An array of products advertised as containing synthetically derived delta-8 THC is offered for sale at a smoke shop in north Seattle on Friday, Feb. 25, 2022. Washington lawmakers are making a last-ditch attempt to block intoxicating, synthetically derived cannabis products, including gummy candies and vape oil, from being sold at gas stations, convenience stores and smoke shops after earlier bills failed. (AP Photo/Gene Johnson)
Cannabis legislation for private and medicinal use has increased over the past few years globally, including in several African countries for medicinal use as well as farming for profit. Currently, South Africa is the only country in Africa that has legalized the recreational use of cannabis, with the signing into law of the Cannabis for Private Purposes Act by President Ramaphosa on 28th May 2024, which was preceded by an earlier ruling of the Constitutional Court of South Africa in September 2018 which found the criminalization of home use and cultivation of cannabis for personal use by adults unconstitutional.
On the 7th of March 2025, the Cannabis for Private Purpose Act was juxtaposed with the announcement in the South African government gazette, driven by the National Department of Health, which declared a ban on all edible cannabis products, in particular around the import, manufacture and sale of these products (including capsules, gummies, sweets, baked goods/confectionery and beverages). This ban sparked immense controversy, especially among cannabis advocates and industry players and was lifted on the 26th March 2025 for further input.
The passing of the South African legislation for recreational use raised a number of public health concerns, and similarly to other settings, one of these was around edible cannabis products which may be particularly appealing to children and younger adolescents, who may (accidentally or not) consume products containing δ-9-tetrahydrocannabinol (Δ9THC), the psychoactive ingredient in cannabis. While it is often argued that cannabis is safe, there are notable gaps in our understanding. Specifically, although children and adolescents are known to be particularly susceptible to the effects of THC, there is insufficient knowledge about the impact of cannabidiol (CBD), frequently considered the “safe” ingredient, on the developing brain, which continues to mature until approximately 25 years of age.
An editorial piece by established South African researchers highlighted evidence of long-lasting neurological changes, cognitive deficits and mental health issues when cannabis is used frequently by young people A recent study conducted in a tertiary hospital in Cape Town supports this, revealing increased cannabis use among adolescents admitted with mental illnesses in the periods following the aforementioned ruling. Data emanating from the South African Community Epidemiology Network on Drug Use (SACENDU) also demonstrated that there has been an increase in cannabis admissions for under 18s since the 2018 Constitutional Court ruling.
Benefits of edible cannabis products: Is it all bad?
It is important to disentangle the different ingredients of cannabis products before making a blanket ban on all of them. For example, products containing hemp seeds which can be used to make flour and oils rich in essential fatty acids and proteins have been found to have an exceptional high nutritional value and even produce economically viable livestock feed.
Products containing CBD only, or a combination of THC and CBD, have been somewhat associated with positive medical outcomes among adults. At least some evidence, although not conducted in studies with rigorous methods, show alleviation of common mental health symptoms, pain reduction and increased appetite or decreased nausea for people with chronic illnesses. Edible cannabis products are generally also viewed as less harmful and even advocated for from a harm reduction perspective given that oral ingestion decreases the risk of infections, such as pneumonia and bronchitis, due to comprised pulmonary defenses when smoked. While there are no known studies conducted in South Africa, in terms of those individuals who present at treatment with cannabis as their primary substance of use, there is a higher proportion who report smoking cannabis daily and for those that report eating or drinking cannabis products, this varies in frequency. Research conducted in other countries, such as a recent study conducted in Canada found that people surveyed preferred edible products, with 65% of those sampled indicating a preference for sweets.
What do we know about harms associated with edible cannabis products specifically?
Since a major concern with the passing of the 2018 ruling and 2024 legislation is the potential negative health effects of cannabis products on children and adolescents and the resultant increase in burden on health and social services, it is necessary to look at existing knowledge on these products. A recent review summarizing the research found that in children under 12 years old, exposure to these products containing THC is often accidental (unintentional ingestion) as they are not distinguished from non-cannabis containing products. Despite the varying quality of the included studies, children hospitalized after ingesting these products exhibited lethargy, impaired concentration, muscle weakness, racing heartbeat, and slow or shallow breathing. Older people may also be likely to have a negative reaction to edible cannabis, as shown in a recent study also conducted in Canada, where increased rates of visits to emergency departments for cannabis poisoning was found in older adults following edible cannabis legislation. These can have detrimental health effects especially if we consider that edibles containing THC often have longer-lasting effects than other methods of administration, with symptoms of psychosis reported to last up to days in studies in the USA.
Another key concern when it comes to these edible products is around labelling and regulation of products that contain THC. Although serving sizes of THC (e.g. 10 mg, 20 mg, 50 mg and 100 mg) are supposed to be displayed on packaging, many consumers do not understand these or what an appropriate dosage may be for them. These serving sizes also do not take into account the increasing number of strains of cannabis used in edible products, which may have different properties and effects, or the delayed time onset of THC if it is present in these products. This makes measurement of strength challenging despite recent advances in establishing an international standard measure of THC of 5mg, including in edible products. The labelling and regulation of products has however not been implemented in South Africa. In other countries where recreational cannabis has been legalized, much lower THC limits of products have been set in order to address public health and safety concerns such as the unintentional use of products by children. For example, in Canada 10mg of THC per package is the maximum regardless of the number of edible products in the package. In certain states in the USA where cannabis is legalized, the standard unit of 5mg is the maximum amount of THC per serving. Of course, edible products that are made at home cannot be regulated in the same manner.
So where do we stand?
While it does not make sense to ban all cannabis-containing products, it is time to think critically about the public health ramifications with regards to edible cannabis products. First, it is imperative to educate people in South Africa on both the benefits and potential harms of using cannabis edibles so that they can make informed decisions to use these products in the safest manner possible. This does not only apply to the purchasing of these products, but also for those adults who choose to make them in their own homes.
Second, research using rigorous methods should explore potential benefits of cannabis edible products, including those with CBD-only or hemp as their main ingredient instead of lumping all products into the same category. While this kind of evidence exists predominantly in North America, it is lacking in South Africa, which is currently in a unique position in attempting to curb cannabis edibles but allow for the recreational use of cannabis.
Third, additional work on policy around standardizing limits of THC in particular in edible cannabis products to levels between 5 and 10 mg should be seriously considered. Related to this, labelling of these products should be clear and easy to understand, especially for cannabis-naïve individuals and/or children, adolescents and older adults. Only then should we make conclusions about the so-called dangers of edibles, which may be completely different depending on ingredients in South Africa
