Let’s Talk About International Cannabis Policy

By Orsi Feher ’16, SSDP’s Europe Global Fellow

In November 2016, the World Health Organization (WHO) launched a scientific assessment on the uses and potential harms of the plant Cannabis sativa L. and its derivatives through their Expert Committee on Drug Dependence (ECDD). Their final recommendation was expected to be presented to the United Nations’ Committee on Narcotic Drugs (CND) this December for member states to have time to study and discuss before voting on possibly rescheduling cannabis in March at the annual CND meeting. [1] All controlled drugs are scheduled by their perceived level of harm and directly impacts the international law and regulation of drugs. CND members vote on scheduling new substances every March in accordance with WHO recommendations. Cannabis is now listed as a drug with the highest potential of harm and the least medical usefulness. This has been so since 1961, without any scientific evaluation or reassessment of the original scheduling decision.

The overwhelming majority of the international Cannabis community seemed to be confidently optimistic about the ECDD report. We expected the WHO to recommend placing Cannabis and its derivatives in a suitable schedule which recognizes its medical and therapeutical potential. Therefore, the first ever International Cannabis Policy Conference was organized in Vienna, starting on the exact date of the expected WHO announcement, with the aim of exploring the policy landscape after the WHO’s outcome and align the efforts of the private and civil sector with the UN’s own Sustainable Development Goals (useful links: https://www.un.org/sustainabledevelopment/sustainable-development-goals/ and https://www.unodc.org/documents/ungass2016/Contributions/Civil/Health_Poverty_Action/HPA_SDGs_drugs_policy_briefing_WEB.pdf).

Although the WHO has regretfully postponed their recommendation indefinitely, the conference went ahead with a lot to speculate on and to discuss. One of those discussions included a panel on Harm Reduction and Cannabis with a Youth Perspective. SSDP, as a partner NGO to the conference, hosted a workshop where I was joined by Jessica, a Student Ambassador from Oxford, UK and Michelle from Canadian Students for Sensible Drug Policy.

The reason we wanted to talk about this very specific overlap between harm reduction and cannabis policy is that not only is Cannabis the most widely used drug worldwide among young people, but we are also a “key population” for policymakers. Plenty of statements and legislative decisions have been made in the name of protecting children and young people; in 2016 at the UN General Assembly Special Session on Drugs (UNGASS), the theme “Creating a Better Tomorrow for the World’s Youth” was widely promoted. [2] The theme refers to goals set in the Political Declaration and Plan of Action on Drugs, agreed at the CND in 2009. Following the promise of protecting youth, ‘our most precious asset’ to society, there is no point of reference in the UN drug conventions describing special measures for youth, and limiting the harms to youth, due to the War on Drugs. Protecting us has been an excuse for draconian policies and we are rarely asked how we imagine a “better tomorrow”.

In most countries, Cannabis is the drug most widely used, both among the general population and among youth. A global estimate, produced for the first time by UNODC, based on available data from 130 countries, suggests in 2016, 13.8 million young people, mostly students aged 15–16 years, used cannabis at least once over the previous 12 months, equivalent to 5.6 per cent of the global population in this age range. Annual use of cannabis in 15–16 year old people was higher than among the general population aged 15–64 years (3.9 per cent in 2016). [3]

The Global Drug Survey paints a slightly different picture; 53% of their respondents between ages 16-25 have said they have used Cannabis in the past year and almost 60% used Cannabis at least once in their lives. This is not a prevalence of use but rather a sample characteristic that shows that about half of youth who take an online survey on drugs have used Cannabis. Based on the Global Drug Survey’s indicators, among the participants who indicated use in the past 12 months, 53.6% had used Cannabis on 52 days or less (so about once a week or less) and 26.8% used it on 200 or more days. Importantly, the survey found big country differences regarding the preferred Cannabis products and almost half of the youth sample (45.9%) preferred high potency herbal Cannabis.

According to the UNODC itself, the estimated number of people who used Cannabis in 2016 is 16% higher than the number estimated in 2006. Even though their main intention is to minimize/limit the use of cannabis, the UNODC’s own data shows the current regulatory system has not worked. [4]

Although above the global average, cannabis use in the European Union has fluctuated over the last decade, during which 6-7% of the population aged 15–64 years reported having used cannabis in the past year. The prevalence of cannabis use among students aged 15–16 years in Europe has remained largely stable over the past decade, about twice the rate of the general population. (5)

Although it is not a popular statement in spaces organized around furthering Cannabis access, no drug is without its risks, being legal or illegal (or somewhere in-between). We have to recognize the worry of prohibitionists is sometimes rooted in legitimate concerns. Addressing those concerns, however, has clearly not coincided with considering the current realities and needs of those people affected most by drugs in different regions of the world.

Most medical and scientific research suggests that early (12–14 years old) to late (15–17 years old) adolescence is a critical risk period among young people (6) and those in treatment for Cannabis use disorders tend to be younger, in their early twenties on average (7). In the Global Drug Survey 2018, 31.9% of respondents aged 16-25 years who used cannabis in the past 12 months said they would like to reduce their Cannabis use in the next year. Of them, only 10% intend to seek help into changing their substance use behavior. [12]

The path from initiation to the harmful use of substances among young people is influenced by many factors, of which some are often out of our control. No factor alone is sufficient to lead to the misuse of substances and, in many instances, these influences change over time. [8] To refer to the “gateway drug” argument, it would be appropriate to quote the UNODC’s own data on the World Drug Report that states “Adolescent users of Cannabis may come into contact with other Cannabis-using peers or drug dealers who supply other drugs, which may result in increased exposure to a social context that encourages the use of other drugs” [10]. Along with this line of logic, it should be of extremely high importance for any policymaker worried about young people to create spaces for us where we can find trustworthy information without stigma and without predisposing ourselves to be vulnerable to other risks, which are present on the black market. We need places where information exchange, counseling, or just a realistic conversation about cannabis use is available, possible, and welcome. Unfortunately, this has not been the accepted strategy in most countries. [11] The Global Drug Survey has even shown that in cases of Cannabis related emergency, some young people are afraid, unable, or instructed not to call for help.

So when it comes to Harm Reduction and effectively creating a safe environment for youth in the face of the emerging trend of Cannabis use, there was a lot of slack to be picked up by civil society, among whom SSDP, I am proud to say, has been doing an outstanding job.

Globally, we at SSDP don’t exclude other drugs in our work, conversations, or activities when it comes to harm reduction. Because it is the most frequently used illegal substance among our peers, we organize communities locally and connect them globally to create an environment in which reducing the harms of cannabis consumption is possible. Furthermore, fostering unrestricted dialogue about our relationship to drugs and individuals and communities helps us identify underlying issues regarding drug use in society.

We have identified punitive policies to be causing us more harm than the substance itself, and all over the world we are taking action. Our US chapters have participated in 28 successful campaigns to change Cannabis policies in the US since 2010, including operating a phone bank which has made tens of thousands of calls to voters. Our members in Ireland have passed campus-wide legalization referendums at five major Irish universities. Members in Mexico participate in classical activism by holding protests outside the Supreme Court during proceedings on cases related to cannabis policy. Dozens of other chapters organize stakeholder forums with decision makers and stakeholders to help move the policy needle forward in their own countries. And of course, we represent all of our peers at the United Nations.

An important factor of reforming Cannabis laws are taking into account the risks associated with the changing availability of a substance that was prohibited and stigmatized in various ways for a long time. When we hold workshops on cannabis policy in SSDP Austria, we always ask participants what advice would they give to their 16-year-old self about Cannabis. Every single answer has mentioned educating themselves beyond what has been presented to them in school or at home.

One important harm reduction measure is effectively communicating the true possible harms and benefits of engaging in Cannabis use.  Our chapters have organized informal and formal peer-education events in community spaces and schools. Our CSSDP family has done amazing work as well. Seeing the emergence in the use of cannabis prevalence among 14-24 year-olds in Canada, they created a Sensible Cannabis Education, a Toolkit for Education Youth. In the preparation of the booklet, CSSDP held youth forums and their roundtable event, Youth Speak, has been commended by the Task Force on Cannabis Legalization and Regulation in Canada. The representative of Health Canada, a member of the national delegation to CND last year, has publicly praised CSSDP’s contribution to the progress in the country around Cannabis. Michelle, a Research Assistant at the Therapeutic, Recreational, and Problematic Substance Use Lab at the University of British Columbia and the Vice Chair of CSSDP’s Board of Director, told our workshop participants about the process of creating the toolkit, the major issues identified by youth in the process, and the harm reduction principles that are an outcome of their consultations. As a bottom line, she emphasized that access to evidence-based drug education is critical for the well-being of young people. Approaches which meaningfully include youth voices and experiences should be prioritized, ensuring education resonates with realistic youth experiences as both users and non-users. Drug education and cannabis conversations should be inclusive of both prevention and harm reduction in order to maximize effectiveness and protect all youth.

An important issue around Cannabis and young people often missing from the debate are the pediatric aspects of the current status quo. Jessica brought a case study to the ICPC workshop from her Ph.D. on social legal studies. She told us the story of Riley Maedler, who was 7 years old when bone tumors on her skull started aggressively eroding her face. After her surgeries, Riley started to have seizures that would leave her dizzy, her legs numb and immobile, and with headaches lasting for days. Drugs used to treat the seizures had troubling effects from making her lethargic and unwilling to participate in normal activities to becoming extremely agitated while also fighting bouts of depression on top of increasing jaw pain and tooth degeneration. While researching treatment options, Rylie’s mother found cannabis oil that made major improvements in her life. Eventually, Riley’s seizures were at 90 percent control, but she still had to leave school grounds to take her medication, sometimes missing classes and making her feel like an outsider. So Riley started to advocate for medical Cannabis, meeting policy makers and various stakeholder to eventually have her law, Senate Bill 181 “Riley’s Law”, passed in 2016. This expanded the use of medicinal marijuana oil to those under 18 if they have intractable epilepsy and certain muscle disorders.

“I sat in Health Class and watched videos on how cannabis [they actually called it Pot and Marijuana] are very bad for you…I’ve never seen them do this on other medicines like chemotherapy or antibiotics. I’m not sure why they would single out my medicine or some of my friends’ loved one’s medicine…These videos are part of our curriculum so they have to show them. They need to be updated or just don’t show them.” – Riley Maedler

As of today, the future of the global Cannabis regulation framework is uncertain, but what is certain is that when talking about legally regulating Cannabis, there are many factors to be considered.  One of those key aspects is how this change is communicated to people, particularly to youth. One of our participants said something that should truly concern policymakers. He said once he tried Cannabis, liked it, and kept using it without experiencing a negative impact on any area of his life, he realized that the majority of education he received about the substance has been false. This has led him to lose trust in his national institutions, political “safety” mechanisms, and educators. Is continuing to pursue scare-tactics which have no scientific proof of deterrence worth losing the trust of young people?

This year, The Global Drug Survey is asking their respondents about important/relevant health-related information that would be useful to use when it comes to commercializing Cannabis  – www.globaldrugsurvey.com

References:

1. https://www.who.int/medicines/access/controlled-substances/ecdd/q-a-ecdd-2018/en/
2. Barrett, Damon (2015), ‘A Better Tomorrow for the World’s Youth’? Accountability for children and young people at the 2016 UN General Assembly Special Session on Drugs, New York: OSF
3. United Nations Office of Drugs and Crime. World Drug Report 2018, Vienna: United Nations
4. ibid
5. EMCDDA (2017), Statistical Bulletin, Publications Office of the European Union, Luxembourg.
6. United Nations Office of Drugs and Crime. World Drug Report 2018, Booklet 4, page 4. Vienna: United Nations
7. ibid
8. Global Drug Survey data, courtesy of dr. Larissa Maier
9. United Nations Office of Drugs and Crime. World Drug Report 2018, Booklet 4, page 3. Vienna: United Nations
10. United Nations Office of Drugs and Crime. World Drug Report 2018, Booklet 4, page 4. Vienna: United Nations
11. Sarosi P. How do students see drug prevention in Hungarian schools? Budapest: Drug Reporter; 2018 [Available from: https://drogriporter.hu/en/how-do-students-see-drug-prevention-in-hungarian-schools/.