Injecting Risk Factors Onto Each Other

Many of the risk factors overlap each other and have subsequent effects on each other; it is important to keep this collusion of effects in mind and how they impact on treatment options for CUD. Though the use of cannabis is a practice that has existed in South Africa and many parts of the world for hundreds of years, the change in cannabis use, legislation and availability has changed the state of cannabis. The body of research on risk factors continues to be investigated and continues to change along these lines.

Outlined below are some of the risk factors on cannabis use and CUD:

•  Tobacco users.
•  Those in unstable and abusive family settings.
•  Family history of substance abuse disorders and history of cannabis use.
• Use of cannabis by immediate family or caregivers i.e. second generation cannabis users.
•  Individuals who are in lower socio-economic bands.
•  Ease of access to cannabis.
•  Children or adolescents who show poor academic performance and school-related problems such as dramatic drop in grades, truancy and reduced interest in general school activities and outcomes.

•  Associated external problems, mostly conduct problems often seen in preteens and adolescents, which leads to delinquent behaviours and the impact of peer influence to use substances such as cannabis.
•  The uneven education system that “contributes to anxieties about the loss of control over youth; unfilled expectations and early disillusionment are considered by many as key factors that encourage experimentation with drugs among the young”.
•  Individuals who struggle to cope with emotional states and socially distressing situations, will likely partake in cannabis use and then develop a physiological dependency on a substance.
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• Children who live with adults who abuse drugs, these children are victimised by such adults and may turn to drug use, these children view the substance abuse behaviour as normal. Such adults are less able to monitor the child’s behaviour and activities.
•  Individuals with a history of trauma.
•  Individuals with mood disorders, antisocial personality disorder or tendencies.
•  Individuals who are easily susceptible to expectancy theory and the positive conditioning effects of substance use.
• Individuals in cultures that view and take part in cannabis use as part of culturally acceptable norms and rituals.
• Genetic predispositions to substance abuse and addictions.
• Other substance abuse disorders and mental disorders in early adulthood.
•  Shared genetic affiliations and environmental settings to substance abuse.
•  Neurobiological factors such as the development of maladaptive mechanisms in the brain that lead to chronic addition.
•  Adolescence is a vulnerable period for the possible development of CUD due to the social, psycho-emotional and biological changes occurring at this time.
• Younger age of onset of use
• Psychiatric comorbidity and then tendency to ‘self-medicate’.
•  The existence of externalising and internalising disorders and disruptions.
•  Those with behaviour disinhibition tendencies.

The most important implication for the now permitted personal and private use of cannabis is the socio-cultural and socio-environmental impacts it will have in South Africa. The ruling has both advantages and disadvantages for South Africa. The advantages may be harder to verify given South Africa’s long-standing history with cannabis, cannabis trade and given the countries political history. The author of this review is against the ruling and so will first look at the disadvantages associated with the ruling. The disadvantages and the negative effects are interrelated and include historical, economic, political, social and health matters that will be discussed in more detail below.  Many of these matters relate directly back to the risk factors mentioned above, as well as the common association that cannabis use has as a recreational and life-style drug, further developing the disapproving view of decriminalising cannabis use for private recreational use.

The availability and diversity of cannabis is the first disadvantageous factor that is highlighted in the ruling. The availability of cannabis is directly related to the ruling; and there has been an increase in the amount used amongst current cannabis users and in the number of new users, including increased use by minors. Cannabis is relatively cheap in South Africa and smoking cannabis is the cheapest, simplest and most-effective method of using in South Africa. The potency of cannabis is influenced by external factors, which are not regulated, this impacts the availability and diversity of cannabis in South Africa. The more widely accepted use and legislation of cannabis around the world has also lead to a multiplicity in cannabis products being available and produced, the more available a product is, the more people would be willing to engage with it.