MARIKA SBOROS: Dressing up dagga in a business suit

Products containing cannabidiol (CBD) oil are suddenly all over the place, in SA and globally.

Should you buy and use them? That depends on who you speak to.

CBD is controversial, not just because it derives from the Cannabis sativa plant, which thrives in many areas of SA and is more commonly known as dagga. The plant also contains the psychoactive compound, tetrahydrocannabinol (THC).

Scientists have identified more than 100 active chemical compounds in cannabis, known as cannabinoids, with CBD and THC the most well-known.

Unlike THC, CBD won’t make you “high” and has fewer unwanted effects. And depending on the variety of the cannabis plant, extracted CBD content often includes traces of THC.

Ironically, compared to CBD, THC has far more research supporting benefits. Despite that, CBD is big business with attendant competing interests and conflicting research.

What is not in dispute is that you are spoilt for choice.

There are bath salts, soaps, shampoos, creams, soft and hard drinks (including beer), coffees, teas, foods, chocolates, popsicles and even dog biscuits all claiming to be infused with CBD oil.

There are also medicines, tinctures and herbal CBD supplements with claims of health benefits ranging from alleviation of cancer symptoms, erectile dysfunction and sleep problems to pain control.

Unsubstantiated health claims are where most CBD controversy originates.

Neon signs of industry growth are two industry-led events taking place this week. The Cannabis Expo 2019 runs at the Sandton Convention Centre from November 2-December 1. It includes a convention with panel discussions and presentations from “global industry leaders”. Tickets at the door for the full event cost R1,900.

The three-day Global Cannabis Dealmakers’ Conference at the V&A Waterfront ends on Tuesday. It carries a heftier price tag of $999 (about R14,800) for full access to the main event and $1,594 “all-in”.

Other signs are cannabis cultivation and product companies springing up faster than the weed itself.

There is now a Cannabis Development Council of SA (CDCSA), a self-regulating body of public and private-sector stakeholders. The CDCSA’s stated mission: to position the Eastern Cape as SA’s “pioneering cannabis agro-processing hub”.

There’s no doubting the oodles of boodle to be made from CBD.

Over-regulating CBD, an inherently safe drug that is difficult to produce or measure, is taking a microscopic view without the microscope.

—  Dr Marlon Germon

In the US, one wag called the CBD industry “the Wild West meets Wall Street”.  A report shows that sales of CBD products through health and wellness outlets reached $52.7m in 2018, triple that of 2017.

It is early days for the industry in SA but signs are auspicious despite worldwide concerns about the “dark” side.

A recent report in the Journal of the American Medical Association refers to CBD’s “murky status”. It raises questions about safety, efficacy, legality and whether CBD is a dietary supplement or a drug.

Research shows that CBD content often does not match product labels. In many cases, CBD content is too low to prove anything other than placebo. In other words, you’ll get zero therapeutic benefit.

Johannesburg GP Dr Marlon Germon also sees something “shady” about the industry. He and other medical doctors worldwide say it’s the logical conclusion of “prohibition” drug eras and the failed global “war on drugs” former US president Richard Nixon declared more than 48 years go.

That war gave rise to drug policies that are essentially “drug apartheid”, these doctors say. The terminology signals SA as a leader.

 “SA was the first country to outlaw the commercial cannabis trade,” says Germon.

It did so by “interweaving draconian policies of social division based on skin colour”. It used unscientific, racist policies of drug control to push for international prohibition as early as the 1920s.

Germon is a member of the International Drug Policy Consortium and travels the world to drug-policy events. He attended the 10th Conference on Cannabinoids in Medicine in Berlin earlier in November. Organised by the International Association for Cannabinoid Medicines, it attracted about 460 delegates, mostly medical doctors and scientists from 35 countries.

He works closely with the few medical doctors in SA brave enough to support legalisation of cannabis and fight drug apartheid openly.

Drug apartheid sanctions the sale and use of drugs proven dangerous but considered “socially acceptable”, Germon says. These include tobacco and alcohol but also sugar, caffeine and others.

It demonises a drug such as cannabis despite research showing that it is safer than tobacco and alcohol — and a whole lot safer than opioid and benzodiazepine drugs, he says.

It ignores that cannabis is socially acceptable in communities in SA and abroad.

The biggest problem, Germon says, is that industry, politics and money, not science, wisdom and compassion, drive drug policies.

Police chief Bheki Cele’s continued public insistence that dagga is a “dangerous gateway drug” doesn’t help. Neither does the legalisation of CBD before THC.

“That’s unscientific and a distraction from the real medicine,” says Germon.

CBD is really only clinically proven to treat childhood epilepsy, he says. It is no better or worse than other drugs available for pain relief. Many are not much better than placebo.

The problem is “big and small sharks swimming in the cannabis waters in SA”, Germon says.

There is a real risk that the CBD industry in SA will become “just another cartel like Big Pharma, with few companies controlling the wealth and regulations”.

Those views echo in the work of another Berlin conference speaker, Dutch biochemist Arno Hazekamp.

He is a full-time cannabis researcher within the Dutch medicinal cannabis programme, one of the world’s first legal programmes. He regularly calls for better regulatory control globally based on accurate labelling and more scientifically supported health claims.

Germon is also pushing for an external, central, reliable authority in SA checking products and claims, similar to the one being set up in the Netherlands. 

Cannabis control is not rocket narcotic science; it just requires looking at “the bigger picture, not just the non-psychoactive compound”, Germon says.

That bigger picture is that drug use in society cannot be stopped or prevented.

“Over-regulating CBD, an inherently safe drug that is difficult to produce or measure, is taking a microscopic view without the microscope,” he says.

“It’s everything else that comes with CBD that could be harmful, like pesticides or toxic solvents used during the extraction process. All the while, not focusing attention on inherently more harmful substances outside the field of vision.”

Germon wants all drugs legalised. It is the only way to destroy drug apartheid, black markets and the violence, death and destruction they spawn, he says.

He sees little chance of an integrative approach to CBD on the horizon in SA.

If there is to be one, it must include good science and “sharing the wealth and focusing on solving local health and socio-economic problems of most South Africans”, he says.

CBD in numbers

20mg — The maximum amount of CBD a product can contain for it to be legally sold as a health supplement without a prescription, according to standards published by the health ministry in May. Alternatively, the final processed product should contain no more than 0.0075% of CBD.

0.001% — The amount of THC a full-spectrum oil containing both CBD and THC is legally allowed to contain if being sold.

1kg — The estimated amount of cannabis plants (leaves, flowers and small stalks) with an average CBD percentage of 13% that you need to produce 100ml of full-spectrum oil. Once distilled, this can produce about 40ml of pure CBD oil.

R800 — The average price for a 10ml bottle of CBD oil (mixed with a carrier oil to comply with legal percentages). This price is dependent on the supplier, quality and concentration of the oil and may be much higher for purer oil and less for oil mixed with more carrier oil.

$39.1bn — The estimated increase in global legal cannabis spending between 2019 and 2024. (Source: Statista 2019)

Author: Sanet Oberholzer

Disclaimer: All quantities provided are estimates. Exact quantities will depend on the profile of individual plants.

Sources: SA government, Druid’s Garden, Statista 2019