CommentaryCould cannabis liberalisation lead to wider changes in drug policies and outcomes?
Introduction
Important changes in drug policy are occurring in the Americas. Following commercialisation of medical cannabis in the USA under the reassurance of the Ogden memo in 2009, several US states have legalised the sale of recreational cannabis. Uruguay has legalised home growing and social clubs, and will soon start selling cannabis for recreational use in pharmacies, while Canada may soon become the second American country where cannabis can be legally bought for that purpose (NYT, 2017).
These changes are profoundly different from what has been the historical consensus for global drug policy, and may have important health and social implications (Hall & Lynskey, 2016; Subritzky, Pettigrew, & Lenton, 2016). To understand fully the consequences of these developments however a narrow focus on cannabis policies and cannabis use is not sufficient. We argue here that, first, the current rapid changes in cannabis policy may have the potential to affect wider drug policies, such as law enforcement policies around opioid and stimulant use, both in the Americas and elsewhere; and second, if such wider policy changes occur, they could have a far more significant impact on health than the current changes in cannabis policy alone. For this reason, robust and systematic monitoring and evaluation of the outcomes of changes in cannabis policy, both in terms of drug use and of their wider health and social consequences, is important (Wiessing, Des Jarlais, Hughes, Ferri, & Griffiths, 2015).
International drug control, currently framed by three UN Conventions, was introduced with an explicit intention to protect public health (UNODC, 2008). The 1961 and 1971 Conventions on narcotic drugs and psychotropic substances insisted on criminal penalties for drug traffickers, but the 1988 UN Convention against illicit traffic in narcotic drugs and psychotropic substances provided additional legal mechanisms; for the first time it requested (although did not oblige) criminal penalties for personal possession. This was an attempt to balance the existing obligations of producer countries to reduce production and trafficking with new obligations of consumer countries to reduce demand (United Nations Office on Drugs and Crime, 2005). For this reason, drug control has tended to be seen as a predominantly criminal justice issue (UNODC, 2008). As one of several drugs addressed by these Conventions, cannabis policies do not work in isolation but form part of a wider system of drug laws (EMCDDA, 2016), regulating the supply and use of other drugs such as opioids and cocaine. Despite some calls for the revision of the Conventions, such a move would be complex (Bewley-Taylor, Blickman, & Jelsma, 2014). In more recent years, policies have been developed to address the health and public safety threats posed by new psychoactive substances, though criminal penalties for personal possession might be omitted in Europe (European Monitoring Centre for Drugs and Drug Addiction and Eurojust, 2016). The issue of the interaction of policies addressing different drugs has nevertheless been somewhat neglected in the scientific literature, and this paper attempts to bring this to the fore.
Section snippets
Limitations
Some national policy interventions to protect public health, in areas such as prevention, treatment or harm reduction may be limited in variety or scope, or even prohibited, due to the nature of the drug being illicit. There are many direct examples of this, such as opioid substitution treatment and needle and syringe provision being strictly regulated or not allowed in some countries. More indirectly, if health concerns are not taken sufficiently into account in criminal justice policies and
Conflicts of interest
We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Author contributions
BH and LW share lead authorship. LW had the original idea, BH and LW wrote all drafts, with substantial contributions of DDJ and PG.
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Drug policy analysis
2023, Substance Use and Addiction Research: Methodology, Mechanisms, and TherapeuticsThe importance of PEOPLE who use drugs within drug policy reform debates: Findings from the UK Drug Policy Voices online survey
2022, International Journal of Drug PolicyCitation Excerpt :Global changes in drug policy mark a shift from strict prohibition to both health-based and human rights-based approaches that reduce or eradicate the criminalisation that surrounds the personal use of drugs. To increase policy legitimacy and outcomes, it is widely acknowledged that people who use drugs (PWUD) should be involved in debates, processes, and future policy formation (Askew & Bone, 2019; Cheng et al., 2021; Greer & Ritter, 2019; 2020; Hughes et al., 2018; Lancaster et al., 2018, 2014; Levy, 2018; Monaghan et al., 2018; Osborne & Fogel, 2017; Roberts, 2014). “Without engaging the affected community in decisions that affect their lives, governments, academics, and advocates alike risk promoting drug policy reform that is not relevant or meaningful to PWUD themselves” (Greer & Ritter, 2019:45).
Growing pains: An overview of cannabis quality control and quality assurance in Canada
2021, International Journal of Drug PolicyCitation Excerpt :Theoretically, as a result of standardization through governmental oversight, Canadian consumers can expect safety, consistency and reliability when purchasing legal cannabis products. With ongoing calls for the safe supply of other drugs, the legalization of cannabis can be viewed as a mechanism for providing safe supply through a quality-controlled system as well as a potential example of safe supply in action (Csete & Elliott, 2020; Hughes, Wiessing, Des Jarlais, & Griffiths, 2018; Sánchez-Avilés, 2020). This paper focuses on the QC/QA protocols and frameworks for cannabis in Canada, starting with a descriptive overview of the current regulatory regime, followed by an analysis of the strengths and weaknesses of the implemented framework, and finishing with considerations for the future.
Deconstructing prohibitionist ideology: A sociocognitive approach to understand opinions on UK drug policy and the law
2019, International Journal of Drug PolicyCitation Excerpt :Despite these national policy developments the public, especially those with lived experience of use, have been consistently left out of drug policy debates. Many have argued that people who use drugs should indeed be integrated within these debates to increase policy legitimacy and outcomes (Osborne & Fogel, 2017; Levy, 2018; Ritter, Lancaster, & Diprose, 2018; Lancaster, Sutherland, & Ritter, 2014; Hughes, Wiessing, Des Jarlais, & Griffiths, 2018; Greer & Ritter, 2019; Monaghan, Wincup, & Wicker, 2018). Emerging findings from research with people who use drugs (PWUD) on their views on drug policy and the law reports the diversity of opinions and a lack of clarity around terminology (Greer & Ritter, 2019; Lancaster, Ritter, & Stafford, 2013; Lancaster et al., 2014; Lancaster, Treloar, & Ritter, 2017; Ritter, 2015; Ritter et al., 2018).
Attitudes toward legalization of marijuana in the United States, 1986-2016: Changes in determinants of public opinion
2019, International Journal of Drug PolicyCitation Excerpt :From the standpoint of drug policy, partisan opposition stands to prevent individuals who might benefit from medical marijuana from doing so, and it also helps to keep inconsistent policies in place. In the United States, the federal government continues to classify marijuana as a Schedule I Controlled Substance (Hughes, Wiessing, Des Jarlais, & Griffiths, 2018), a designation for drugs “with no currently accepted medical use and a high potential for abuse.”2 Yet, in 2017, a report by the National Academies of Sciences, Engineering, and Medicine concluded that cannabis and cannabinoids can be effective in the treatment of chronic pain as well as nausea and vomiting associated with cancer chemotherapy.
Association between cannabis laws and opioid prescriptions among privately insured adults in the US
2019, Preventive MedicineCitation Excerpt :The decline in opioid prescriptions may be occurring in specific populations independent of reduced strictness of cannabis use laws. Cannabis liberalization and decriminalization policies by themselves have positive and negative consequences in public health and legal arena (Hughes et al., 2018; National Academies of Sciences, Engineering, and Medicine, 2017; Hall and Lynskey, 2016); but if the goals of such policies include stemming opioid abuse and overdose, caution must be exercised by policy makers as current evidence of opioid users replacing opioids with cannabis is weak and prone to ecological fallacy (Finney et al., 2011; DiBenedetto et al., 2018). Furthermore, while our findings reveal an association between decreased opioid prescriptions and implementation of medical use cannabis laws, causation should not be implied.