Canada is at a turning point in terms of cannabis policy. The Task Force on Marijuana Legalization and Regulation has released its discussion paper for input. The Task Force proposes five elements of a new system for cannabis. I discuss each of these elements from the CDPC’s perspective.
- Minimizing harms of use
A public health approach to cannabis policy focuses on principles of social justice, human rights and scientific evidence. It puts health promotion and the prevention of harms at the forefront. Through health promotion, we can enable Canadians to increase control over their health and, ultimately, reduce the health and social harms associated with cannabis use.
How do we use health promotion to assist Canadians in making healthy choices? There is a great example in British Columbia with a program called iMinds. It is offered in schools to teach young people health literacy when it comes to drug use. They learn the knowledge and skills they need to navigate in a world where drug use, including cannabis, is common.
Drug literacy is built by engaging Canadians in honest, thoughtful discussions about drug use in order to encourage them to express themselves and think critically about their beliefs, attitudes and behaviours related to drugs. They learn to assess the complex ways in which drugs have an impact on the health and wellbeing of individuals, communities and societies. They learn about the diversity of reasons people use drugs and the social attitudes and norms related to various drugs. They also develop personal and social strategies to manage the risks and harms related to drugs. As we repeal prohibition on cannabis, we need to include such health promotion approaches.
- Establishing a Safe and Responsible Production System
The production of cannabis for personal use needs to be legal. Current legal production of cannabis is for medical purposes only and occurs through a few licensed commercial producers, often big corporations, who can only distribute cannabis through mail order. Licensed producers must adhere to strict manufacturing practices to produce cannabis for medical purposes. Quality control and proper packaging and labelling are of course important, though some argue licensed producers are currently overly regulated.
It would be easy for existing licensed producers to open up their sales for personal use once Canada regulates cannabis, and I know they are already planning for that to happen. What is less clear is how the smaller producers will be integrated into a regulated market. Like craft beer and wine, there is a growing movement to integrate craft cannabis producers into the regulated market. We support their licensing for commercial purposes.
For non-commercial, personal use, we also support the home cultivation of a limited number of plants, with access to municipal inspections to meet building codes and standards.
- Designing an Appropriate Distribution System
Store fronts for the sale of cannabis for personal use have been a source of tension in Canada over the last few years. Almost 20 years ago, a social movement emerged in Canada to provide access to cannabis for medical purposes through medical cannabis dispensaries or compassion clubs. Founders of these dispensaries did so to ensure people had safer, more controlled options to cannabis. These dispensaries remain in legal limbo despite the fact that courts have recognized that they provide a valuable service. In 2002, the Senate Special Committee on Illegal Drugs recommended that medical cannabis dispensaries be integrated into the federal medical cannabis program. The supply of a legal source of cannabis for medical purposes through licensed producers has worked for many but has not succeeded in meeting the varied needs of all of those who use it for medical purposes.
We now find ourselves with a proliferation of cannabis dispensaries that may or may not be strictly dispensing cannabis for medical purposes. In my opinion, this situation speaks to the fact that cannabis is widely used and Canadians want access to it for personal use.
It is clear that we need to integrate retail sales outlets into how we move forward with cannabis regulation.
- Enforcing Public Safety and Protection
Cannabis is unique and we need to keep these unique characteristics in mind as we develop cannabis policy. Cannabis is a plant that is widely used for personal use, medical or otherwise. It has a wide range of therapeutic effects. It is exceptionally safe, in that there is no lethal dose of cannabis, unlike almost any other product on the market, even table salt. That is useful information to have under a public health approach to cannabis that focuses on health promotion and reducing harms.
That said, cannabis is a psychoactive substance and we need to approach it responsibly and respectfully. We need to address the complexity of driving under the influence of cannabis. We also need to provide adequate services to those who struggle with problematic cannabis use.
Now the human rights aspect of a public health approach to cannabis strives to deal with cannabis in a way that does not harm others. Under prohibition, people who use cannabis have been criminalized and incarcerated, stigmatized and discriminated against. Some more than others. Many agree that prohibition has done more harm than cannabis use.
As Canada prepares to regulate cannabis for personal use, we urge the government of Canada to immediately stop arresting Canadians for possession of cannabis.
- Accessing Cannabis for Medical Purposes
As we move forward with the regulation of cannabis, let’s not forget about the needs of people who use cannabis for medical purposes.
I was recently part of a coalition of health charities and patient groups that issued recommendations to keep in mind to meet patients’ needs for medical purposes as we develop cannabis regulation.
Canada needs to invest in research on cannabis for therapeutic purposes to expand the evidence base. I refer you to research priorities we recently identified at a medical cannabis research roundtable of key cannabis researchers, health charities and patient groups.
Canadians with various health conditions and states of mobility want access to a variety of products in various forms and in a range of potencies, through a variety of distribution options. There is a need for onsite dispensing through pharmacies and dispensaries. Mail order through licensed producers remains a good option, especially for those in rural and remote areas and those who have limited mobility. Self-production of a few plants for personal, non-commercial use, perhaps even collective gardens, must also be allowed.
These thoughts are the CDPC’s contribution to this important conversation. I welcome your input.
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Lynne Belle-Isle, PhD, is Co-founder and Chair of the Canadian Drug Policy Coalition. She is a National Programs Manager with the Canadian AIDS Society and a Research Affiliate of the Centre for Addictions Research of BC. Her health services research focuses on access to cannabis for medical purposes. She testified as an expert witness in R. v. Beren. Her ongoing collaborative work has been used in various court cases challenging the constitutionality of the Marihuana Medical Access Regulations.
