Mounting pressure to legalise bhang over its medicinal value

By PATRICK MATHANGANI

Scientists at the University of Nairobi are working on what could be a major breakthrough in treating the brain — using bhang to ferry medicine into its much-protected cells.

They figure that the ingredient responsible for the highs experienced by marijuana smokers could just be the right vehicle to carry medicine into the brain, which is so fortified with fatty cells that most drugs won’t penetrate its walls.

This has been a huge problem for doctors and researchers.

Known as THC, the chemical is highly soluble in fats and readily penetrates the brain, giving users a euphoric feeling as soon as they inhale bhang. The process being tried involves bonding antibiotics into THC. The brain easily disposes of the chemical if it enters in small amounts.

Once this is injected into the body, the THC rushes into the brain and releases the antibiotic. The brain then disposes of it. If  it works, millions of patients with brain problems could benefit from drugs that have for long been ineffective because they could not access the brain.

Marijuana use is illegal in Kenya, and even accessing it was no walk in the park for scientists. The bhang being used was obtained from a police station in Nakuru, where it had been kept after it was seized from traffickers.

“If it works, it will help in treating a lot of brain problems,” said Prof Jacob Midiwo, who is supervising the research. “It will be a very big breakthrough in brain science.”

The research comes at a time when debate on legalisation and decriminalisation of marijuana is raging. Scientists have found more than a dozen positive attributes for the much-maligned herb, and some countries are considering legalising it.

The World Health Organisation identifies therapeutic use of cannabis that includes treatment of asthma and glaucoma, stimulation of appetite and treatment of convulsions. Research has shown it could be used to alleviate nausea and throwing up.

It has been recommended as a painkiller for terminally ill patients, including those with cancer. However, the WHO also warns of its negative effects.

Prof Midiwo is, however, totally opposed to decriminalisation.

“There is always a chance of abuse,” he said. “The best thing is to restrict access. If you don’t, then people are going to abuse it, especially young people.”

Cannabis is more dangerous than tobacco, he said, observing it ultimately alters the brain functions of everyone who uses it.

However, scientists should be allowed to grow their own marijuana for research purposes, he added. “If you look at the balance, THC is more dangerous than beneficial. There are psychological effects it has that damage other cells,” he said. “Long time use leads to someone behaving as if they are crazy.”

Known as the miracle plant for thousands of years, marijuana is one of the most controversial natural herbs. It has attracted critics and defenders in equal measure.

The weed has mainly been blamed for causing psychotic behaviour, and has been thought to trigger schizophrenia. This is one of the most severe mental illnesses.

Other effects include hallucinations, impairing brain functions, airway injury, lung infections and lowering IQ. Some researchers also says it increases risk on bronchitis. 

Scientists are divided down the middle on the use of the drug, which is now grown in all continents and used by up to 224 million people worldwide, according to the UN.

One tough-talking group regards recreational use of marijuana as totally unacceptable. In Kenya, few have taken a liberal view following research indicating it can be put to good use for humanity.

One such person is Dr Lukoye Atwoli, a psychiatrist with more than ten years experience treating mental disorders in Kenya. For Dr Atwoli, cannabis has been unfairly demonised, yet some legal drugs such as alcohol and cigarettes have far much worse effects on health and society.

Dr Atwoli’s research on substance abuse and trauma has been published in several peer-reviewed journals. While many medical doctors declare decriminalisation of marijuana as a no-no, Dr Atwoli says much of the hype and fear spread about its use is based on ignorance.

He says many patients with mental illness turn to drugs as a desperate form of self-medication. Some research has suggested that many people turn to drugs because they are mentally ill.

“Many relatives of young people with mental illness think their sons are using cannabis,” he said. “However, I find that many were actually sick before they started using it. We are blaming cannabis unfairly in my view.”

Adds Dr Atwoli: “There are more burdens associated with alcohol — lungs, addiction, broken homes. The tobacco burden is huge. We spend billions in Kenya treating tobacco-related diseases.”

He makes his stand clear on decriminalisation: “We are spending a lot of resources chasing people with three rolls of bhang. Chasing people who have cannabis is really a waste of resources. Even people who are sick end up in jail instead of hospitals.”

For him, recreational use of cannabis would not cause as much damage to society as recreational use of alcohol and cigarettes.  The United Nations Office on Drugs and Crime says up to four per cent of Kenyans were using cannabis in 2010, representing about 1.6 million people.

Proponents of decriminalisation opoint to the irony of allowing the sale of tobacco, a killer drug responsible for the suffering of millions of people worldwide. Research on marijuana and mortality has been inconclusive.

According to the World Health Organisation, tobacco kills up to half of its users, translating to six million people every year.

“More than five million (of these) are from direct tobacco use and more than 600,000 are non-smokers exposed to secondhand smoke. Unless urgent action is taken, the annual death toll could rise to more than eight million by 2030,” says the WHO. Most of these deaths are as a result of cancer, with Kenya reporting 18,000 new cases annually, according to government figures.

The UN body says the tobacco epidemic “is one of the biggest public health threats the world has ever faced.” There are about one billion tobacco users globally, compared to 224 million cannabis smokers.

A Nacada report titled Rapid Situation Assessment of the Status of Drug and Substance Abuse in Kenya and released in December showed 16.7 of respondents have used a tobacco product. Thirty per cent of tobacco users develop lung cancer. Nicotine, the active ingredient in tobacco, is toxic to humans and has been used to make insecticides.

Alcohol  is also listed as one of the most abused drugs in Kenya. Nacada’s survey showed 13.6 per cent of Kenyans aged between 15 and 65 drink alcohol. That translates to 5.4 million people.

Although it is legal, alcohol’s effects have been devastating to the nation. It has been blamed for traffic accidents by drink-drivers. It also causes liver diseases, raises risk of cancers, pancreatis, diabetes, heart disease, causes dependence and the breakup of homes. It is riskier when used together with tobacco.

“I’m disturbed by the message being passed about cannabis,” said Dr Catherine Syengo Mutisya, a consultant psychiatrist and deputy medical superintendent at Mathari Hospital. “Research has strongly suggested that there is a clear link between early cannabis use and later mental health problems in those with a genetic vulnerability and that there is a particular issue with the use of cannabis by adolescents.”

Up to 70 per cent of young people who seek help for mental problems at the hospital had smoked marijuana, she said.

“From our experience, the young people who have psychosis have used cannabis. We see it as a culprit because for many of them, they have no family history of mental illness.” Doctors there have seen a similar pattern for patients with schizophrenia, she added.

However, she is opposed to sending drug users to jail.

Under Kenyan law, possession of bhang for personal use attracts less sentences than possessing other narcotics. The law prescribes a sentence of ten years for the possession of bhang, and 20 years for other narcotics. This is according to the Narcotic Drugs and Psychotropic Substances (Control) of 1994.

“Taking people to prison is not the right thing to do,” Dr Mutisya said. “The best thing is to counsel them; these are people who need help.”

Some states in the US have decriminalised the use of cannabis for personal and medical reasons. Other states allow only possession, but not sale of the drug. Last month, the state of Colorado allowed sale of marijuana to adults, but under strict regulation.

Prof Abiy Yenesew, who has studied properties of local herbs, says the world is increasingly accepting the medicinal values of marijuana. Although used for more than 10,000 years for medicinal purposes, it is only recently that its use in medicine has been debated.

It has a huge potential in supplying raw material for human medicine, he added.

But he says it would be too early for Kenya to allow recreational use of marijuana. The level of education and awareness among the public is too low. But it would also be wrong to condemn the herb for just one compound, while hundreds more found in it are beneficial.

“The debate should continue,” he said. “The medics should have a choice to be able to use these drugs where other drugs recognised by this country fail. That alternative should not be denied to practitioners.”