ILL AND NEED MARIJUANA? HEAD SOUTH TO RWANDA

It could be the first step in fulfilling the hazy dream of many a
reggae artiste.

Marijuana, considered as dangerous as cocaine and heroin in the
statute books, remains illegal in all East African countries.

However, this may change. In June last year, Rwanda took the initial
steps in legalising marijuana strictly for medical purposes, the
first country in Africa to do so.

The proposed law provides that marijuana will only be administered in
health institutions to relieve pain or to treat mental problems.

Rwanda's Minister of Health, Dr Richard Sezibera while presenting the
draft law to Parliament, said that the objective of the Bill was to
contribute to the protection of the population while "ensuring that
drugs and psychotropic substances are exclusively available for
scientific and medical purposes".

If the Bill passes into law, Rwanda will join the ranks of countries
such as Belgium and Canada, where, with a doctor's prescription,
patients are allowed to possess a small amount of the drug to
alleviate chronic debilitating symptoms such as neuropathic pain and
side effects of chemotherapy.

The implications of the move in the region are potentially far-reaching.

It is speculated that with the greater availability of a relatively
affordable pain treatment that medical marijuana offers, Rwanda could
conceivably become the hospice care capital of East Africa, in a
region where specialised care and anti-pain medication for the
terminally ill is often out of reach of most patients.

The attempt is not without controversy, however, and it is feared
that the assent of the Bill into law could have other unintended
spillover effects in the region.

To conservatives, the Bill presents a potential "slippery slope": an
initially innocuous move that could disrupt the drug market in the
region, creating a demand that other East African countries -- where
marijuana remains illegal -- would be eager to come in and fill,
possibly resulting in the smuggling of the drug into Rwanda from the
wider East African region.

Cannabis, often seen as an entry point to hard drugs, remains the
most widely used illicit substance in the world.

Globally, the number of people who had used cannabis at least once in
2008 is estimated to be between 129 million and 191 million, or 2.9
per cent to 4.3 per cent of the world population aged 15 to 64.

Worldwide, cannabis seizures amounted to 4,600 metric tonnes in 2008.
Cannabis herb is also the most widely trafficked substance in terms
of volume and geographical spread.

Figures indicating marijuana use in East Africa are scanty, but
according to the 2010 World Drug Report compiled by the UN Office on
Drugs and Crime (UNODC), it is estimated between 4.5 million and 9.19
million people in East Africa used the drug at least once in 2008,
representing between 3.4 per cent and 7 per cent of the population
aged between 15 and 64.

According to the UNODC, in East Africa, fairly large-scale cannabis
cultivation occurs in Kenya and Uganda, primarily in the Lake
Victoria basin, the Mt Elgon region, in the central highlands around
Mt. Kenya and along the coast.

As much as 1,500 hectares of cannabis are estimated to be cultivated
in this area, some in the lower farmlands concealed among traditional
crops and some in higher altitude areas regarded as national wildlife reserves.

According to official reports, 80 per cent of the cannabis in
Tanzania is grown domestically, with 20 per cent being imported from Malawi.

Ninety per cent of locally produced cannabis in Tanzania is consumed locally.

The medicinal use of marijuana is legal in a number of countries
including Belgium, Canada, the Netherlands, the Czech Republic,
Israel, and 15 states in the US.

No African country has legalised the use of the drug even for
medicinal purposes, and jail terms can be as long as 10 years for
possession, and 20 years for distribution.

In attempting to legalise the drug strictly for medicinal purposes,
Rwanda may well be following in the footsteps of California in the
US, where the drug was made legal in 1996 and an entire industry
sprouted up around medical marijuana.

There, patients can grow, possess and use marijuana for medicinal
purposes, after securing a doctor's recommendation.

A patient's primary caregiver may also provide marijuana, though many
patients turn to marijuana dispensaries to obtain the drug.

A patient with a note from his or her doctor can also grow up to six
plants or possess no more than half an ounce of marijuana.

But individual counties can also set their own regulations, causing
some to relax their standards even further.

Because of these relatively liberal regulations, numerous medical
marijuana dispensaries operate throughout the state in accordance
with state law.

However, growers, dispensaries and other middlemen often come into
conflict with the US federal government and federal law enforcement
agencies, under whose jurisdiction the drug remains illegal.

In a medical setting, marijuana is used to treat nausea especially as
a result of chemotherapy, loss of appetite, chronic pain, anxiety,
arthritis, glaucoma, multiple sclerosis, insomnia, epilepsy,
inflammation and migraines, among other conditions.

The drug is also used to ease pain and improve quality of life for
people who are terminally ill, such as those with cancer and Aids patients.

Critics of the use of medical marijuana often raise the question: Why
turn to marijuana for medical reasons when other legal medications
are available?

Supporters respond that patients do not simply use cannabis for the "high".

They argue that laws that authorise marijuana use for medical
purposes work on the premise that certain symptoms and diseases can
best be treated with marijuana.

Marijuana advocates argue that marijuana has been shown to decrease
nausea and increase appetite, which can be essential for cancer and
Aids patients who are having difficulty keeping down food or
maintaining adequate nutrition.

For glaucoma sufferers, marijuana helps to lower intraocular eye pressure.

Also, some types of pain, such as peripheral neuropathy, respond
better to marijuana than conventional pain relievers.

An extensive body of research exists surrounding the medicinal value
of marijuana.

Much of it revolves around delta-9-tetrahydrocannabinol (THC), one of
the cannabinoids in marijuana.

THC is what causes people to feel "high" and also what gives cannabis
some of its medicinal properties, such as increased appetite.

According to a number of papers published by scientific journal
Nature, the human body produces endocannabinoids, its own natural
version of cannabinoids.

The body will produce endocannabinoids when needed, but most of the
time, their effect is very shortlived.

Endocannabinoid receptors are found throughout the body but are
especially prominent in the brain.

The cannabinoids in marijuana, like THC, bind to these receptors,
producing various effects, some medicinal, such as reducing pain or
anxiety, but also the feeling of being high.

Besides its medical uses, research has shown that cannabinoids slow
down the development of certain cancers.

Medical research has focused on how to extract the medical benefits
of cannabis without producing intoxication.

For example, Marinol is used for treatment of nausea in cancer and
Aids patients.

Marinol is considered a legal alternative to marijuana, much in the
way that morphine, extracted from opium, is a legal, alternative to
smoking opium or heroin.

Nevertheless, the use of Marinol has been deemed less effective and
more expensive than marijuana.

According to the US-based lobby group the National Organisation for
the Reform of Marijuana Laws, Marinol lacks some of the compounds
that make marijuana medically beneficial.

In addition, smoking herbal marijuana provides patients with a faster
acting medication.

Marinol may also be more psychoactive than natural cannabis and
present its own set of side effects.

Marinol's oral route of administration is partly for its heightened
psychoactivity compared to inhaled cannabis as it is metabolised in
the liver into chemicals that can be up to five times more potent
than natural THC.