Tuesday, June 30, 2020
The question in the title of this post is the headline of this effective new Leafly article, which builds off the research noted in this prior post about the "right" minimum age for legal access to recreational cannabis. Here are excerpts:
When it comes to legal cannabis, the random collection of ages across North America is curious. Every US state that allows recreational cannabis sales requires customers to be at least 21 years old. In Canada the minimum age is 19, except in Alberta (where it’s 18) and Québec (which started at 18 but raised it to 21 earlier this year).
In most jurisdictions, medical marijuana is legal for people age 18 and older, with a doctor’s recommendation.
What difference does it really make if someone is 18, 19 or 21? A research team at Memorial University in Newfoundland, Canada, recently investigated the question. Instead of looking at the immediate health and safety of young adults, they assessed later life outcomes — namely educational attainment, lifetime cigarette smoking habits, and general physical and mental health. In their study, the Memorial University team concluded that the ideal minimum legal age for cannabis was 19....
Health experts cite THC exposure in adolescents causes changes to the brain’s folding patterns, decreased neural connectivity, thinning of the cortex and lower white matter, among other symptoms. However, one recent study suggests any changes to brain structure caused by cannabis use in adolescence cleared up by the time subjects were in their 30s.
Another ongoing study in the Saguenay region of Quebec took MRI scans of over 1,000 adolescent brains in 2002, and the same subjects are currently being re-evaluated as adults — results pending.
If the serious nature of brain health is such a risk, why not just make cannabis illegal until a person’s mid-20s? In the real world, policymakers have to weigh human nature’s penchant for the forbidden with appropriate rules and consequences. In an ideal world, sure — and in this ideal world underage kids never go looking for cannabis from illicit sources, either. In the real world, though, policymakers have to weigh human nature’s penchant for the forbidden with appropriate rules and consequences. In an ideal world, alcohol would also be outlawed for health reasons, but we all know how Prohibition worked out.
Prior to the Oct. 2018 opening of legal cannabis sales in Canada, a government task force took a hard look at the best-legal-age question. That group found that the higher the minimum legal age, the more likely adolescents will seek out unregulated sources, risking both consumption of potentially more dangerous products and also incarceration.
Prior related post:
June 30, 2020 in Business laws and regulatory issues, International Marijuana Laws and Policies, Medical community perspectives, Medical Marijuana State Laws and Reforms, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)
Monday, May 18, 2020
The title of this post is the title of this interesting new research by multiple authors now appearing in the journal BMC Public Health. Here is its abstract:
Choice of minimum legal age (MLA) for cannabis use is a critical and contentious issue in legalization of non-medical cannabis. In Canada where non-medical cannabis was recently legalized in October 2018, the federal government recommended age 18, the medical community argued for 21 or even 25, while public consultations led most Canadian provinces to adopt age 19. However, no research has compared later life outcomes of first using cannabis at these different ages to assess their merits as MLAs.
We used doubly robust regression techniques and data from nationally representative Canadian surveys to compare educational attainment, cigarette smoking, self-reported general and mental health associated with different ages of first cannabis use.
We found different MLAs for different outcomes: 21 for educational attainment, 19 for cigarette smoking and mental health and 18 for general health. Assuming equal weight for these individual outcomes, the ‘overall’ MLA for cannabis use was estimated to be 19 years. Our results were robust to various robustness checks.
Our study indicated that there is merit in setting 19 years as MLA for non-medical cannabis.
Tuesday, April 14, 2020
Students in my Marijuana Law, Policy & Reform seminar continue "taking over" through presentations on research topics of their choice, and I will continue providing in this space background on their topics and links to relevant materials they provide. The first presentation this week will focus on the country to the north, and here is how the students working on this big topic describes their plans along with background readings they have provided:
The presentation will focus on medical marijuana in Canada. Like with the United States, the national attitude towards medical marijuana in Canada has evolved over the years. It was only four short years after California effectively legalized medical marijuana in 1996, that a Canadian court ruled Canadians had a right to use medical marijuana. It took almost two decades after that court ruling for marijuana to be fully legalized in Canada. Because marijuana is legal in Canada, there is much that can be learned from research conducted in the country. Research on illegal drugs is often met with push back from the government. Full legalization has opened the door for all aspects of research into the effectiveness of marijuana for treating all kinds of illnesses. This research is necessary to facilitate a better understanding of marijuana and it benefits world-wide.
Government of Canada, "For people registered or designated to produce cannabis for medical purposes"
Government of Canada, "Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids"
Tuesday, February 25, 2020
The title of this post is the title of this new "technical report" from the European Monitoring Centre for Drugs and Drug Addiction and authored by Bryce Pardo, Beau Kilmer and Rosalie Liccardo Pacula of the RAND Europe/RAND Drug Policy Research Center. The full 76-page report is worth reviewing in full, and here are some excerpts from the report's executive summary:
To learn more about these new cannabis regimes and their consequences, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) commissioned a review of the changes governing recreational cannabis policies in the Americas and an overview of preliminary evaluations. Findings from this research are intended to inform discussions about the development of a framework for monitoring and evaluating policy developments related to cannabis regulatory reform. Key insights include the following.
In addition to the populations of Canada and Uruguay, more than 25 % of the US population lives in states that have passed laws to legalise and regulate cannabis production, sales and possession/use for recreational purposes. In the US, allowing licensed production and sales is often at the discretion of sub-state jurisdictions, which may impose further zoning restrictions on cannabis-related activities. This variation can complicate analyses that attempt to compare legalisation and non-legalisation states, especially when the outcome data are not representative at state level.
The peer-reviewed literature on cannabis legalisation is nascent, and we observe conflicting results depending on which data and methods are used, as well as which implementation dates and policies are considered. It is important to remain sceptical of early studies, especially those that use a simple binary variable to classify legalisation and non-legalisation states. This scepticism should extend to the many studies that fail to account for the existence of robust commercial medical cannabis markets that predate non-medical recreational cannabis laws. Even if a consensus develops on certain outcomes, it does not mean that a relationship will hold over time. Changes in the norms about cannabis use and potentially other substances, the maturation of markets and the power of private businesses (if allowed) could lead to very different outcomes 15 or 25 years after recreational cannabis laws have passed. Evaluations of these changes must be considered an ongoing exercise, not something that should happen in the short term....
One insight arising from the evaluations of the regulatory changes in the Americas to date is the importance of the amount and range of data collected before the change; simply comparing past-month prevalence rates will not tell us much about the effect of the change on health. While US jurisdictions have been moving quickly to legalise the use of cannabis, the data infrastructure for evaluating these changes is limited. In contrast, Canada has made important efforts to field new surveys and create new data collection programmes in anticipation of legal changes. This highlights the importance of any jurisdictions that are considering changes to the regulatory framework for cannabis starting to think about improving data collection and analysis systems in advance.
While there is much to learn from what is happening in the Americas, policy discussions should not be limited to approaches that have been implemented there. There are several regulatory tools (e.g. minimum pricing, potency-based taxes) that receive very little attention — if any — that could have important consequences for health, public safety and/or social equity. It needs to be recognised that all decisions of this nature involve trade-offs and acknowledging that individuals (and governments) have different values and preferences for risk when it comes to cannabis policy is important for productive debates on this controversial topic.
February 25, 2020 in International Marijuana Laws and Policies, Recreational Marijuana Commentary and Debate, Recreational Marijuana Data and Research, Recreational Marijuana State Laws and Reforms | Permalink | Comments (0)
Monday, January 27, 2020
I have started another semester of my Marijuana Law and Policy seminar at The Ohio State University Moritz College of Law, and early in the semester I spend considerable time exploring the history of all sort of drug laws (including, of course, those dealing with alcohol and so-called harder drugs). Thus, I was very pleased this week to see this new extended posting at the MIT Press Reader authored by Ryan Stoa (the author of “Craft Weed”). I recommend the full piece, and here are excerpts from the start and end of the great piece:
Before the war on drugs put marijuana farmers firmly in its crosshairs, cannabis was being grown openly and with commercial success on every continent on earth, much as it had been for centuries.
This ancient and extensive history of cannabis farming has given rise to the idea that prohibitions put in place in the mid-20th century were the first of their kind — a whirlwind of racial, political, and economic forces that successfully used marijuana prohibition as a pretext for suppression. By contrasting prohibition with our ancient history of cannabis farming, some historians make our modern-day drug laws appear irregular and shortsighted....
Yet, while unprecedented in scope, the United States’ war on drugs was not the first of its kind. The reality is that marijuana has been controversial for almost as long as humans have been farming it. Many societies throughout history have banned cannabis cultivation and use. What many of these crackdowns and prohibitions have in common is social and economic inequality, or a distrust of the unknown. When members of a minority or lower class embrace marijuana use, the ruling class moves to outlaw marijuana as a form of suppression and control. Marijuana is perceived to be a threat to the order of society, and stamping it out naturally begins with a prohibition on cultivation.
What many of these crackdowns and prohibitions have in common is social and economic inequality, or a distrust of the unknown. As a case in point, the ancient Chinese might have been the first cannabis farmers — and, as far as we know, were the first to write about psychoactive marijuana — and yet they may also have been the first to reject it as a socially acceptable drug. The rise of Taoism around 600 BCE brought with it a cultural rejection of intoxicants. Marijuana was then viewed as antisocial, and derisively dismissed by one Taoist priest as a loony drug reserved for shamans. The sentiment persisted into the modern era — to this day, marijuana struggles to disassociate itself with the stained history of opium in China....
The historical record illustrates that while many regions of the world have tolerated or embraced marijuana farming in the past, plenty of others have seen authorities attempt to exterminate farmers and their crops. Targeting the first step in the supply chain is a logical starting point for prohibitionists, and marijuana’s role as an agent of religious, political, or economic change has long made it a threat to the established social order.
Our marijuana-farming ancestors of the past could have told us, based on experience, that when prohibitionists come after cannabis, they will do so in predictable ways. They will use rhetoric to associate the plant with violence, depravity, and other more dangerous drugs, as the European temperance movement did in France and Great Britain. They will use a militarized show of force to eradicate crops, persecute farmers, and dissuade the next generation from growing marijuana, as the Ottomans did in Egypt. They will portray marijuana users as religious extremists or dangerous minorities, as Pope Innocent VIII did in Europe, Sunni Muslims did in the Middle East, or white South Africans did in South Africa. The best-case scenario, they might say, is that the authorities will turn a blind eye to the unstoppable forces of supply and demand, much as the Portuguese did in Brazil or the British did in India.
In telling us this, our marijuana-farming ancestors might as well have been writing the playbook for the 20th-century war on drugs. The cannabis prohibition era in the United States did not invent this “greatest hits” collection of tactics that prohibitionists have been using for centuries; it simply brought them all together in one place, and injected them with more financial and military resources than any prohibition movement in history has ever seen.
Monday, September 9, 2019
Old folks like me remember when one had to track down a hard copy of an issue of High Times in order to read about marijuana and policy reform. But times sure have changed, and the latest media marker of modern high times may be the new newsletter that was rolled out today by Politico, a highly respected inside-the-beltway media outlet covering politics and policy. This newsletter is described this way:
This newsletter launches at a historic moment for marijuana and cannabis policy. Marijuana is legal on some level in 33 states but illegal at the federal level, creating a bewildering and complex web of legal, regulatory and business questions that even the most expert policy makers and lawyers struggle to answer.
This newsletter offers a sneak preview of what we will do for our Pro subscribers starting next month. Our mission for Pro readers is to cover these policy issues with passion and expertise, to deliver exclusive news and analysis, and to report on cannabis from a neutral, unbiased point of view. We come to this issue with no pre-cooked narrative about what should happen on cannabis policy. Our stories will focus on what POLITICO Pro does best: explaining policy issues and the politics behind them and delivering the news in an easy to digest format so that you can use our content to make business decisions.
And here are two new stories from the Politico team about happenings inside and outside the Beltway:
This could be a big moment for marijuana and Congress. But Democrats are fighting Democrats over whether to focus on social justice issues or industry priorities like banking. Marijuana advocates are divided among themselves over whether to push for full legalization or settle for less far-reaching legislation. And many Republicans — some of whom are seeing the benefits of cannabis legalization in their home states — are still decidedly against any legalization on the national level, even for medicinal uses.
At the same time that Congress is in gridlock, there is growing national support for cannabis, which is illegal at the federal level but at least partially legal in 33 states. In addition, public opinion is shifting rapidly, with nearly two-thirds of Americans supporting legalization according to Gallup — double the level of support two decades ago. That’s led to a steadily growing number of lawmakers on both sides of the aisle who represent states with legal cannabis markets, making them more sympathetic toward legislation aimed at helping the burgeoning industry — which brought in roughly $10 billion in sales last year.
These conflicts between state and federal law have created a rash of problems for cannabis companies, including lack of access to banking services, sky-high federal tax rates and bewildering questions about exactly what business practices are legal.
The United States is feeling some North American peer pressure to get in on the cannabis boom. Producers in Canada, where marijuana is legal for medicinal and recreational uses, are already planning for a future where pot is a globally traded commodity, and some are setting themselves up to profit if it is legalized in the U.S.
In Mexico cannabis is legal for medicinal purposes, and the landscape could shift further: The country's new president, whose party controls a majority in the national legislature, sent a proposal to the Mexican Senate late last year to legalize recreational use.
September 9, 2019 in Federal Marijuana Laws, Policies and Practices, International Marijuana Laws and Policies, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)
Friday, August 30, 2019
The title of this post is the title of this notable new article just published via the journal Contemporary Drug Problems and authored by Tobias Kammersgaard. Here is its abstract:
Several drug policy researchers have noted that the concept of harm reduction could be applied to the field of drug policing in order to assess the negative consequences and potential benefits of policing in this area. However, the application of harm reduction principles to drug policing has only been realized to a limited extent in the current responses to drug use and markets. Accordingly, studies that empirically investigate already existing policing practices, which might be described as operating within such a harm reduction framework, are relatively scarce.
In order to address this gap, this article provides an investigation of how policing of an open drug scene has been organized in Denmark since drug possession has been partly decriminalized, following the introduction of drug consumption rooms in Copenhagen. The policing of this open drug scene was investigated through document analysis, interviews, and observations with a patrolling police officer. The article argues that decriminalization has resulted in a shift in the “logics” of policing by enabling the production of an alternative “governable identity” for the drug-using subject, where people who use drugs could more readily be perceived as citizens with rights rather than just as offenders. Accordingly, in this new logic, the violence and victimization experienced by marginalized people who use drugs could more readily be identified as proper objects for police action. The study contributes to our knowledge of how the police can become potential allies rather than adversaries in harm reduction initiatives and broader public health concerns.
Thursday, April 18, 2019
The title of this post is the headline of this interesting New Yorker commentary authored by Stephen Marche. Here are excerpts:
This 4/20 will be different, at least in Canada. It will be the first celebration of marijuana since the country made pot legal in October, 2018. The time passed since the end of prohibition hasn’t been long enough to establish any direct consequences from legalization so far, but one thing has already become painfully clear from Canada’s experiment. When you make pot legal, you make it super, super boring....
Other than new signs at the airport warning the more dull-witted Canadian citizens to dispense of their marijuana in the appropriate receptacles before leaving the country, it was hard to notice any real change after the passage of the marijuana laws. The pot dispensaries, semi-underground before the end of prohibition, were supposed to disappear, but went on just as before. They’ve just becoming increasingly polished. The place where I buy my weed looks like a Pottery Barn, and it was so busy the other day that they gave me one of those buzzers they hand out at Shake Shack to tell you when your order is ready. I had to wait twenty minutes.
It’s also money that’s making pot boring. Recently, I went to a champagne-and-hot-wings party — a superb concept, by the way — in a wealthy neighborhood in Toronto, and it felt like half the people attending were in the cannabis industry in one way or another; many of them had transitioned from hedge funds. Marijuana stocks have overtaken real estate as the standard conversational go-to of Toronto dinner parties. And you have not understood how banal marijuana can be until you overhear two parents watching their kids at a swimming lesson discuss how I.S.O. 9000 certification affects the marketing efforts for stocks of C.B.D.-extract companies....
Even a few months after legalization, I find myself wondering how much of the pleasure of marijuana came from its illicitness. When you used to pass around a joint, you were sharing a little naughtiness, a tiny collective experience of rebellion. Now, at a party, when you a pass around a joint, you’re basically saying let’s go stare at things for a while. When I see cops on the street today, there is nothing I do that might upset them. We are on the same side, utterly. It’s pathetic.
There may still be dangers to marijuana, of course. The public-health effects of legalization are, as yet, unknown. Nobody knows whether legalization will lead to higher rates of teen-age mental illness, or to traffic accidents. But, already, it is unimaginable that marijuana would be made illegal again. Even with the brief distance of a few months since the end of prohibition, the sheer stupidity of the drug war appears absolute. Marijuana isn’t worth the attention of the police. It’s not even that good a drug. It wouldn’t be in my top five, anyway.
One of the most important consequences of marijuana’s legalization is that the drug can now be studied. We might learn how it works and what it does to people. Clinical trials will replace the loose collection of vague anxieties and promotional pseudoscience that have dominated discussions of marijuana up to this point in history. It will finally be possible to think sensibly about marijuana. And what could be more boring?....
It has to be said, in boredom’s defense, that it’s the cure for a great number of evils. The cliché holds that America is losing the war on drugs, but it’s not quite accurate. Cocaine and heroin have never been cheaper. Overdose deaths recently topped car accidents as a more likely cause of death for adults in the United States. But America is very much winning the war on drugs that are legal: tobacco use has declined sixty-seven per cent since 1965, and drunk-driving fatalities by forty-eight per cent since 1991. Of course, the way America reduced the use of these drugs wasn’t by killing bad guys and arresting users en masse, but by treating them like social problems with collective solutions. Yawn. No one’s going to make a season of “Narcos” out of that.
Canada is proving, once again, the deep political power of boredom: if you want to suck the power and glamour out of drugs, let the government run them.
April 18, 2019 in Business laws and regulatory issues, History of Marijuana Laws in the United States, International Marijuana Laws and Policies, Recreational Marijuana Commentary and Debate | Permalink | Comments (1)
Monday, February 4, 2019
Blogging was light last week in part part because I was on the road for much of the time (participating in this great event among other activities). During my travels and thereafter, I saw what seemed like a month's worth of notable blogworthy marijuana stories, and here I will try to play catch-up with an abridged round-up via links and headlines:
February 4, 2019 in History of Marijuana Laws in the United States, International Marijuana Laws and Policies, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Who decides | Permalink | Comments (0)
Monday, December 24, 2018
Effective accounting of Top 5 marijuana reform developments in 2018 (with a couple extra added for emphasis)
German Lopez has this effective Vox piece serving as a kind of marijuana reform year in review under the headlined "5 moments that show 2018 was marijuana legalization’s biggest year yet: From Canada to Michigan to California, marijuana legalization had a very big year." Here are excerpts from the start of the piece with his top 5 listing as it appears therein:
When we look back, 2018 may be the year in which marijuana legalization really won.
Canada legalized marijuana, defying international treaties (which the US is also a part of) that prohibit fully legalizing cannabis.
After legalizing marijuana in 2016, California opened the world’s biggest fully legal pot market in early 2018.
Michigan became the first state to legalize pot in the Midwest.
State legislatures, particularly New York, New Jersey, and Vermont, began taking legalization more seriously. And while Congress didn’t legalize pot at the federal level, it did legalize industrial hemp.
Together, these developments represented a tidal wave for legalization — a massive shift that’s making legal pot look more and more inevitable across the country.
Here are the five major stories of marijuana legalization this year, and why they matter.
1) Canada legalized marijuana...
2) California opened the world’s biggest legal marijuana market...
3) Michigan became the first state in the Midwest to legalize pot...
4) State legislatures began taking legalization seriously...
5) The federal government legalized hemp...
This top five list strikes me as sound, though I think the federal legalization of hemp should find a place higher on the list and I have a few additions that I think could reasonably compete for a top five spot. First, I think it very significant that serious medical marijuana reforms were enacted by ballot initiative with strong majorities in 2018 in the very red states of Missouri, Oklahoma and Utah. Senators in very red states will be able to stop or limit or shape any future federal marijuana reforms, so having red states come into the reform fold is so very important for the fate and future of federal reform efforts. Second, and perhaps worth of a coming future post, arguably the biggest story of 2018 was a non-story, namely the decision in January of (now former) Attorney General Sessions to repeal the Cole memo shaping federal marijuana enforcement and then the failure of the new Sessions memo amounting to much of anything. I was not too worried that all that much would come from repeal of the Cole memo, but that so little resulted still strikes me as another telling sign of the state of marijuana reform as we close out 2018.
December 24, 2018 in Campaigns, elections and public officials concerning reforms, History of Marijuana Laws in the United States, International Marijuana Laws and Policies, Medical Marijuana Commentary and Debate, Recreational Marijuana Commentary and Debate, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (0)
Saturday, December 15, 2018
The title of this post is the headline of this effective recent piece by John Collins of the London School of Economics written for the BBC. Here are excerpts:
Around the world attitudes towards the use of cannabis are shifting. Mexico's new government plans to legalise recreational cannabis use, as does the incoming government of Luxembourg. Meanwhile, New Zealand's Prime Minister Jacinda Ardern is considering a referendum on what its approach should be....
What has led one country after another to move towards a relaxation of their laws and, in many cases, outright legalisation?
It was only in 2012 that Uruguay announced it would be the first country in the world to legalise recreational cannabis use. In large part, the move was aimed at replacing links between organised crime and the cannabis trade with more accountable state regulation.
Later the same year, voters in Washington State and Colorado became the first in the US to support legalisation of the drug for non-medical use. Under President Barack Obama, a critic of the US-led war on drugs, the US government stepped back from enforcing federal laws and effectively gave states a green light to explore alternatives....
The tide has crept across the Americas, with Canada legalising the sale, possession and recreational use of cannabis nationwide in October.
That Mexico will legalise marijuana seems a virtual certainty. The new government of Andrés Manuel López Obrador has introduced a bill that would legalise its medical and recreational use, while the country's supreme court recently ruled an absolute ban on recreational use unconstitutional.
Other countries are pushing ahead. Although the sale of cannabis remains illegal, possession of small amounts is no longer a crime in countries including Brazil, Jamaica and Portugal. In Spain it is legal to use cannabis in private, while the drug is sold openly in coffee shops in the Netherlands. Still more countries allow the use of medicinal cannabis.
Around the world, there are many more countries where change is under way:
In the UK, doctors have been allowed to prescribe cannabis products since November
South Korea has legalised strictly-controlled medical use, despite prosecuting residents for recreational use overseas
A death sentence given to a young man selling cannabis oil has stirred debate about legalisation in Malaysia
South Africa's highest court legalised the use of cannabis by adults in private places
Lesotho became the first African country to legalise the cultivation of marijuana for medicinal purposes
Lebanon is considering the legalisation of cannabis production for medical purposes, to help its economy....
With countries worldwide moving towards some form of legalisation, others are rushing to catch up. Often, as in many parts of Latin America, governments want their farmers to have access to the potentially lucrative medicinal cannabis markets that are developing.
Corporations have also expressed interest. For example, Altria, which owns cigarette brands including Marlboro, has made a $1.86bn (£1.46bn) investment in a Canadian cannabis company. Over time, as the US demonstrates, it is quite possible that the medical trade could quite easily morph into recreational sales - potentially opening up an even bigger market.
One immediate obstacle is that cannabis for recreational purposes cannot be traded across borders. Countries can only import and export medicinal cannabis under a licensing system supervised by the International Narcotics Control Board.
Farmers in countries such as Morocco and Jamaica may have a reputation for producing cannabis, but they can't access markets that domestic producers sometimes struggle to supply - as happened in Canada following legalisation....
Governments that want to move towards legalisation face a challenge: steering a course between uncontrolled legalisation and hard prohibition. Poorly-regulated industry and mind-altering substances are not a combination about which many societies would feel comfortable. But it seems a virtual certainty that more countries will change their approach to cannabis in the coming decades. As such, domestic and international rules will need to catch up.
Sunday, December 9, 2018
I just came across this morning this remarkable article published this month in The Lancet Psychiatry titled "The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016." The array of data in the article is fascinating (and overwhelming), and here is its summary:
Alcohol and drug use can have negative consequences on the health, economy, productivity, and social aspects of communities. We aimed to use data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 to calculate global and regional estimates of the prevalence of alcohol, amphetamine, cannabis, cocaine, and opioid dependence, and to estimate global disease burden attributable to alcohol and drug use between 1990 and 2016, and for 195 countries and territories within 21 regions, and within seven super-regions. We also aimed to examine the association between disease burden and Socio-demographic Index (SDI) quintiles.
We searched PubMed, EMBASE, and PsycINFO databases for original epidemiological studies on alcohol and drug use published between Jan 1, 1980, and Sept 7, 2016, without language restrictions, and used DisMod-MR 2.1, a Bayesian meta-regression tool, to estimate population-level prevalence of substance use disorders. We combined these estimates with disability weights to calculate years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 1990–2016. We also used a comparative assessment approach to estimate burden attributable to alcohol and drug use as risk factors for other health outcomes.
Globally, alcohol use disorders were the most prevalent of all substance use disorders, with 100·4 million estimated cases in 2016 (age-standardised prevalence 1320·8 cases per 100000 people, 95% uncertainty interval [95% UI] 1181·2–1468·0). The most common drug use disorders were cannabis dependence (22·1 million cases; age-standardised prevalence 289·7 cases per 100000 people, 95% UI 248·9–339·1) and opioid dependence (26·8 million cases; agestandardised prevalence 353·0 cases per 100000 people, 309·9–405·9). Globally, in 2016, 99·2 million DALYs (95% UI 88·3–111·2) and 4·2% of all DALYs (3·7–4·6) were attributable to alcohol use, and 31·8 million DALYs (27·4–36·6) and 1·3% of all DALYs (1·2–1·5) were attributable to drug use as a risk factor. The burden of disease attributable to alcohol and drug use varied substantially across geographical locations, and much of this burden was due to the effect of substance use on other health outcomes. Contrasting patterns were observed for the association between total alcohol and drug-attributable burden and SDI: alcohol-attributable burden was highest in countries with a low SDI and middlehigh middle SDI, whereas the burden due to drugs increased with higher SDI level.
Alcohol and drug use are important contributors to global disease burden. Effective interventions should be scaled up to prevent and reduce substance use disease burden.
Tuesday, November 20, 2018
The title of this post is the title of this new commentary in The Hill authored by Helen Clark, a member of the Global Commission on Drug Policy and the former prime minister of New Zealand. Here are excerpts:
In my experience as head of my country’s government and previously a health minister, as a former senior official at the United Nations, and more recently as a member of the Global Commission on Drug Policy, I’ve found debates on drug policy tend to be divisive and passionately ideological. On one point, however, there is a clear and growing consensus: Around the world, the so-called “war on drugs” is failing.
It has been estimated that globally more than $100 billion a year is spent waging this silent war, with over $40 billion of that spent in the United States alone. Yet, despite the huge amount of funding invested in drug control, the challenges are rising, not reducing, and the core objectives in the United Nations charter of promoting human rights, peace and security and development are being dramatically undermined by global drug policies. Unfortunately, there is even less consensus on the question of where we go from here....
A starting point for understanding better the political context is a new landmark report by the International Drug Policy Consortium — a global civil society network of over 170 non-governmental organizations focusing on drug policy — which has laid bare the drug war’s failures in the starkest terms. The 2009 10-year U.N. drug strategy committed governments worldwide to creating a world free of drugs by 2019. But with each passing year, the world has moved further and further from this fantastical goal.
As the report highlights, drug use has not disappeared but instead has risen by 31 percent between 2011 and 2016. Illegal drug markets have expanded relentlessly to meet this growing demand, with opium and coca production rising respectively by 130 percent and 34 percent between 2009 and 2018. Beneath this shocking failure of the 10-year strategy to meet its “eradication” goals lie even bleaker realities. To quote the late Kofi Annan, former U.N. secretary general and a member of the Global Commission on Drug Policy: “I believe that drugs have destroyed many lives, but wrong government policies have destroyed many more.”
Indeed, the number of drug-related deaths continues to reach new peaks, with 450,000 drug use-related deaths in 2015 alone. Much of this rise is driven by the North American opioid overdose crisis, with total overdose deaths in the United States reaching a record 72,000 people in 2017. This is more than the total number of U.S. soldiers who died in the Vietnam War.
Punitive drug law enforcement is fueling mass incarceration and prison overcrowding, with one in five of the world’s 10 million prisoners — tens of thousands in the United States alone — now incarcerated for drug offences, mostly for minor, nonviolent drug possession. This proportion is even greater for women, reaching over 50 percent in several Latin American countries and over 80 percent in Thailand.
Furthermore, drug market-related violence has spiraled to unprecedented levels. In Mexico alone, there have been up to 250,000 killings and 32,000 disappearances since 2006. This horrific level of bloodshed is compounded by illegal state actions where, at its extremes, the war on drugs is providing political cover for some of the most egregious human rights abuses taking place anywhere on the planet. Thousands have been executed for drug offences over the past decade and, according to several human rights groups, up to 12,000 people have been killed extrajudicially in horrific drug war operations in the Philippines since 2016.
Rather than eradicating drugs, prohibition is empowering and enriching organized crime groups. The combined impact of the drug war-fueled criminality, violence and corruption ranges from harm in U.S. cities and other developed countries to undermining development in low- and middle-income countries....
As the Global Commission on Drug Policy again highlighted only last month, if the so-called “war on drugs” continues unchallenged, achieving the U.N. Sustainable Development Goals — the universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity — will be difficult, if not impossible, for many populations across the world.
It is hard to imagine a global policy enterprise that has delivered poorer value for money. The global community should ask what another trillion dollars spent in the coming decade might achieve if directed to more positive ends.
The reforms needed to deliver on our shared goals may not be easy to achieve, but they are not unsurmountable. They include pivoting away from failed punitive enforcement towards proven health and harm reduction policies; ending the criminalization of people who use drugs; mainstreaming human rights and development in policy thinking; and exploring responsible legal regulation models for cannabis and other drugs.
Thursday, November 1, 2018
The title of this post is the headline of this new Reuters article. Here are the interesting details:
Mexico’s Supreme Court on Wednesday ruled that an absolute ban on recreational use of marijuana was unconstitutional, effectively leaving it to lawmakers to regulate consumption of the drug.
Announcing it had found in favor of two legal challenges filed against prohibition of recreational marijuana use, Mexico’s top court crossed the threshold needed to create jurisprudence: five similar rulings on the matter. That creates a precedent other Mexican courts will have to follow.
“This is a historic day,” Fernando Belaunzaran, an advocate of drug reform and member of the opposition leftist Party of the Democratic Revolution (PRD), said.
The Supreme Court made its first ruling to allow a group of people to grow marijuana for personal use in November 2015. In a statement, the court said the ruling did not create an absolute right to use marijuana and that consumption of certain substances could still be subject to regulation. “But the effects caused by marijuana do not justify an absolute prohibition on its consumption,” it said.
The court ordered federal health regulator COFEPRIS to authorize people seeking the right to use marijuana to do so personally, “albeit without allowing them to market it, or use other narcotics or psychotropic drugs.” Congress would now have to act to regulate the use of marijuana in Mexico, Belaunzaran said.
Thursday, October 18, 2018
Will Canada's legalization of marijuana impact coming legalization votes in Michigan and North Dakota and elsewhere in US?
The question in the title of this post is my domestic reaction to the big international marijuana reform news of Canadian marijuana legalization efforts becoming a reality. This new Politico article, headlined "Members of Congress, businesses push for homegrown weed," reports on some of the US echoes of what has transpired in the country up north this week, and here are excerpts:
Washington just got some major peer pressure to embrace the bong. Its vast northern neighbor Canada legalizes the retail sale of marijuana nationwide Wednesday. The Canadian cannabis sector is already estimated to be worth $31 billion and upstart marijuana companies have soared on the New York Stock Exchange.
But America’s patchwork of state laws — and federal ban on marijuana — put American pot companies at a high disadvantage. It's unclear whether the push to liberalize U.S. marijuana laws will get very far: Attorney General Jeff Sessions has declared war on marijuana, though his efforts have been dampened by a not-so-hostile White House. Yet Rep. Dana Rohrabacher (R-Calif.) said last week that the White House plans to address cannabis reform following the midterms.
Rohrabacher's efforts are bolstered by a chorus of congressional and business voices calling on the Trump administration to respond with an “America First” policy on pot. A publicly traded U.S. cannabis company bought a full-page ad in the Wall Street Journal Tuesday with a message to President Donald Trump: Canada will take over the U.S. marijuana market if we don't legalize soon....
A bipartisan group of American lawmakers fumed last month when the U.S. Drug Enforcement Agency gave the green light to importing Canadian marijuana for research purposes. The 15 lawmakers, many of them representing states that have legalized recreational cannabis, protested to the DEA and Sessions that dozens of American companies already requested permission to produce marijuana for study. They wrote that allowing the University of California, San Diego, one of the applicants, to import marijuana capsules from Canada-based Tilray, Inc., was “adding insult to injury.”
Noting that Trump had issued a "Buy American" executive order, the lawmakers urged the administration to ensure that the domestic need for cannabis research be met by American institutions. The concerns are not just limited to medicinal marijuana. Recreational use is gaining a foothold in U.S. states. Voters in North Dakota and Michigan will vote on ballot initiatives on legalization on Election Day.
Already, nine states and the District of Columbia, have legalized pot, and 31 others allow medical marijuana. “I think it frankly cries out for a federal solution,” Rep. Kevin Cramer (R-N.D.), now challenging Democrat Heidi Heitkamp for her Senate seat, told POLITICO. “And this is tough stuff — this is hard stuff to talk about — because I’m a law-and-order congressman, but it’s impossible to ignore what’s going on. … If the federal government itself doesn’t do something to sort of at least provide the banking system that allows for greater oversight and regulation, I think we’re just setting ourselves up for a bit of a rogue industry rather than a highly regulated one.”
Though this piece is focused on federal US policies, I am especially interested in the reality that the two states voting on full legalization this election cycle both border Canada. I have been thinking that voters in the (bluish) state of Michigan were on a path toward legalization even before these developments in Canada, but I have also been guessing that voters in the (deep red) state of North Dakota were not going to be ready to vote for full legalization. But maybe developments up north could change these dynamics among the voters
October 18, 2018 in Campaigns, elections and public officials concerning reforms, History of Marijuana Laws in the United States, Initiative reforms in states, International Marijuana Laws and Policies, Political perspective on reforms, Recreational Marijuana Commentary and Debate, Recreational Marijuana State Laws and Reforms, Who decides | Permalink | Comments (1)
Wednesday, October 17, 2018
Canada has plans for mass pardons of low-level marijuana offenders in conjunction with legalization reforms
As my various in-box fill up with stories about the start of marijuana legalization in Canada, this particular piece garnered my attention given my work on the intersection of marijuana reform and criminal justice reform: "Feds to announce plan to pardon Canadians convicted of simple possession of pot." Here are the basics:
The federal government will announce on Wednesday morning that it intends to proceed with a plan to grant pardons to Canadians who have past simple possession charges.
Sources have confirmed to CTV News that the government intends to issue pardons, and not record expungements or amnesty, for cases of possession of 30 grams or less, as that will be legal as the new recreational legalization regime comes into force at midnight tonight....
The pardons won't be granted immediately, but ministers are expected to outline options that could be used to facilitate the pardon process, and potential ways to expedite the sometimes protracted endeavor. One option could be an application-based approach, where people would have to fill out a form to qualify.
Asked about pardons on the Hill earlier on Tuesday, Prime Minister Justin Trudeau said “we’re going to be working on that as I’ve said, as soon as the day of legalization comes into force.”
NDP MP Murray Rankin tabled a private member’s bill earlier this month that pushed for the expungement of records of anyone who carries a criminal record for past minor, non-violent pot possession convictions. By his estimate there are hundreds of thousands of Canadians that carry personal possession charges for marijuana.
Tuesday, September 18, 2018
Top court in South Africa rules that privacy rights protects adult use of marijuana in private places
As reported in this BBC article, "South Africa's highest court has legalised the use of cannabis by adults in private places." Here is more about a major ruling for marijuana reform:
In a unanimous ruling, judges also legalised the growing of marijuana for private consumption.
South Africa's government had opposed its legalisation, arguing the drug was "harmful" to people's health. It has not yet commented on the ruling, which is binding.
Three cannabis users who had faced prosecution for using the drug brought the case, saying the ban "intrudes unjustifiably into their private spheres".
In his judgement, Deputy Chief Justice Raymond Zondo said: "It will not be a criminal offence for an adult person to use or be in possession of cannabis in private for his or her personal consumption." It will, however, remain illegal to use cannabis in public, and to sell and supply it....
This judgement is a reminder that South Africa's hard-won constitution is among the most liberal in the world, backing individual rights, and in this case the right to grow and smoke your own marijuana in private, against the government's concerns about public health and public order.
The Constitutional Court's ruling focuses on the issue of privacy, and a person's right to do as they please in their own home. The potential implications of the binding judgment are enormous, and unpredictable - particularly in terms of the criminal justice system, which routinely locks up thousands of overwhelmingly poor South Africans for using or dealing in small amounts of cannabis.
It is possible that the ruling, by allowing users to grow their own marijuana at home, could undermine the stranglehold of powerful drug gangs that blight so many communities. But the police, who argued against this change, will worry that the ruling will create more ambiguity and send the wrong signal to criminals.
The court has not approved - in any form - the trade in marijuana, meaning the government will not be able to profit from taxing a legalised industry.
In political terms, the landmark ruling emphasises the primacy of South Africa's constitution, which brushed aside the united opposition of numerous government ministries at a time when the authority and credibility of many of this young democracy's other institutions have been eroded by corruption and poor governance.
The court gave parliament 24 months to change the law to reflect its ruling. Adults who used marijuana in private would be protected by the ruling until the law was amended.
The court did not specify the quantity of cannabis a person can grow or use in private. Parliament would have to decide on this, it said.
The full opinion in this case, Minister of Justice and Constitutional Development v Gareth Prince, is available at this link, and here is a key paragraph from its introduction:
It is declared that, with effect from the date of the handing down of this judgment, the provisions of section 5(b) of the Drugs and Drug Trafficking Act 140 of 1992 read with Part III of Schedule 2 of that Act and with the definition of the phrase “deal in” in section 1 of the Drugs and Drug Trafficking Act 140 of 1992 are inconsistent with the right to privacy entrenched in section 14 of the Constitution and, are, therefore, constitutionally invalid to the extent that they prohibit the cultivation of cannabis by an adult in a private place for his or her personal consumption in private
Tuesday, July 31, 2018
Constitutional Court in the country of Georgia holds marijuana consumption is protected by the right to free personality
Though I am surely losing something in the translation of Georgian web pages here and here, I am still sure a ruling by Georgia's Constitutional Court this week is a big deal. This press report, headlined "Georgian Court Abolishes Fines For Marijuana Consumption," provides these details:
Georgia's Constitutional Court has abolished administrative punishments for the consumption of marijuana, making the Caucasus country the first former Soviet republic to legalize usage of the drug.
The ruling by four senior court judges on July 30 concerns only the consumption of cannabis, while cultivation and selling remain a crime, the court said in its ruling. It added that punishing a person for consuming cannabis would comply with the constitution only if consumption put a third party at risk.
"According to the applicants [Zurab Japaridze and Vakhtang Megrelishvili], the consumption of marijuana is not an act of social threat. In particular, it can only harm the user's health, making that user him/herself responsible for the outcome. The responsibility for such actions does not cause dangerous consequences for the public," the court said.
"The Constitutional Court highlights the imposition of responsibility of marijuana consumption when it creates a threat to third parties. For instance, the court will justify responsibility when marijuana is consumed in educational institutions, public places, such as on public transport, and in the presence of children,” it added....
Japaridze told reporters the ruling was a victory for a freer Georgia. "This wasn't a fight for cannabis. This was a fight for freedom," he said.
In late November, the Constitutional Court decriminalized use of marijuana or other forms of cannabis-based drugs but preserved administrative punishment, such as a fine, for marijuana use. Before that, Georgia's Criminal Code defined repetitive use of marijuana and possession of more than 70 grams of dried cannabis as a crime for which individuals could face punishment that does not include imprisonment.
It is striking and somewhat telling that now a former Soviet satellite republic that still shares a border with Russia now has more progressive protections for fee use of marijuana than does the US of A. One might hope that those who preach freedom in the US would take a lesson from this ruling, but I suspect that few know for sure where Georgia is on the map and fewer still will know it now constitutionally protects the freedom to consume marijuana more than does the US government or its federal courts.
Monday, July 9, 2018
I have long thought that the economic development potential of marijuana reform could be one big reason the movement has staying power. Against that backdrop, this new New York Times article about economic (over?)excitement in Canada really struck me because of the comparison to the dot-com boom. The piece is headlined, "Legal Marijuana Is Coming to Canada. Investors Catch the Buzz." Here is an excerpt:
A financial boom not seen since the dot-com mania of the late 1990s has overtaken Canada. The legalization of recreational marijuana, scheduled for this autumn, is not only a momentous social change and public health challenge, but also a rare opportunity for entrepreneurs like Mr. Asi to be in on the birth of what they hope will become a multibillion-dollar industry.
Early signs of a boom abound: Marijuana growers have plowed millions into investments that, without having recorded profits yet, have stock-market values measured in billions. Down-on-their-luck towns like Chesterville, Ontario, hope that marijuana will reverse economic decline. Former politicians and law-enforcement officials who once opposed legalizing recreational marijuana have now joined or formed companies to cash in on it.
Some provincial governments forecast that tax revenue from marijuana sales will help balance their budgets. And companies offering every kind of service or product — from real estate to packaging — are all out for a piece of the action....
Mr. Trudeau’s government portrayed the legalization of recreational marijuana — Canada has had a medical marijuana system since 2001 — as a way to wipe out the black market, not as a potential job creator or moneymaker for either the government or investors. In effect, he promised a system in which marijuana would be available, but not promoted.
As a result, the federal government will license growers in Canada, and provinces will decide how it is sold to consumers. In some provinces, notably Alberta, the government went with privately operated shops. Others, like Ontario and Quebec, will essentially adopt a variation of the system of government-owned stores that has been used for alcohol sales since Prohibition ended.
Under regulations recently released, marijuana will generally be treated more like cigarettes than alcohol. Advertising will be severely restricted — as will the ability of Canada’s marijuana makers to turn themselves into household brand names. Packages must be uniform and plain, aside from vivid, yellow health warnings and tiny logos. Even baseball caps, T-shirts and all other logo-laden giveaways promoting marijuana brands will not be permitted....
Cam Battley, who once worked in the pharmaceutical industry and who is now the chief corporate officer of Aurora Cannabis (market value: 5.6 billion Canadian dollars; losses in the first part of this year: 20 million dollars), acknowledged that the soaring values of marijuana companies may not be justified in every case. But he also rejected suggestions that the dreams surrounding the industry may, well, go up in smoke. “People should be cautious and do their homework on the cannabis sector,” Mr. Battley said. “We’ve become a mainstream industry in Canada. On this, we’re not seen as a wild and crazy country. I think the world trusts Canada to get cannabis right.”
Wednesday, June 20, 2018
The title of this post is the headline of this effective new Vox article that reports on the big marijuana reform news from the big country up north and details some of the likely echoes for Canada's neighbor and the rest of the world. I recommend the entire piece, and here are excerpts:
Canada has become the first wealthy nation in the world to fully legalize marijuana. The Senate approved Bill C-45, also known as the Cannabis Act, on Tuesday. The measure was already approved by the House of Commons, so the Senate’s approval means it’s now set to become law.
The measure legalizes marijuana possession, home growing, and sales for adults. The federal government will oversee remaining criminal sanctions (for, say, selling to minors) and the licensing of producers, while provincial governments will manage sales, distribution, and related regulations — as such, provinces will be able to impose tougher rules, such as raising the minimum age. The statute largely follows recommendations made by a federal task force on marijuana legalization. Canadian and provincial governments are expected to need two to three months before retail sales and other parts of the law can roll out.
None of this may seem too shocking in the US, where already nine states have legalized marijuana for recreational use and 29 states have allowed it for medicinal purposes. What sets Canada apart, though, is it’s doing this as a country. Previously, the South American nation of Uruguay was the only one that legally allowed marijuana for recreational purposes.
Canada, like the US, is part of international drug treaties that explicitly ban legalizing marijuana. Although activists have been pushing to change these treaties for years, they have failed so far — and that means Canada will be, in effect, in violation of international law in moving to legalize. (The US argues it’s still in accordance with the treaties because federal law still technically prohibits cannabis, even though some states have legalized it.)...
In moving forward, the Canadian government is now walking a fine line: It’s hoping to legalize marijuana to clamp down on the black market for cannabis and provide a safe outlet for adults, but it’s risking making pot more accessible to kids and people with drug use disorders. It is taking a bold step against outdated international drug laws, but it could upset countries like Russia, China, and even the US that have historically adopted a stricter view of the treaties. And while Canadian lawmakers may feel marijuana legalization is right for their country, there’s a risk that legal Canadian pot will spill over to the US — perhaps causing tensions with Canada’s neighbor and one of its closest allies. Whether Canada is successful in its legalization attempts will depend on how it strikes a balance between these concerns. And depending on how it pulls this off, it may provide a model to other countries interested in legalization — including the US....
Legalization carries risks too. It could lead to more use and misuse by making pot cheaper and more available. Mark Kleiman, a drug policy expert at New York University’s Marron Institute, estimates that in the long term a legal marijuana joint will cost no more to make than, say, a tea bag — since both products come from plants that are fairly easy to grow. It would also be available to anyone (of legal age) in retail outlets after legalization — meaning it would no longer require a shady or secretive meeting with a drug dealer. Those are benefits for people who use marijuana without problems, to be sure, but easier access could also pose a risk for people who can’t control their cannabis consumption.
Although marijuana isn’t very dangerous compared to some drugs, it does carry some risks: dependence and overuse, accidents, nondeadly overdoses that lead to mental anguish and anxiety, and, in rare cases, psychotic episodes. Still, it’s never been definitively linked to any serious ailments — not deadly overdoses, lung disease, or schizophrenia. And it’s much less likely — around one-tenth so, based on data for fatal car crashes — to cause deadly accidents compared to alcohol, which is legal....
Canada is striking a balance unlike that of the US’s legalization experiments so far. So far in the US, the eight states that have legalized pot sales have done so with a model similar to alcohol. (Vermont has only legalized possession, not retail sales.) Basically, they’re setting up their systems to allow a for-profit pot industry to flourish, similar to the alcohol industry.
Drug policy experts, however, often point to the alcohol industry as a warning, not something to be admired and followed for other drugs. For decades, big alcohol has successfully lobbied lawmakers to block tax increases and regulations on alcohol, all while marketing its product as fun and sexy in television programs, such as the Super Bowl, that are viewed by millions of Americans, including children. Meanwhile, alcohol is linked to 88,000 deaths each year in the US.
If marijuana companies are able to act like the tobacco and alcohol industries have in the past, there's a good chance they’ll convince more Americans to try or even regularly use marijuana, and some of the heaviest users may use more of the drug. And as these companies increase their profits, they’ll be able to influence lawmakers in a way that could stifle regulations or other policies that curtail cannabis misuse. All of that will likely prove bad for public health (although likely not as bad as alcohol, since alcohol is simply more dangerous).
There are policies that can curtail this, some of which Canada’s plan will allow. For example, Canada’s measure restricts marketing and advertising. In the US, this is generally more difficult because the First Amendment protects commercial free speech. (Tobacco marketing is largely prohibited due to a massive legal settlement.) But in Canada, the restrictions could stop marijuana companies from marketing their product in a way that targets, say, children or people who already heavily use cannabis....
Canada’s bill also lets provinces entirely handle the distribution and sales of marijuana — up to letting provincial governments directly manage and staff all pot stores by themselves. While state-run liquor stores aren’t unheard of in the US when it comes to alcohol, it’s widely seen as risky in America with marijuana: Since cannabis is illegal at the federal level, asking state employees to run marijuana shops would effectively ask them to violate federal law. But since Canada is legalizing marijuana nationwide in one go, it can do this — and several provinces are expected to take up this option.
The promise of government-run marijuana shops is that they could be better for public health. In short, government agencies that run shops are generally going to be more mindful of public health and safety, while private companies are only going to be interested in maximizing sales, even if that means making prices very low or selling to minors and people with drug use disorders. Previous research found that states that maintained a government-operated monopoly for alcohol kept prices higher, reduced youth access, and reduced overall levels of use — all benefits to public health.