22 February 2015
Facts About Cannabis
Australia is behind the times on the medical use of cannabis
The assertion that cannabis is highly addictive ignores firm evidence. The most authoritative review comparing addictiveness of drugs rates physical dependence on a scale of 0–3. Heroin is ranked 3; tobacco, barbiturates and benzodiazepines, 1.8; alcohol, 1.6; and cannabis, 0.8 (See Table 3 from Development of a rational scale to assess the harm of drugs of potential misuse, published in the Lancet in 2007).
Australians, together with citizens in the US and New Zealand, are the world's greatest users of cannabis per head of population (See Table 1 from United Nations Office on Drugs and Crime World Drug Report, 2011). Prohibition has failed to prevent widespread use and young people report that they can readily access it (Australian Institute of Health and Welfare 2010 National DrugStrategy household survey report). Potential medical users are often, for example, in the later stage of a battle with painful cancer, finding problems with morphine, other analgesics and nausea with chemotherapy. Others seek relief from painful conditions such as muscle spasm in multiple sclerosis. Cannabis is believed to reduce seizures in Dravet syndrome, a rare genetic myoclonic epileptic encephalopathy beginning in infancy. Most parents of affectedchildren (84%) report much lessened frequency or abolition of seizures with medical cannabis. They should have continuing access to it until trials using purified cannabidiol (CBD), believed to be the active component for these children, provide a superior agent.
Australia is behind the times on medical cannabis. Currently, 23 states in the US have legalised use of cannabis for medical conditions, as has Canada since 2001. Other countries approving it include Israel, Holland and the Czech Republic. Portugal, in 2001, removed penalties for personal possession and use of all illicit drugs, but with rigorous administrative processes to handle problem use.
Eliminating prohibition is not a disaster if there are sensible processes to control drug-related harms. Just take a look at Portugal, where they decriminalised the use and possession of all illicit drugs in July 2001. From a study, What can we learn from the Portuguesedecriminalization of illicit drugs? which appeared in the British Journal of Criminology in 2010;
The issue of decriminalising illicit drugs is hotly debated, but is rarely subject to evidence-based analysis. This paper examines the case of Portugal, a nation that decriminalised the use and possession of all illicit drugs on 1 July 2001. Drawing upon independent evaluations and interviews conducted with 13 key stakeholders in 2007 and 2009, it critically analyses the criminal justice and health impacts against trends from neighbouring Spain and Italy. It concludes that contrary to predictions, the Portuguese decriminalisation did not lead to major increases in drug use. Indeed, evidence indicates reductions in problematic use, drug-related harms and criminal justice overcrowding. The article discusses these developments in the context of drug law debates and criminological discussions on late modern governance.
An Australian and US study found that removal of legal action and possible imprisonment for possession and use makes no difference to the patterns of use of cannabis, This is the abstract of the study, The impact of cannabis decriminalisation in Australia andthe United States;
This paper summarises and compares the impacts of cannabis decriminalisation measures in two countries. In Australia, an expiation model of decriminalisation succeeded in avoiding the imposition of criminal convictions for many offenders, but substantial numbers of offenders received criminal convictions because of a general "net-widening" in cannabis offence detections, and the failure of many offenders to pay expiation fees and thus avoid criminal prosecution. Despite these problems, the expiation approach has been cost-effective, reducing enforcement costs without leading to increased cannabis use. In the United States, cannabis decriminalisation similarly reduced enforcement costs, with enforcement resources generally redirected toward trafficking and other illicit drugs. There were no increases in cannabis use or substantial problems that could be ascribed to decriminalisation. The implications to other countries are discussed, with particular attention to the importance of implementation issues, monitoring and evaluation. Although decriminalisation has succeeded in reducing enforcement and other costs without increasing the problems associated with cannabis use, the same impacts would not necessarily result from the legalisation of cannabis or the decriminalisation of other illicit drugs.
World Health Organisation mental health surveys of 17 countries found that “countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones”. There is no rational basis for the view that weakening prohibition to permit use for medical conditions would lead to a surge in general use.
Adapted from an article in the Medical Journal Australia
David G Penington DM, FRCP, FRACP
University of Melbourne, Vic., Australia