Changes in cannabis use post decriminalisation in mental health care users in South Africa

Background: Personal cannabis use was decriminalised in South Africa in 2018. Cannabis use increases the risk of mental illness (MI) and worsens prognosis in patients with MI. The impact of decriminalisation on cannabis use remains unclear. Aim: To examine cannabis use patterns by self-report and u...

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Main Authors: Rachel Moshori, Lisa Galvin, Laila Paruk
Format: Article
Language:English
Published: AOSIS 2025-03-01
Series:South African Journal of Psychiatry
Subjects:
Online Access:https://sajp.org.za/index.php/sajp/article/view/2305
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author Rachel Moshori
Lisa Galvin
Laila Paruk
author_facet Rachel Moshori
Lisa Galvin
Laila Paruk
author_sort Rachel Moshori
collection DOAJ
description Background: Personal cannabis use was decriminalised in South Africa in 2018. Cannabis use increases the risk of mental illness (MI) and worsens prognosis in patients with MI. The impact of decriminalisation on cannabis use remains unclear. Aim: To examine cannabis use patterns by self-report and urine multidrug screening (UMDS) among psychiatric inpatients at Chris Hani Baragwanath Academic Hospital (CHBAH). Setting: CHBAH, Soweto, South Africa. Methods: A retrospective review of clinical records comparing patients admitted to CHBAH psychiatry pre- and post-decriminalisation. Results: A total of 244 patients were included, with 57% using cannabis based on self-report and/or UMDS. Although not significant, overall cannabis use was higher post-decriminalisation (63.1%) than pre-decriminalisation (50.8%). Self-reported use increased slightly post-decriminalisation (56.6% vs. 50.0%), while UMDS-confirmed use was significantly higher (32.8% vs. 17.2%). Cannabis use was associated with male gender and younger age, with younger admissions post-decriminalisation. Conclusion: Decriminalisation did not significantly increase overall or self-reported cannabis use; however, more patients tested positive on UMDS post-decriminalisation. Young males remain at higher risk of cannabis use.
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series South African Journal of Psychiatry
spelling doaj-art-502a2eb0b34b4afaac004aabf7dd0cbd2025-08-20T01:50:57ZengAOSISSouth African Journal of Psychiatry1608-96852078-67862025-03-01310e1e1010.4102/sajpsychiatry.v31i0.2305765Changes in cannabis use post decriminalisation in mental health care users in South AfricaRachel Moshori0Lisa Galvin1Laila Paruk2Department of Psychiatry, Faculty of Health, University of the Witwatersrand, JohannesburgDepartment of Psychiatry, Faculty of Health, University of the Witwatersrand, JohannesburgDepartment of Psychiatry, Faculty of Health, University of the Witwatersrand, JohannesburgBackground: Personal cannabis use was decriminalised in South Africa in 2018. Cannabis use increases the risk of mental illness (MI) and worsens prognosis in patients with MI. The impact of decriminalisation on cannabis use remains unclear. Aim: To examine cannabis use patterns by self-report and urine multidrug screening (UMDS) among psychiatric inpatients at Chris Hani Baragwanath Academic Hospital (CHBAH). Setting: CHBAH, Soweto, South Africa. Methods: A retrospective review of clinical records comparing patients admitted to CHBAH psychiatry pre- and post-decriminalisation. Results: A total of 244 patients were included, with 57% using cannabis based on self-report and/or UMDS. Although not significant, overall cannabis use was higher post-decriminalisation (63.1%) than pre-decriminalisation (50.8%). Self-reported use increased slightly post-decriminalisation (56.6% vs. 50.0%), while UMDS-confirmed use was significantly higher (32.8% vs. 17.2%). Cannabis use was associated with male gender and younger age, with younger admissions post-decriminalisation. Conclusion: Decriminalisation did not significantly increase overall or self-reported cannabis use; however, more patients tested positive on UMDS post-decriminalisation. Young males remain at higher risk of cannabis use.https://sajp.org.za/index.php/sajp/article/view/2305cannabisdecriminalisationpsychotic disorderssouth africamental healthsubstance usepsychiatric admissions
spellingShingle Rachel Moshori
Lisa Galvin
Laila Paruk
Changes in cannabis use post decriminalisation in mental health care users in South Africa
South African Journal of Psychiatry
cannabis
decriminalisation
psychotic disorders
south africa
mental health
substance use
psychiatric admissions
title Changes in cannabis use post decriminalisation in mental health care users in South Africa
title_full Changes in cannabis use post decriminalisation in mental health care users in South Africa
title_fullStr Changes in cannabis use post decriminalisation in mental health care users in South Africa
title_full_unstemmed Changes in cannabis use post decriminalisation in mental health care users in South Africa
title_short Changes in cannabis use post decriminalisation in mental health care users in South Africa
title_sort changes in cannabis use post decriminalisation in mental health care users in south africa
topic cannabis
decriminalisation
psychotic disorders
south africa
mental health
substance use
psychiatric admissions
url https://sajp.org.za/index.php/sajp/article/view/2305
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AT lisagalvin changesincannabisusepostdecriminalisationinmentalhealthcareusersinsouthafrica
AT lailaparuk changesincannabisusepostdecriminalisationinmentalhealthcareusersinsouthafrica