There is a lot of confusion across the globe regarding whether to decriminalise cannabis use with or without legalisation. Some countries like Canada, UK, France, Switzerland, Belgium have been trying to make rules more permissive. The realisation that cannabis may have therapeutic value in certain situations like cancer & HIV weight loss, nausea associated with chemotherapy etc may be partially responsible for this. But there is strong international pressure, especially from the International narcotics control bureau (INCB), to abide by the global policies framed in accordance to UN conventions.
I recently presented a seminar in regard to this reviewing the evidence for and against cannabis use decriminalisation and legalisation.
These are the bottom lines-
Hazards related to cannabis use:
It is a well accepted fact that deaths related to alcohol and tobacco (which are legally permitted substances) are more than cannabis by a ratio of at least 10:1. So question is, what is the basis of cannabis being illicit while both alcohol and tobacco are not? Is it just that the countries which are major producers of alcohol and tobacco products have more clout in the international arena?
Current evidence suggests that there is robust evidence for an association between cannabis and psychosis. But there is not enough evidence for a suggestion of causality. The relation could be through a third, hidden environmental or genetic factor.
Another point that has been often raised against cannabis is that, it acts as a gateway drug. That is, use of cannabis leads to use of other harder drugs like cocaine or heroin. Actually, the evidence suggests that this could be true. But the conclusion could be different depending on what mechanism one accepts as behind this. For example, if this is due to users of cannabis coming in contact with drug peddlers who also deal in hard drugs, then the best approach would be uncoupling the supply by legalising cannabis and decreasing the contact with hard drug peddlers. But if the gateway effect is due to a decreased psychological resistance after using cannabis or a need for bigger highs, avoiding contact by prohibition of cannabis may be more relevant. Evidence from Netherlands where cannabis was legalised suggests that hard drug use has not been dented by allowing coffee shops which serve cannabis products. So probably, legalisation of cannabis is not going to help to prevent the gateway effect.
Medicinal cannabis use:
One of the developments which have led to a revival of ‘legalise cannabis’ argument has been the recent realisation that cannabis has significant role in managing cancer or HIV weight loss, nausea related to chemotherapy etc. But a review of evidence suggests that there are lot of methodological issues with the studies conducted including lack of any real blinding. Meta-analyses suggest that currently there doesn’t appear to be any hard evidence to prefer cannabis for any of these medical indications over the currently available medications for the same indication.
Experiences with cannabis policy:
So what is the problem with maintaining the status quo and letting cannabis be a prohibited drug? The question is whether the costs of prohibition are more than acceptable. In the specific case of India, since 1985, after Narcotic drugs and Psychotropic substances act (NDPS) came into being, 75% of law enforcement activities has been in relation with cannabis. Almost 80% of all arrests in relation to drug use are due to cannabis. All this in a country where there is long tradition of using cannabis as indigenous medicine. Bhang is a part of our festivals and use of cannabis is so closely intertwined with our culture… Also wild growth of cannabis is so rampant in some states that banning the growth of cannabis doesn’t have any meaning… Even in USA, which is comparatively very stringent in enforcement of prohibition of cannabis, the use of cannabis has remained constant despite increasing number of arrests (by around 150%) over the years. Compared to Netherlands which is an example of legalisation of cannabis, the rates of cannabis use in USA has been higher. It has been also shown that the trends of cannabis use in Netherlands in last 2-3 decades are similar to waves in many other countries which have stringent policies. So it has been proposed that cannabis use go through certain trends which are independent of the government policies for controlling or liberalising cannabis use. So what is the point of shelling out tax payer’s money for law enforcement for controlling cannabis use?
So what is the verdict? It appears that decriminalisation of cannabis personal use may be sensible. But at the same time, as trends in certain situations show, legalisation of cannabis can lead to unhealthy promotion of cannabis use by private interests (like tobacco or alcohol) leading to unhealthy trends.