30 December 2008
Issue 2689 of New Scientist magazine, page 6-7
Radical alternatives proposed for cannabis controls
by Andy Coghlan
WHAT should we do to minimise the harm cannabis can cause to the health and welfare of users and to society at large? The answer, according to a report by a group of prominent academics and government advisers, is to change the law to allow the state to prepare and distribute the drug for recreational use.
This controversial proposal comes from a commission assembled by the Beckley Foundation, a British charity dedicated to exploring the science of psychoactive substances. "The damage done by prohibition is worse than from the substance itself," says Amanda Feilding, the founder of the Beckley Foundation.
The Beckley commission's ideas will be aired in March at a meeting in Vienna, Austria, of the UN Commission on Narcotic Drugs. The UNCND will report to a meeting of the UN general assembly later this year that will set international policy on drug control for the decade to come.
Marijuana is now the world's most widely used illicit drug. The latest figures from the UN Office on Drugs and Crime (UNODC) indicate that in 2006-7 some 166 million people aged 15 or above, or 3.9 per cent of this age group, used it regularly. Just 1 per cent of the world population uses other illegal drugs. Cannabis use is particularly widespread in rich countries. Around 40 per cent of Americans and one-third of Australians say they have tried it.
The evidence assembled by the Beckley commission left it in no doubt that cannabis damages the health of heavy users, especially those who start as teenagers. Such users are at increased risk of suffering from psychosis, and lung and heart disorders. They are also more likely to drop out of school early, be involved in traffic accidents, and be poor parents (see "How bad is it?"). The report also found evidence that cannabis may act as a "gateway drug", increasing the likelihood that users will go on to try more damaging drugs such as heroin or cocaine.
The report details a sharp rise in the potency of marijuana, with levels of delta-9-tetrahydrocannabinol (THC) - the chemical that gets cannabis users "stoned" - typically double to treble what they were a decade ago. This, it says, is partly the result of a switch to growing the plant indoors under continuous lighting.
Potent varieties, sometimes known as "skunk" or "sinsemilla", now make up 80 per cent of the market in the UK and the Netherlands according to a report published by the UK home office. These varieties also lack a compound called cannabidiol found in other cannabis strains, which when present may help prevent THC triggering psychotic episodes. About 9 per cent of regular cannabis users become dependent - experiencing withdrawal if they stop using - and suffer ill health as a result of their drug use, the Beckley authors say.
Despite the undoubted dangers associated with marijuana, the Beckley report concludes that it is far less harmful to users and to society in general than other illicit drugs such as heroin and cocaine, and far less damaging than the legal drugs tobacco and alcohol. There have been only two documented deaths from marijuana overdose, the report notes. This contrasts with 200,000 deaths from all causes each year attributed to other illegal drugs, 2.5 million deaths annually related to alcohol and 5 million to smoking.
Because possession of cannabis is illegal, its harmful consequences extend beyond possible damage to immediate health, the Beckley report points out. In particular, users are at risk of punishment and acquiring a criminal record. "If you don't think being arrested is a harm, you are unpersuadable," says criminologist Peter Reuter of the University of Maryland, a co-author of the report. "In the US, 750,000 people were arrested in 2006, and I think that's a substantial harm."
The report recommends that marijuana should be sold legally, subject to strict standards to ensure it is not strong enough to cause psychological problems. This, it says, would allow a strict age bar to be imposed that would prevent children from buying it, and put the criminal gangs who peddle it out of business. Cannabis buyers would not be offered other drugs by the licensed dealers, removing this as a possible route of progression from cannabis to other drugs.
The framework for drug laws worldwide is now set by the 1961 Single Convention on Narcotic Drugs, which has been signed by the overwhelming majority of nations. Though the convention requires that all signatories make possession of cannabis illegal, some have experimented with decriminalisation. The Netherlands, for example, no longer arrests and punishes people found to have small amounts of cannabis, though large-scale supply remains illegal and in the hands of criminal gangs.
The legalisation proposed by the Beckley group is likely to face strong opposition in Vienna both from the UN Office on Drugs and Crime and from many governments. The fear is that easing up on cannabis will undermine the whole international effort to combat recreational drug use. "Cannabis is the most vulnerable point of the whole multilateral edifice," Antonio Maria Costa, executive director of the UNODC, said in a speech in March 2008.
The US has set its face firmly against any move towards legalisation, fearing that this would produce a nation of dope-heads. A document launched in July 2008 by the US Office of National Drug Control Policy (ONDCP) declared marijuana to be "the greatest cause of illegal drug abuse".
Dave Murray, head of research at the ONDCP, told New Scientist that strict enforcement of anti-drug laws had helped cut teenage use of marijuana by 25 per cent between 2001 and 2008. In the absence of prohibition, it would have been difficult to achieve that," he says.
By contrast, the Beckley authors, among others, argue that punishment does not reduce cannabis use and itself causes harm. Their view is backed by a study in 2000 by Simon Lenton of the National Drug Research Institute in Perth, Western Australia, which compared what happened to people in Western Australia, where cannabis possession attracts a criminal conviction and penalty, with those in South Australia who were given non-punitive infringement notices. He found that 32 per cent of those "criminalised" reported adverse employment consequences compared with 2 per cent of "infringers". The criminalised users were also far more likely to be involved in crime again, and to suffer housing and relationship problems.
Feilding accepts that there may be few takers in Vienna for her group's proposals. But the mere fact that an alternative to the strict prohibition of cannabis will even be considered is a breakthrough in itself, she says.
How bad is it?
The most damaging of the possible ill effects of cannabis use is psychosis. "You're 40 per cent more likely to get psychotic disturbances if you're a user from early life," says Les Iverson at the University of Oxford, who is a member of the UK government's Advisory Committee on the Misuse of Drugs (ACMD). He points out, however, that cannabis is not necessarily the cause in all these cases.
Dave Murray, head of research at the US Office of National Drug Control Policy, says that in the US the rise in strength and market dominance of potent marijuana strains has paralleled a rise in emergency hospital admissions of people suffering psychoses after cannabis use.
Another worry with cannabis is that it is a "gateway" drug encouraging use of more damaging substances. Murray says that cannabis users who start young are between 9 and 15 times as likely to become heroin or cocaine users. "We can't say one causes the other, but there's a strong correlation," he notes.
There is also the danger of traffic accidents: cannabis intoxication raises a driver's risk of crashing by 1.3 to 3 times. By contrast, alcohol intoxication raises the accident risk by up to 15 times.
About 9 per cent of regular cannabis users become dependent, compared with 32 per cent of tobacco smokers, 23 per cent of heroin users, 17 per cent of cocaine users and 15 per cent of those drinking alcohol. Respiratory and lung cancer risks are also raised for cannabis users, and they can sustain damage to verbal learning ability, memory and attention. According to the Beckley report, permanent changes in receptors of the hippocampus, prefrontal cortex and cerebellum have been seen in heavy cannabis users. There are also links between early cannabis use and poor school performance. Whether this is a result of cannabis itself, or because they share some other common cause, such as poverty, is not known. Overall, an analysis of 20 drugs by David Nutt at the University of Bristol, UK, who chairs the ACMD, rated cannabis as the 11th most harmful drug, well behind alcohol and tobacco.
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