INVESTIGATING KEY STAKEHOLDER SUPPORT FOR

PROPOSED CANNABIS POLICY REFORM IN GHANA

By Nana Kwame Baah

A Thesis

Submitted in Partial Fulfillment

of the Requirements for the Degree of

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Master of Science

IE in Applied Criminology

Northern Arizona University

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May 2020
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Approved:

Christine Arazan,PhD. Chair

Lisa Tichavsky, PhD.

Parwez Bemsel, PhD.

 ProQuest Number: 27962529

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 ABSTRACT

INVESTIGATING KEY STAKEHOLDER SUPPORT FOR PROPOSED

CANNABIS POLICY REFORM IN GHANA

NANA KWAME BAAH

Over the decade, cannabis use has increased in Ghana especially among the

youth. The growth in use could be attributed to cannabis being fairly priced among other illicit

substance including cocaine and heroin. Also, the local production of cannabis makes it easily

accessible. Although cannabis use has increased, cannabis use, trafficking, and cultivation is

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illegal and attracts criminal punishment. There have been several calls by the public to revise the

current laws on cannabis in the country.

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The Narcotics Control Board (NACOB), is the lead agency in enforcing narcotics laws in
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Ghana has recently drafted a bill. The NACOB commission bill 2019 is to improve NACOB's

capacity to deal with the current trend in the narcotics trade. The proposed bill seeks to control

and eliminate trafficking of narcotics to ensure public safety, collaborate with other
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organizations to provide rehabilitation of persons with drug use disorder and provide an

alternative crop for farmers who cultivate narcotic plants. Through interviews, the study engaged

fourteen Christian faith-based leaders in Accra and Kumasi on the proposed bill.

These faith-based leaders stated that the proposed bill in an appropriate response to curb

the growth of cannabis use among the youth. Moreover, the bill is an admission of a lapse in the

delivery of their duties. Eliminating the trafficking of narcotic drugs will reduce the supply of

cannabis to the end-users. NACOB collaborating with other organizations to rehabilitate people

with drug problems improves labor productivity. The youth are the most affected population and

treating these youth is essential to the well-being of the country.

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The faith-based leaders expressed concerns about NACOB's lack of personnel to effectively

enforce nationwide control to eliminate the trafficking of cannabis. Furthermore, the bill

proposed an alternative crop for farmers that grow cannabis. Respondents were skeptical about

the particular alternative since cannabis is profitable due to its short maturity period compared to

the main cash crops like cocoa. The faith-based leaders suggested mass education as one of the

ham reduction strategies to control the growth of cannabis. Also, the mass media should be

involved especially the radio to reach a wider population.

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 Acknowledgements

My heartfelt gratitude to my committee chair, Dr. Christine Arazan whose commitment

to see me finish my project on time was beyond imagination. I cannot thank her enough for her

patience, understanding and intellectual guidance throughout my project. Further, I would like to

express my profound appreciation to my two abled committee members Dr. Lisa Tichavsky and

Dr. Parwez Besmel for their suggestions, comments, advice, and positive criticisms to the

success of this write-up/project.

Also, I would want to express my appreciation to the Investigating Difference Creative

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and Scholarly Projects Grants for their financial assistance during my research. Many thanks to

the Department of Criminology and Criminal Justice for their academic guidance throughout my

master’s program.
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Lastly, I am thankful to my wife Rebecca Annorbah for her support and encouragement
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throughout my project.
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 Table of Contents

Abstract ........................................................................................................................................... ii
Acknowledgements ........................................................................................................................ iv
Table of Contents ............................................................................................................................ v
Chapter One: Introduction and Statement of the Problem ............................................................. 1
Reflexive Statement ........................................................................................................................ 1
Statement of the Problem ................................................................................................................ 3
Thesis Roadmap .............................................................................................................................. 6
Chapter Two: Ghana’s Unique Landscape, Current Approach to Marijuana Use, and the Role of
Stakeholders in the Political Process .............................................................................................. 8
Landscape and Demography of Ghana ........................................................................................... 8
Cannabis use in Ghana .................................................................................................................... 9
Narcotics Control Board (NACOB).............................................................................................. 10
Access to Health Care Resources for Misuse/Addiction to Cannabis .......................................... 12
Ghana’s Prison .............................................................................................................................. 14

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Stakeholders in the Political Process and Policy Reform in Ghana.............................................. 16
Studies on Cannabis in Ghana ...................................................................................................... 20
Research Questions ....................................................................................................................... 22
Chapter Three: Literature Review with a Focus on Marijuana Laws, Associated Harms and
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Benefits for Marijuana Use, and the Landscape of the International Community ....................... 25
Overview of Cannabis................................................................................................................... 25
Cannabis and its Components ....................................................................................................... 26
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Demography of Cannabis Users ................................................................................................... 27
Mode of Cannabis Use/Delivery ................................................................................................... 28
Current Trends on Seizures ........................................................................................................... 29
Harms to the Individual ................................................................................................................ 30
Suicide Death and Ideation ........................................................................................................... 31
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Cannabis and Brain/Mental Effects .............................................................................................. 32

Respiratory Problem ..................................................................................................................... 34
Harms to Society ........................................................................................................................... 35
Stigma and Help-Seeking Behavior .............................................................................................. 35
Benefits of Cannabis ..................................................................................................................... 36
Chapter Summary ......................................................................................................................... 38
Chapter Four: Theoretical framework for drug Policy Reform Approach to Marijuana: Focus on
the International Community ........................................................................................................ 40
Criminalization of Cannabis ......................................................................................................... 41
Decriminalization of Cannabis ..................................................................................................... 44
Legalization of Marijuana ............................................................................................................. 45
Current Policy Framework in Ghana ............................................................................................ 47
Chapter Five: Methodology and Research Strategy ..................................................................... 50
Qualitative Approach .................................................................................................................... 51
Research Strategy.......................................................................................................................... 51
Getting the Project Approved by the Institutional Review Board (IRB) ...................................... 52
Participants and Sampling Procedure ........................................................................................... 52

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Data Collection ............................................................................................................................. 54
Data Analysis ................................................................................................................................ 54
Chapter Six: Findings and Results ............................................................................................... 57
Setting the Context ........................................................................................................................ 57
Concerns about Drug Use ............................................................................................................. 60
Causes of Cannabis Growth .......................................................................................................... 64
Potential Benefits from the Legalization/ Decriminalization of cannabis .................................... 74
Adverse effect of Legalizing/Decriminalizing cannabis............................................................... 77
Concerns about NACOB Proposed Bill ........................................................................................ 83
Appropriate Response to Cannabis Use ........................................................................................ 89
Chapter Seven: Discussion and Recommendations for Future Research and Policy. .................. 94
Cause of Cannabis Growth. .......................................................................................................... 94
Potential Benefits from the Legalization/ Decriminalization of Cannabis ................................... 99
Adverse Effect of Legalizing/Decriminalizing Cannabis in Ghana ........................................... 102
Concerns of NACOB Proposed Bill ........................................................................................... 104
Appropriate Response to cannabis Growth................................................................................. 106
Recommendation for Future Research........................................................................................ 108

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Policy Recommendation ............................................................................................................. 109
Chapter Eight: Limitation and Conclusion ................................................................................. 114
Limitations .................................................................................................................................. 114
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References ................................................................................................................................... 120
Appendix A: ................................................................................................................................ 128
Appendix B: Informed Consent Consent to Participate in Research .......................................... 129
Appendix C: Semi-Structured Interview Schedule ..................................................................... 132
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 List of Tables
Tables ……………………………………………………………………….
Sample Demographics ……………………………………………………… 60

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 Chapter One: Introduction and Statement of the Problem

This thesis examines the appropriate response to the growth of cannabis use in Ghana.

The paper focuses on Ghana where marijuana possession, use, and trafficking are all criminal

offenses. This thesis examines the views of faith-based leaders who are key stakeholders in the

political reform process; many of whom have a great influence on the country’s policies and

laws. This chapter provides a background to the study with a reflexive statement, a statement of

the problem, and a thesis road map.

Reflexive Statement

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Growing up I had brilliant and talented classmates who became friends. Some of these
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friends dropped out of school not because of financial problems but as a result of their addiction

to illicit drugs. I never viewed these actions as a problem until after college I saw a number of
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my high school colleagues on the streets begging for money to buy food. The condition of

youthful addiction to illicit drugs was similar when I went to another region in the country for

national service. In Ghana, national service is a one-year service to the nation after graduating
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from college. I was posted to the Western region for my national service.

Within the Western region where I did my national service, the story was similar but in a

different mode. Wassa Akropong is a small mining town, characterized by the influx of illegal

mining of gold popularly known as “galamsey.” The mining activity enticed a good number of

the youth to work at the sites to make a living instead of going to school. The ages of youth

involved in galamsey ranged from 12 to 16 years. The activities at the illegal mines promoted

child labor coupled with illicit substance use. I developed an interest in the fight against illicit

substance use after witnessing the effects these substances had on its users especially children

and the violence users portrayed when the illicit substance is used in high quantities.

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 Consequently, I made a conscious effort to participate in the fight against substance abuse

and its harmful effects on users and society at large. Thus, in 2013 I joined Narcotics Control

Board (NACOB), the drug enforcement agency in Ghana. I worked for five years as an Assistant

Narcotics Analyst. I was stationed at the Kotoka International Airport where we analyzed flight

manifest for suspected drug traffickers. Additionally, we conducted and analyzed test on

suspects. We made an arrest if the tests turned out positive. Throughout my stay at NACOB, I

joined the campaign train to move across the nation to educate people and create awareness on

the effects of narcotics.

With the work experience gathered as an Assistant Narcotic Analyst, I believed it was

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important to acquire knowledge in academia. My interest in drug related issues following my
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experience at Western region also motivated me to stop at nothing in becoming a more skilled

narcotics officer. This research concentrates on cannabis because it is the most used narcotics in
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Ghana (Hormenu, Elvis, Thomas & Dietmar, 2018; Kalunta-Crumpton, 2016; World Drug

Report, 2018).

Ghana is one of the few sub-Saharan countries in Africa that cultivates cannabis in large
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quantities. The production of cannabis has made cannabis common and easily accessible to the

public. Cannabis is also inexpensive compared to other narcotics (The African Cannabis Report,

2019). Furthermore, majority of the cannabis produced in Ghana is consumed internally with the

rest trafficked to Western countries (Bureau for International Narcotics and Law Enforcement

Affairs, 2019). According to the Ghana Statistical Service report (2013) Ghana has a youthful

population. These same youth represent majority of cannabis users. This has the potential of

affecting the human capital of the nation.

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Statement of the Problem

Cannabis is one of the few substances that is widely cultivated and commonly consumed

(Csete et al., 2016; Gage, Hickman & Zammit, 2016; Hall, 2015; United Nations Office on

Drugs and Crime, 2007; Walsh et al., 2017; World Drug Report, 2018). According to the World

Drug Report (2018), there are about 192 million users of cannabis. Among the countries that

reflects this world trend is Ghana. Ghana ranks among the leading producers of marijuana, along

with Nigeria in sub-Sahara African (International Narcotics Control Strategy Report, 2017; The

African Cannabis Report, 2019; World Drug Report, 2018). In Ghana, the World Drug Report by

the UN office on drugs and crime posits Ghanaians aged 15 to 64 smoked cannabis products in

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2006 (Adu-Gyamfi et al., 2014; Hormenu et al., 2018; Lamptey, 2005; UNODC, 2007).
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In an interview with Ghana Broadcasting Corporation (GBC), the acting head of

Education at Narcotics Control Board (NACOB) revealed that about 22 percent of Ghanaians of
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school-going age are engaged in illicit substance use (Larnyoh, 2017). NACOB asserts that out

of a total of 50,000 drug users, 35,000 of these users are within the age group of 15 to 20 years

(Hormenu et al., 2018). These statistics reveal that a greater number of Ghanaians in junior and
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high schools are involved in substance use.

The increased use in cannabis in Ghana especially among the youth has sparked debate

on cannabis use in Ghana. The debate has boarded on the removal of sanctions on cannabis use

and allowing cannabis use to be legal. Others have called for NACOB to be strict in enforcing

the criminal sanctions as the harms caused by cannabis use is detrimental to individuals and has

repercussion on the society. Noting that the enforcement of the criminal sanctions will deter

offenders and prospective offenders as well.

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 To begin with, there are people of the view of removing sanctions on cannabis. Thus,

cannabis should be legalized. Proponents of legalization believe legalizing cannabis will help

improve the current economic situation and therefore called on the government to legalize

cannabis. Some advocates include the former Executive Secretary of Narcotics Control Board

(NACOB), Mr. Akrasi Sarpong (Ghanaweb, 2014). He has openly expressed his support for the

legalization of cannabis. To him, legalizing cannabis would aid in regulating its use and allow

the nation to realize its economic benefits (Ghanaweb, 2014). Additionally, Executive Director

of the Ghana Standards Authority proposes legalization of cannabis for export. The Executive

Director’s call is geared towards a state-led cultivation which will be exported to generate

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income for the state (The African Cannabis Report, 2019).
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Despite these suggestions, there are opposing views on the legalization of cannabis. Dr.

Akwesi Osei, the Chief Executive of Ghana’s mental health authority highlights that cannabis
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pose health hazards to users (Jafaru, 2014). Hence, the country should avoid legalization in order

to avert the many health hazards that cannabis poses to its users (Jafaru, 2014; The African

Cannabis Report, 2019). Further, a Circuit court judge who had presided over some drug cases
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proposed the review of the drug laws in Ghana (Ghanaweb, 2014). The judge was against

legalizing cannabis, stating that it may worsen the current situation. He further suggested a

review of the penalties for drug use and possession in terms of quantity (Ghanaweb, 2014).

Another advocate against the legalization of cannabis is Dr. Kwesi Anning. He is the

Director, Faculty of Academic Affairs & Research at the Kofi Annan International Peacekeeping

Centre. He is of the opinion that countries that produce cannabis products are faced with many

problems including fighting addiction and growth in usage (The African Cannabis Report, 2019).

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Therefore, he strongly opposes the legalization of cannabis in Ghana to avoid such problems.

These advocates insist on the application of criminal sanctions to cannabis offense.

With the debate of legalization and criminalization ongoing, there are some advocates in

the middle of the debate. These are those who are partially against criminalization and likewise

against legalization. These other crops of advocates want a blend and that is to only

decriminalize cannabis without legalizing it. That is removing the criminal sanctions of cannabis

offense with fines and administrative sanctions. One of such group is the Rastafarian council of

Ghana. According to the council removing the criminal sanctions from cannabis offense will

positively influence how police officers handle youth involved in cannabis use (Taylor, 2019).

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In order to propagate their views, the Rastafarian council planned a march in May 2019, but the
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police denied their request (Taylor, 2019).

According to the Rastafarian council, the march was to create the awareness that cannabis
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is a natural plant so incarcerating its users is a human right abuse (Taylor, 2019). Further, Dennis

Afram a leading member of the group asserts that it is awkward to imprison cannabis users who

are not criminals in the nation’s congested prisons (Taylor, 2019). Additionally, pro-cannabis
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group like West Africa Drug Network support decriminalization of cannabis. The group is of the

view that decriminalization of cannabis is a better option in fighting the cannabis menace (The

African Cannabis Report, 2019).

Furthermore, advocates like former UN Secretary-General, Mr. Kofi Annan, provides

government with scenarios of alternative to criminalization. He asked the government of Ghana

not to only look at the negative side of the hard drug but also consider the benefits that the

country can derive after decriminalizing cannabis (Spiegel International, 2016). In his article Lift

the Ban, Mr. Kofi Annan asserts that the initial trends of areas where cannabis is legal depict no

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upsurge of drug use or drug-related crimes. He further states that the global illicit market has a

turnover of $330 billion, adding that legalization reduces the black market and spare young

people of criminal records. He reiterates that the global estimate of implementing prohibition,

totals $100 billion annually although it has little impact on drug usage (Spiegel International,

2016).

In recent times, the Narcotics Control Board (NACOB) Ghana, has drafted a bill to make

changes to the laws concerning narcotics in general. This new bill titled Narcotics Control

Commission Bill 2019 seeks to provide funds for rehabilitation and treatment for person with

substance abuse disorders. Also, the bill hopes to find alternative means of livelihood for farmers

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who cultivate illicit narcotic plants.
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With this shift in use of marijuana products, coupled with the proposed NACOB, it is

important to examine the opinion of some influential bodies in the policy making process in
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Ghana. To address the appropriate response to cannabis use in Ghana, this study engages faith-

based leaders who are key stakeholders and play a role in the formation of laws including that of

the NACOB bill.

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Thesis Roadmap

This thesis is structured to initially provide the discourse of cannabis use in Ghana and the

various suggestions in terms of the approach to handle the problem of misuse of cannabis.

Chapter two focuses on Ghana and its socioeconomic structure. Chapter two continues with the

current approach to marijuana use and the role of stakeholders in the political process. Chapter

three provides an overview of cannabis, the harms associated, and benefits associated with

cannabis. In addition, chapter four summarizes the international policy framework for drug

policy reform.

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 Following the policy framework, chapter five discusses the method employed in the study

and the approach in recruiting participants as well as the process to analysis the data collected.

Furthermore, Chapter six summarizes the findings of the research from the interviews conducted.

Lastly, Chapter seven highlights the limitation of the findings and provides recommendations for

future studies.

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 Chapter Two: Ghana’s Unique Landscape, Current Approach to Marijuana Use, and the

Role of Stakeholders in the Political Process

This chapter focuses on the unique landscape which includes the demographics and

socioeconomic status of Ghana. The chapter delves into a brief history of cannabis in the country

and the legal framework that applies in the possession, cultivation and trafficking of cannabis. In

discussing the laws that applies, the role of NACOB is examined. And so is the role of

stakeholders in the political process in Ghana. Furthermore, the chapter discusses the state of the

health and prison services that handle people who are involved in narcotics. Finally, the chapter

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concludes with studies on cannabis in Ghana, the research objective, and research questions.

Landscape and Demography of Ghana

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Ghana is located on the West African coast in the African continent. The country is

bordered by Togo on the east, Burkina Faso on the north and Cote d’Ivoire on the west. The
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south of Ghana is the Gulf of Guinea which stretches on the coastline. Ghana gained

independence from the British on March 6, 1957 and became a republic in the British
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Commonwealth of Nations on July 1, 1960 with Accra as its administrative and political capital

(GSS, GHS, & Demographic, 2015).

According to Ghana Statistical Service (GSS) (2013), Ghana’s population is 24,658,823

with 38.3 percent under 15 years of age, 57 percent between 15- 64 years and the elderly

population (65 years and above) accounted for 4.7 percent. In the same report, as of 2010 the

average unemployment rate was 5.4 percent for the entire country and much higher in urban

areas. Also, the proportion of unemployed decreased with increasing age. In 2010, 42.7 percent

of the unemployed population were aged 15-24 years, 46.2 percent aged 25-44 years, 9.9 percent

aged 45-64 years and 1.3 percent aged 65 years and older (GSS, 2013).

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 In the past two decades, Ghana has taken major strides toward democracy under a multi-

party system, with its independent judiciary winning public trust (World Bank Group, 2019).

Ghana consistently ranks in the top three countries in Africa for freedom of speech and press,

with strong broadcast media, and with radio being the medium with the greatest reach (World

Bank Group, 2019). Factors such as these provide Ghana with a solid social capital. According to

the World Bank Group (2019) Ghana’s economy continued to expand in 2019 as the first-quarter

gross domestic product (GDP) growth was estimated at 6.7%, compared with 5.4% in the same

period of the previous year.

Cannabis use in Ghana

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Cannabis, also known as marijuana, has several names in Ghana including “ganja”,
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“ntaampi”, “abonsam tawa”, “wee” and “taaba” (Adu-Gyamfi and Brenya, 2014; Akyeampong,

2005; Hormenu, Elvis, Thomas & Dietmar, 2018). According to Akyeampong (2005) and the
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African Cannabis Report (2019), cannabis was introduced into Ghana by war veterans who had

fought in Asia during the second world war.

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Akyeampong (2005) mentions that during the period right after independence in 1957,

some cocoa farmers intercropped their cocoa plantation with marijuana to benefit from the sale

of the herb in between cocoa harvests. This was especially lucrative in 1958 when the world

market prices for cocoa declined. Furthermore, cannabis was associated with people who

engaged in risky and or strenuous activities such as stevedoring, farming, prostitution, and

burglary (Akyeampong, 2005).

Currently, Ghana ranks among the leading producers of marijuana along with Nigeria in

sub-Sahara African (International Narcotics Control Strategy Report, 2017; World Drug Report,

2018). The favorable weather conditions for cultivating cannabis could be a major factor in

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Ghana’s high rank among producers of cannabis (The African Cannabis Report, 2019). The hot

and humid climate in the country’s large regions including Western, Ashanti and Brong Ahafo

offers an ideal condition for the cultivation of cannabis (The African Cannabis Report, 2019).

Also, the profitability of the crop entices farmers to cultivate the crop (Akyeampong,

2005; The African Cannabis Report, 2019). Therefore, farmers cultivate cannabis by

intercropping cannabis with staples like cocoa, cassava or okra to serve as a disguise

(Akyeampong, 2005; The African Cannabis Report, 2019). The high production of cannabis has

its proportionate consumers as well. The Bureau for International Narcotics and Law

Enforcement Affairs (2019) and World Drug Reports (2018) assert that majority of cannabis

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produced in Ghana is consumed internally, and some transported to other countries in Europe.
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The World Drug Report (2018) states that West and Central Africa leads the chart for

annual prevalence of cannabis use with North America and Oceania following. West Africa and
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Central Africa tops prevalence of cannabis use with 13.2 percent followed by North America and

Oceania with 12.9 percent and 11.0 percent respectively. In Ghana, Adu-Gyamfi et al. (2014),

Hormenu et al. (2018) and the World Drug Report (2018) assert that young people, mostly
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students between the age(s) of 15-16, used cannabis at least once in the previous months. Also,

young people between age(s) 18 -24 used cannabis six times higher than people aged 35- 60

years. The prevalence of cannabis in Ghana is a reflection of the drugs’ prevalence in the sub-

Saharan region.

Narcotics Control Board (NACOB)

Ghana’s narcotics control law is based on international narcotics control conventions

(Bridge and Loglo, 2017; Kalunta-Crumpton, 2016). These conventions include the Single

Convention on Narcotic Drugs as amended by the 1972 Protocol, the 1971 Convention on

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Psychotropic Substance, and the 1988 Convention Against Illicit Trafficking of Narcotics Drugs

and Psychotropic Substances (Bridge and Loglo, 2017). These treaties required participating

nations to limit and criminalize the possession, use, trade and distribution of drugs outside of

medical and scientific purposes, and to work together to stop international drug trafficking

(Bridge and Loglo, 2017). Ghana is a signatory state and has ratified the treaty into law, the

Narcotic Drugs Act. Additionally, the enactment of the 1990 Provisional National Defense

Council Law (PNDCL) 236 criminalizes cannabis (Bridge and Loglo, 2017; Kalunta-Crumpton,

2016) and applies criminal sanctions to cannabis offenses included use, cultivation, and

distribution.

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The Narcotic Control board is the lead agency in enforcing narcotics laws in Ghana. The
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agency is governed by the Provisional National Defense Council (PNDC) law 236 (Bridge and

Loglo, 2017; Kalunta-Crumpton, 2016). The purpose of PNDCL 236 is to bring under one
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enactment offenses related to illicit dealing in narcotic drugs. The PNDC law also co-ordinates

activities on illicit narcotic drugs and psychotropic substances. The law makes provision for the

pursuit, seizure, and forfeiture of equipment used in the commission of narcotic drug offenses.
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The PNDC law also provides for property and proceeds acquired or derived from narcotic

drug offenses or illicit narcotic drug dealings to be pursued, seized and forfeited (Bridge and

Loglo, 2017; Kalunta-Crumpton, 2016). The Narcotics Control Board has three main aims which

includes (1) enforcement and control of narcotic control laws in the country, (2) education and

prevention of the use of narcotics, and (3) the treatment, rehabilitation and social re-integration

of narcotic addicts.

The enforcement of drug policy needs adequate training of staffs of NACOB. To beef up

NACOB operations, NACOB received $1 million in funding from the US and with support from

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the United Nations Office on Drugs and Crime (International Narcotics Control Strategy Report,

2017). The funds launched a new program in 2016 to provide basic equipment and training

needed to establish police drug law enforcement units in four of Ghana’s regions where these

units did not exist (International Narcotics Control Strategy Report, 2017). Besides, to support

drug interdiction efforts, the United States provided training to the Ghana Navy on a maritime

vessel.

Ghana, through the Narcotics Control Board, is revising its drug law to provide a more

balanced and proportional response between enforcement and health concerns of illicit drug use.

There is a new NACOB commission bill 2019 before parliament. Parliament approval of the bill

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will empower NACOB to become a commission (NACOB Commission bill, 2019). This bill
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seeks to keep the agency with current laws that affect the commission of a serious offense. The

bill will ensure that the legislation in this country meets the current international standard for
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narcotics offense. And as part of the commission’s responsibility to develop measures for the

treatment and rehabilitation of persons suffering from substance use disorders. Furthermore, the

Commission will develop, in consultation with other public agencies and civil society
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organizations, alternative means of livelihood for farmers who cultivate illicit narcotic plants

(NACOB Commission bill, 2019).

Access to Health Care Resources for Misuse/Addiction to Cannabis

With cannabis as the most common narcotic, there is the probability of people misusing

cannabis. And these people who misuse or abuse cannabis need to be provided with access to

healthcare. In Ghana, there are 123 mental health outpatient facilities, three psychiatric hospitals,

seven community based psychiatric inpatient units, 4 community residential facilities and one-

day treatment center, which is well below what would be expected for Ghana’s economic status

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(Raja, Wood, DeMenil, & Mannarath, 2010). The three public psychiatric hospitals are Accra

Psychiatric Hospital, Pantang Hospital, and Ankaful Psychiatric Hospital. All three public

psychiatric hospitals are located in the southern part of the country. Two are located in the

capital city, Accra and the other is located on the coast in the Central Region (Roberts, Mogan &

Asare, 2014).

According to Roberts et al. (2014) the three psychiatric hospitals in the country have a

total of 1,322 beds. A total of 57,404 patients were treated in outpatient facilities in 2011. This

figure does not include follow up appointments. This equates 237 patients per 100,000 general

population. Furthermore, the diagnoses of admissions to psychiatric hospitals were primarily

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schizophrenia (32%), substance misuse (26%) and mood disorders (19%) (Roberts et al., 2014).
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Out of this number, 14% of all patients treated in mental health outpatient units were 17 years or

younger. Although schizophrenia tops the chart at the psychiatric hospital, patients with cannabis
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use have quite a number.

Jafuru (2014) asserts that the chief psychiatrist of Ghana, Dr. Akwasi Osei stated that

cannabis-related cases account for about 30% of out-patient visits and 10% of admissions to the
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Accra Psychiatric Hospital each year. This report provided first-hand information from the

hospital's out-patients department records. There were no further details to confirm whether after

diagnosis the patients were suffering from cannabis-related problems or other psychiatric

problems. These patients might attribute their problem to cannabis, but further examination could

prove otherwise.

Apart from the limited beds available to accommodate patients lies the issue of number of

health professionals available. The total number of staff working in mental health facilities was

1887 (Raja et al., 2010; Roberts et al., 2014). The breakdown by profession was 18 psychiatrists

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(0.07 per 100,000 population), 31 other medical doctors not specialized in psychiatry (0.13 per

100,000), 1,256 nurses (5.19 per 100,000), 19 psychologists (0.08 per 100,000), 21 social

workers (0.09 per 100,000), and 4 occupational therapists (0.02 per 100,000). With a population

of 24.5 million the ratio of personnel to patients is inadequate.

Moreover, Ghana’s mental health sector is funded primarily by the government and is

supplemented to a small extent by internally generated funds and donations (Raja et al., 2010).

Though the government provides subsidies for these hospitals, the funds are not enough to offset

the cost of running the facility. According to Raja et al., (2010) the budget of the health sector to

the mental health service is 1.4 percent of the health expenditure. And these expenditures are

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very much skewed towards urban areas where the three public psychiatric hospitals are located.
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Furthermore, the budget of the mental health sector is separated without necessarily being

operated as a separate entity from the general health care. Most often than not, the spending of
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psychiatric hospitals is always above the allocation provided by the government (Raja et al.,

2010). For instance, figures from the Ministry of Health in 2011 showed the mental health

budget for the three psychiatric hospitals was 4,516,163 Ghana cedis ($876,925).
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However, the actual spending on mental health in 2011 was $1,098,442. The difference

in amount was because the funding that was initially approved was lower than what was

required. These amounts excluded the salary of personnel emoluments of the staff at the

hospitals (Roberts et al., 2014). The hospital, as a result, subsidizes its activities through a system

of pooling internally generated funds. Unfortunately, these funds are mostly not enough.

Ghana’s Prison

The mental health facilities provide care for people who might have had psychiatric

issues from misusing cannabis. Those who are also apprehended and later proven guilty by the

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court are sentenced to prison. The prison serves as an alternative home to cannabis offenders.

The prison serves as a place to reform inmates and also as a means of retribution for breaking the

laws of the state. According to the Ghana Prison Service statistics, in 2015, the total prison

population was 19,599. This total number includes 7,776 convicted prisoners and 11,823 inmates

on remand.

Out of the 7,776 convicted inmates, 236 were charged with possession of narcotic

substances. This number did not provide a breakdown of narcotic substance, but the high

prevalence of cannabis will imply that cannabis would have the highest number of convicts. The

remand prisoners are inmates awaiting court verdict. The verdict could go in their favor and

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would have spent valuable time in the prison. These remand inmates during their time in prison
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could pick up behaviors that would impact their lives negatively when acquitted.

Adjei, Armah, Gbagbo, Hesse, and Mensah (2006) provide a brief outlook of Ghana’s
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overcrowded prison. For instance, the Nsawam Medium Security Prison designed for a

maximum of 600 prisoners, now accommodates over 2,000 inmates. The James Fort and James

Camp prisons, which were each designed for a maximum of 300 prisoners, now accommodate
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over 900 inmates each with a mean of 55 occupants in the dormitory-type rooms intended for a

maximum of 15. According to the Ghana Prison Service overcrowding in the prisons is estimated

to be 52.87 percent.

The overcrowding of prisons creates a series of problems including vulnerability in

contracting communicable disease and learning criminal behavior from other inmates. In terms

of health, the prevalence of HIV and hepatitis B render inmates vulnerable. Adjei et al. (2006)

posit that there exists high seroprevalence in human immunodeficiency virus (HIV), and

hepatitis C virus (HCV) in these prisons. Furthermore, Adjei et al. (2006) posit the HIV and

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 HCV seroprevalence was probably due to a higher proportion of individuals with prior history of

intravenous drug use, high-risk sexual behavior, poor conditions, and low educational

background. Thus, their low level of education renders them clueless about ways of preventing

such diseases.

Stakeholders in the Political Process and Policy Reform in Ghana

Good decision-making is one of the key elements of good governance. And every nation

strives towards achieving that. Ghana is considered one of the most stable countries in West

Africa since the 1992 transition to a multiparty democratic system (Asante, Fiaveh, & Okyerefo,

2011; Friedrich-Ebert-Stiftung Ghana & HRAC, 2011; Quashigah, 2010). Ghana’s government

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system is made of the three branches of government which are the executive, the legislature and
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the judiciary and are also referred to as the president, parliament and supreme court respectively

(Agyemang, 2014; Friedrich-Ebert-Stiftung Ghana & HRAC, 2011). The legislative power of
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Ghana is vested in the parliamentary.

According to Friedrich-Ebert-Stiftung Ghana and HRAC (2011), the process of law-

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making in parliament is categorized into first reading, second reading, committee or

consideration stage, and finally third reading. During the committee and consideration stage,

parliament refers the bill to private citizens, non-governmental organizations, and public officers

to incorporate their views as civil society (Friedrich-Ebert-Stiftung Ghana & HRAC 2011; World

Bank, 2017). This public hearing is organized by the select committee members of Parliament to

engage citizens to participate directly in the law-making process and this process is gazette in the

process.

Though Ghana is considered a secular state, the constitution recognizes the existence of

religious organization as relevant civil society organization and thus require their representation

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