Funnily enough, as Uruguay passed its historic legislation last night – becoming the first country in the world to make the production, sale and possession of cannabis legal, under a strict and sensible regulatory framework – I was at an event in the House of Commons, organised by some people who advised the Uruguayan government on its decision, discussing how to make the same thing happen elsewhere.
Transform Drug Policy, a splendid little organisation which has campaigned for evidence-based drugs policy for the last 15 years, happened by coincidence to publish its latest work, How To Regulate Cannabis: A Practical Guide, yesterday. The debate around drug regulation has, for years, focused on pointing out the failings of the current system – the public health disaster, the creation of an underclass of young men (mainly men) with life-limiting criminal records, the waste of public money and police time – but hasn’t had much to say about what we should replace it with.
But replacing the current unregulated illegal market with a completely unregulated legal market wouldn’t, really, help. Transform summarise their argument with a simple schematic:
From a public health point of view, there appears to be a “sweet spot” of regulation – limiting the promotion, regulating the outlets, putting an age limit and a safe intoxication limit for drivers – that reduces the harm caused by any drug. (For the record, Transform recognise that the chart hasn’t got any units. It’s a graphical representation of an argument, not a graph of actual effects, although the evidence is very strong that social and health harms are reduced by a strict regulatory framework.)
And this is what Uruguay has done. A small number of private contractors have licences to produce five varieties of cannabis, of specified strengths; sales are limited to registered Uruguayan citizens only, a maximum of 40 grammes a month, monitored by a government database. It’s sold through pharmacists holding a licence awarded by the Ministry of Public Health, and all forms of advertising, promotion and sponsorship are banned.
It’s not, in fact, a libertarian paradise where anything goes, and no one who is interested in the promotion of public health should want that: for the same reasons that advertising, sale and consumption of cigarettes and alcohol is limited, the same should be true of cannabis and all other drugs. It was interesting to hear Steve Rolles, Transform’s chief information officer, say that he wasn’t chiefly interested in the discussion of the specific harms that cannabis causes: the harms of drug use are effectively reduced, whatever they are, by bringing that drug into legal oversight.
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But the harms of cannabis should be discussed. It’s not a purely healing herb, as some think, but as drugs go, it’s one of the more harmless. Prof David Nutt, a neuropsychopharmacologist and the former Government chief science adviser, who spoke at the discussion last night, pointed out that about 100,000 deaths a year in Britain are associated with smoking; about 8,000 with alcohol; and, he said, “about eight with cannabis”. Having realised that they couldn’t make the case that cannabis was killing people, he said, drug warriors “raised the spectre of schizophrenia”. But the link between cannabis and schizophrenia, which is based on one study of Swedish conscripts, is minuscule: even if that study is taken “completely at face value”, he said, you’d have to make about 5,000 men or about 7,000 women stop smoking cannabis altogether to prevent a single case of schizophrenia. It’s simply not an effective way of reducing mental health problems, and you run the risk of stopping people using it as sensible self-medication.
That is all, however, secondary. Whether or not cannabis has a link to mental illness, it’s easier to reduce the dangers by regulating the strength and availability of the drug than it is by making it illegal and hoping it goes away. Fifty years of a war on drugs that has signally failed to reduce drug use, let alone drug harm, is surely evidence enough that it’s time to try something new, and the Uruguay and Transform examples show a possible way forward.
Whether it’ll happen here, though, is hard to say: the Home Office is still keen to look Tough on Drugs, with no apparent interest in the evidence base for their policies. Julian Huppert, the Lib Dem MP who sponsored the meeting, has campaigned for some time – as have the rest of his party, in one of their most sensible suggestions – to have the drug policy brief moved from the Home Office to the Department of Health, making it less about a criminal problem than a public health one. That would be a splendid (and obvious) first step, but something being sensible and obvious does not mean that the Coalition will have the sense or the bravery to see it through. I’ve asked the Home Office for a comment on the Uruguay decision; I’ll post it here when they send it through, but I imagine it will be along the lines that “drugs are harmful, therefore they should be illegal”, and won’t think things through any further than that.
(UPDATE: a nice young lady from the Home Office has, rather sweetly, said that that’s exactly what their statement would be so they haven’t got anything to add.)
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