39-year-old Samuel, a mental health patient, arrived at the Psychiatric department of the Korle-Bu Teaching Hospital with symptoms of temporary confusion, a staring spell and lethargy. He appeared anxious, aggressive, wild and starring around to engage and fight anyone who dared to cross his path. Finally, two male nurses held him down and injected him to calm down and sleep eventually. Samuel’s elder sister – Charlotte, and cousin – Daniel, expressed fear over their brother’s illness. They revealed that for years, Samuel had been a chronic drug abuser, and it is getting worse each day.
“He keeps smoking marijuana day after day, and when you complain about it, he insults you. He is violent toward friends and family sometimes. The use of cannabis for him is like having fun. He sold most of what he owned to buy cannabis and other hard drugs,” the patient’s relatives stressed.
Doctors attending to Samuel debated what led to his interest in the use of drugs, as they quizzed the relatives for further insights. The habit started when Samuel lost his job, could not bear the pain, and resorted to taking alcohol and smoking cannabis. He is currently undergoing rehabilitation at an undisclosed location because of the stigma people associate with mental health issues.
Reports on the health benefits of cannabis worldwide have become a relevant topic of discussion, hence, a call for critical dialogue.
In 2019, the World Health Organisation’s Expert Committee on Drugs Dependence (ECDD) published the results of a detailed review of the evidence around cannabis. As a result, the Committee recommended the removal of Cannabis from ‘Schedule IV’ of the 1961 UN Convention on Narcotic Drugs. The move acknowledges that cannabis has ‘substantial therapeutic components for treating pain and other medical conditions, including epilepsy and spasticity associated with multiple sclerosis.
Also, there has been a lot of confusion in the media about incorporating some special provisions relating to cannabis. According to WHO, research findings prove that Cannabis products contain 0.3 percent of tetrahydrocannabinol (THC), which is essential for industrial, medical and research purposes.
Ghana added its voice to the call to provide an alternative to incarceration for people who use drugs. In 2020, the country’s Parliament passed the Narcotics Control Commission Bill. The bill decriminalised cannabis for health and industrial purposes, and brought a lot of excitement to many players who had followed the legislative process since its introduction in 2015.
In addition, for many civil society organisations (CSOs) in Ghana, the moment was significant in the country’s history of drug policy reform. They applauded the government for the initiative. The new law will provide a more humane drug policy and allow other good examples to emerge in Africa. Ghana’s new drug law, among other things, would help to treat drug use and dependence as a public health issue. Furthermore, the prison term for drug possession for personal use was converted to a fine of between 200-500 penalty units (translating to GH¢2,400 – 6,000).
However, it does not mean that drug use is legalised. Instead of sending people to prison for up to 10 years for simple possession of drugs for personal use, they will offer alternatives to incarceration, in line with the ‘Justice for All’ programme instituted in 2007 – a notable policy to help decongest Ghana’s prisons.
Though under the old law, people were put behind bars for possession of 1 or 2 rolls of marijuana, the consumption of all kinds of drugs kept increasing. Unreasonably suppressive drug control and use approaches have not eradicated drug markets and related harms. Instead, such policies have led to grave consequences for the poor and marginalized, while creating a rich and powerful criminal market.
Ghana’s readiness to Commercialise ‘Wee’ for Foreign Exchange
Has Ghana shown a lot of commitment to commercialising cannabis ‘Wee’, which can provide economic gains for the country?
It is a known fact that some farmers cultivate cannabis for a living. And with the passage of the Narcotics Bill into law, they were hoping to be allowed to grow it in commercial quantities.
Many scholars and well-respected citizens in society are very optimistic the time has come for the Cannabis debate to be revisited.
In September 2021, a Court of Appeal Judge, Justice Bright Mensah, called for the need to commercialise cannabis for economic gains. Speaking at a two-day workshop on the Narcotics Control Commission Act 2020 (ACT 1019) in Accra, he had noted that cannabis could be exported to countries that need it the most to fetch foreign exchange for Ghana. The law allows for specialised cannabis for industrial use but not recreational purposes, and strict control of cultivation and usage. According to Judge Mensah, even though the Narcotics Act aims to decriminalise the abuse of drugs, section 43 of the Act does not remove the unlawful abuse of narcotics.
On his part, Mr. Michael Addo, the Deputy Director of Narcotics Control Commission (NARCOC) in charge of enforcement, had opined that drug use remains an offense under the Act, saying that: “Section 46 of the Act gives discretion to the judge to impose a fine on problematic drug users or refer the patient to a rehabilitation facility. Persons who abuse narcotics require counseling and treatment but not incarceration”. Mr. Addo had appealed to the public to show love to problematic drug users to be rehabilitated and socially integrated into society. The Minister of Health, Kwaku Agyeman-Manu, had assured that government will work with the organisation to mobilise funds to establish a rehabilitation centre.
Throughout the world, the streets are home to millions of youths. The conditions on the street render them vulnerable to various psychological problems and health risks, such as a high rate of the sex trade, and substance abuse and misuse. These behaviours ultimately put them at increased risk for physical and mental health problems, including sexually transmitted infections (STIs).
Drug abuse is a social canker, with an alarming rate among the youth due to high unemployment rate and the frustrations of highly qualified students not having access to further education and jobs. However, the primary drug usually abused in Ghana is Marijuana, and the age of incidence of abuse is relatively low, that is between 10 -12 years, primarily due to experimentation.
World Health Organisation’s statistics disclose that globally, an estimated 246million people used drugs in 2013, and around 27million had drug use disorders. In addition, about 400,000 people die of Illicit drug use every year, and it is a risk factor for multiple health conditions such as blood-borne infections, road traffic injuries and suicide. However, World Drug Report 2019 revealed that 35million people worldwide suffer from drug use disorders, while only 1 in 7 people receive treatment.
According to the report, the number of opioid users was an estimated 53million, which has increased by 56 percent from previous estimates. Opioids are responsible for two-thirds of the 585,000 people who died because of drug use in 2017. In addition, about 11million people injected drugs in 2017 and out of that number, 1.4million lived with HIV, and 5.6million with hepatitis C.
Ghana’s example shows that civil society and government can engage in dialogue to realign the countries’ priorities. This would ensure participation, advance sustainable development, and seek a brighter future for our youth.
Patients like Samuel need robust support systems with well-trained health professionals to track their progress after recovery. As our society continues to witness the frustrations of people suffering from depression and anxiety, the debate on drugs gets even more exciting.
On the one hand, when farmers cultivate cannabis commercially, Ghana would earn more foreign capital for developmental projects. We also join the likes of South Africa, Lesotho, Zambia, Uganda, Zimbabwe, Malawi, and Rwanda as the few African countries which have passed the narcotics bill into law. On the other hand is the challenge of implementation and controls. Can we maximise the economic benefits of cannabis while keeping our streets safe from the ills of drug abuse?
The debate continues ……
>>>the writer is a physician, entrepreneur, and policy-maker, passionate about improving the global healthcare landscape. He is the founder and CEO of Claron Health International, an innovative company facilitating the delivery of medical, preventative and digital health services across Ghana and Africa. He can be reached on [email protected]. LinkedIn: https://www.linkedin.com/in/dr-dennisaddo/