on this topic increased during the late 1960s, as well as during the period 1990 - 2008. We noted that South Africa was one of the countries with a high research output; having published numerous articles on cannabis. A comparison of cannabis with other drugs (e.g. alcohol, tobacco, cocaine and heroin) showed that in relation to the proportion of respective drug users, cocaine and heroin are overly represented in terms of research output. When analysing the main subjects of the publications; psychiatry was prominent, especially with regard to research on psychosis. Conclusion. There is increasing interest in research on cannabis. The research only partially reflects the drug's importance with regard to number of users

Haematotoxic evaluation of crude cannabis resin in rats

After chronic administration of crude Cannabisresin (CCR); (20 mg/kg and 40 mg/kg) to Spraque-Dawley albino rats for 21 days; the changes in various haematological indices such as packed cell volume (PVC); total leukocyte count; differential leukocyte count; red blood cell (RBC) count; absolute lymphocyte count; monocyte count; neutrophils and eosinophil counts were evaluated. The results show that the haematological indices such as erythrocytic and leucocytic counts were not significantly (P 0.05) affected by the treatment with the crude cannabinoid resin treated animal groups for the first two weeks of treatment. However in the third week; results showed significant increases (P 0.05) in the above mentioned indices while eosinophils disappeared from the blood of treated groups. It can be concluded from this study that chronic administration of CCR at high doses (above 20mg/Kg) to rats has slight haematotoxic potentials

Cannabisme et troubles mentaux en milieu rural zairois : aspects epidemiologiques

La recherche de facteurs etiologiques des troubles mentaux montre que la consommation du cannabis est l'un des facteurs de risque de troubles du comportement en milieu rural zairois. Une enquete etiologique preliminaire portant sur 156 patients soignes au Centre Neuro-Psycho-Pathologique de Kitwambi donne une incidence du cannabisme de 13 pour cent et permet d'esquisser le profil epidemiologique du cannabisme a haut risque de troubles du comportement en milieu rural. Il s'agit surtout des jeunes adultes; de sexe masculin; celibataires; plus ou moins instruits; s'adonnant aux travaux durs ou des eleves; associant souvent le cannabis a l'alcool et au tabac. Les tableaux cliniques sont domines par les acces psychotiques aigus: acces maniaque; depression; bouffee delirante; confusion mentale aigue: 85 pour cent des cas. Les observations des auteurs denotent le role important de facteurs socio-culturels dans la genese des troubles