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|Major Studies of Drugs and Drug Policy|
|The Report of the Canadian Government Commission of Inquiry into the Non-Medical Use of Drugs - 1972|
The Report of the Canadian Government Commission of Inquiry into the Non-Medical Use of Drugs - 1972
Canadian Government Commission of Inquiry into the Non-Medical Use of Drugs, published by Information Canada, Ottawa, Canada, 1972, Crown Copyrights Reserved
CONCLUSIONS AND RECOMMENDATIONS
of Marie- Andree Bertrand
My colleagues have adopted a position of tolerance in the matter of use which represents a forward step compared to the existing attitude. However, their interpretation of the results of our inquiry does not lead them to recommend the legalization of cannabis distribution through federal-provincial agreement. Despite my esteem for the other members of the Commission and my respect for their point of view, I must dissent from the majority opinion. I recommend a policy of legal distribution of cannabis.
The preceding pages describe the effects of cannabis and the extent and patterns of its use. They establish that a large number of people have used cannabis-more than a million in Canada. Very few of them have ever required medical or psychological treatment as a consequenoe. Smoking marijuana or hashish generally produces no serious personal problems, nor does it result in criminality. The results of surveys also allow us to state that for the vast majority of cannabis users, curiosity and the search for pleasure have been the main motive force.
The facts on which a social policy with respect to cannabis can be based are summarized as follows:
(1) At least one Canadian out of every twenty uses cannabis oocasionally. Excluding people over 60 and under 6, the proportion is one out of every seven or eight. In some populations, every second person uses cannabis.
(2) In the vast majority of cases, use does not give rise to serious psychological difficulties, to crimes or illness.
(3) Cases of habitual and excessive use are exceptional.
(4) For nearly all users, reported motives are: a desire to experiment, and a search for pleasure and escape.
PROHIBITION: EXPENSIVE AND INEFFECTIVE
In Canada, enforcement of the prohibition against cannabis use falls accidentally-almost randomly-on a very small proportion (about 1%) of offenders.
Traffickers are subject to more severe sanctions when arrested than are users; but the control of trafficking is not adequately effective, judging by the amount of cannabis that is readilyavailable. Canadians who cultivate the plant do so with little risk of arrest as long as they do not engage in any large-scale activity.
As for importing, the R.C.M. Police reported a number of very large seizures in the last 18 months. Unfortunately, it is difficult to estimate the proportion of importers affected by these arrests. But considering the quantities of cannabis in circulation, it would appear that law enforcement at this level is no more effective than in the case of domestic trafficking.
The very small number of arrests, compared to the numbers of users traffickers or importers, is not the only consideration in the question of effectiveness. There is also the fact that not only has the legal position on cannabis failed to reduce use or trafficking, but evidence shows that these have become even more widespread than ever. In addition to being ineffective, law enforcement has been very costly. In fact, at least 10,000 to 12,000 arrests and 8,000 convictions have been made against users in the last 12 months. The Commission was told that breaking one network of importers took several months of work by police agents. The total cost to be considered would include time incurred by police and magistrates and, of course, detention costs.
THE NON-EDUCATIVE CHARACTER OF THE LAW
To have an educational impact, a law should be coherent and rest on basic principle. The most commonly invoked principle is that of social danger; thus, severe penalties and the use of law enforcement agencies are generally limited to acts causing a real and serious prejudice to others.
A more important factor underlying problems in the application of the law is the gradual change in opinion taking place among Canadians regarding the harmfulness of this substance. The evidence has been taken into account - cannabis is not an opiate, its use does not induce physical dependence. The earlier opinions of society have been challenged and modified. The attitudes of parents, teachers and police are changing-the R.C.M. Police leave the handling of cannabis matters, in most cases, to local police units. Moreover in a number of cities, municipal police find it futile to look for cannabis users, most of the ordinary sellers are never bothered.
In the summer of 1970 this more reasonable attitude even reached the office of the Attorney General in thc federal Department of Justice; as a result the indictment procedure (for simple possession) could be replaced by summary conviction, under which penalties for simple possession might be lightened. However, the continued prohibition of cannabis has precipitated, among many users, a generalized disrespect for the law. If the laws regarding the use of cannabis are to be effective and have educative value they must be consistent with those laws regulating the use and sale of other drugs, such as alcohol, that have a potential for harm at least as great as that of cannabis.
ABSENCE OF CONTROLS ON PRICE, QUALITY AND POTENCY
Given the actual legislation, conjectures about the economics and the quality control aspect of cannabis distribution are rather futile. In fact, profits are not subject to taxes and price control. As for quality, the clandestine character of the transactions makes analysis and control impossible. Existing analytic data indicate that the various forms of cannabis available illicitly in Canada today vary in THC content over a wide range, and the user has no basis for estimating, in advance, the potency of these different preparations. Such unpredictable variability undoubtedly increases the likelihood of undesirable effects. Standard cannabis of consistent potency would enable the user to more easily anticipate thc effects of use, and to kern to adjust the quantities consumed accordingly. These are some of the considerations which have led me to conclude, not only that the prohibition against possession should be removed, but that the distribution of cannabis should be organized legally.
THE HARM OF CANNABIS
What are the physical and psychic effects of cannabis? In an inquiry led by five individuals, assisted by a large number of investigators, it is inevitable that the interpretation of data will vary from one Commission member to another, from one investigator to another. This phenomenon applies particularly to the present instance: all the pertinent data are there before us, as before the legislators and before the Canadian public. But they will not be given the same relative weight.
I have understood and interpreted the results of the various investigations on the physical and psychological effects of cannabis as follows.
Effects on the Sensory, Cognitive and Psychomotor Functions
Several studies are cited in the previous pages-including those of the Commission-etablishing that under doses sufficient to produce the level of intoxication typically sought, there is generally some acute alteration in perception and, often, an impairment in some cognitive functions, such as short-term memory. As for attention and vigilance, especially important in the handling of complex machinery, the two experiments carried out by the Commission (involving different tasks) lead to contradictory conclusions.
It would appear that under certain circumstances a statistically significant impairment in performance may occur, but the practical significance of many of the test conditions involved is questionable and has not been determined.
With low doses, the great majority of effects which we have just mentioned are either non-existent or negligible, and often impossible to verify. Occasionally, low doses may improve capacity. It is difficult to establish significant effects on most measures. In discussing cannabis effects another variable must be taken into account: the experience of the subject in performing the task- whether under the influence of cannabis or not-may compensate for some of the negative effects. If the subject is not familiar with them, complicated tasks, requiring prolonged attention, are usually not done well under doses typically consumed by regular users.
With regard to psychomotor aptitudes, several variables must be taken into account: dose, sensory, cognitive and muscular requirements of the task, the subject's past experience with the test and his previous history as a cannabis user. The effects under these conditions are quite complex. ln Commission experiments there was no indication that marijuana adversely affected response speed or reaction time. There was a perceptible deterioration in some aspects of tracking performancc after absorption of the higher dose, but not with smaller quantities. Combined alcohol and cannabis use may modify psychomotor functions still more.
Is the ability to drive a vehicle diminished by cannabis? Will cannabis use, under natural conditions, result in increased traffic hazards? Let us remember, to begin with, that we have only laboratory experiments from which to judge, and it is particularly risky to actrapolate from experiments which cannot reproduce the very great number of variables of daily driving. The action of cannabis in this area is related to various effects on the perceptual, cognitive and psychomotor functions, each of which varies according to dose.
It has been shown that cannabis does not give rise to aggression. It seems that cannabis can impair certain driving abilities, but the relative impairment is related to dose and, probably, experience with driving when 'high' and other factors. Even if it is clear that driving while in a state of cannabis intoxication is a risk, and that one should avoid driving in this condition, it has not been shown that cannabis, under natural conditions, results in a serious increase in traffic hazards. What are the users' attitudes in this regard? Some say decidedly that they would not drive when 'high'-jut as the majority refuse to drive when in a state of alcoholic inebriation, even if only slightly so. Other users say that they would drive, but more carefully. Some surveys report that users claim to have learned to compensate for their perceptual and psychomotor impairment. Some experimental support for this contention exists.
No one can look on with equanimity when someone drives a car or an aircraft while intoxicated, no matter what substance is consumed. Dangerous driving of any vehicle can have grave consequences. There is, however, no need to panic where cannabis is concerned. Let us remember, at the outset, that the Canadian penal code carries sanctions which permit prosecution of persons driving dangerously. In my opinion this is sufflcicnt. Many other kinds of buman conditions can never be measured on a Breathalyzer-type of instrument, but they nevertheless, at critical points, make the handling of any machine rather dangerous. The example of a quarrel between husband and wife when one of them is driving comes to mind, as do 'highway hypnosis', driver fatigue and alcohol 'hangover'. Furthermore, driving impairment can be produced by a variety of other drugs, commonly used both medically and non-medically, for which thcrc are no convenient methods of detection.
Cannabis apparently produces acute physiological effects of little general consequence: heart rate is increased, salivation and skin temperature decreased, and there is often a slight reddening of the eyes. Few other short term effects have been reliably detected. It has been suggested that chronic heavy use may have adverse effects on respiratory, cardiovascular, gastrointestinal, liver and neurological function, but such potential effects have not been documented in systematic controlled studies. Not one well-controlled study of chronic or sub-chronic cannabis use in humans has demonstrated any major chronic problems caused by cannabis. Cannabis has not been shown to be lethal in humans.
Cannabis may engender apathy and indolence in some people, but, as we have seen, there is a great deal of controversy on this subject. The role of cannabis in this alleged syndrome is not clear, nor is the research adequate or conclusive. Among certain users who are truly without motivation and spirit, cannabis has not been established as the causal factor in the condition, nor has it been established that its use preceded the apathy.
Although scientists have not been able to agree on the concept of a "cannabis psychosis", and a large number of them refuse to accept it as a specific disorder, it sometimes happens that heavy dosage will trigger an acute psychosis. In North America, these incidents are exceedingly rare.
According to David E. Smith, writing in 1968, adverse reactions to cannabis were extremely rare at the Haight-Ashbury clinic in San Francisco, where more than 30,000 patients, suffering from various drug problems, had been treated.
It is true that there are reports from non-industrial countries (often in the East) of psychoses and chronic behavioural disturbances in some long-term users, characterized by lack of ambition, lassitude and inability to plan. However, it has not been established that cannabis use is a cause of-or even that it preceded-the conditions described, nor has it been established that these conditions are found more frequently among cannabis users than in the population strata to which the users belong-usually the lower socio-economic classes in these countries.
Possible Effects on Maturation
Cannabis affects memory and attention as well as self-perception and the capacity to perceive reality. Alertness and awareness are modified. But, in truth, these acute effects last for several hours, at most, as our experiments have shown. However, it would seem that a severe anxiety state, even when temporary, and changes in perception of one's self and others, could have a greater effect on adolescents than more mature persons. This is because adolescents are passing through an identity crisis, due to their age and other social factors, which drug-related confusion may complicate.
But there is no indication that any such cannabis-related difficulties would have permanent or irreversible effects. We have very few facts to support a hypothesis of inadequate maturation which could be linked to a premature use of cannabis.
Cannabis and Criminality
For 75 years, the principal government-sponsored studies on cannabis use have concluded that there is no causal relationship between cannabis use and criminality. It is also evident that cannabis does not increase aggressivity. By far the greatest crime-inducing drugs are alcohol and, in certain respects, the amphetamines and, for very different reasons, heroin.
However, the law itself, consisting of prohibition with severe penal sanctions, engenders a certain kind of criminality. In fact, cannabis is in such great demand that many young Canadians have discovered they can easily earn large amounts of money selling it. This illicit trade has all the earmarks of a 'black market': buyers are occasionally cheated, lies must be told to explain large sums of money, etc. In any case, the 'black marketing' of cannabis certainly contributes nothing to thc communication between adults and young people. The seller also often offers other drugs besides cannabis to his clientele.
Progression and Multi-Drug Use
It appears that cannabis does not lead to the use of other drugs, but it is true, as our surveys reveal, that a certain proportion of cannabis users take other drugs.
We are not dealing with a phenomenon that is limited to cannabis, LSD and the amphetamines (which arc used in combination by only a few), but with an almost indiscriminate use of mood-changing substances in our socety. When we include alcohol, it can be said that Canadians consume great quantities of a variety of psychoactive drugs, even if cannabis is excluded. A connection between cannabis and the use of other illicit drugs may be at least partially a function of the illegal status of cannabis which necessitates regular user involvement in illicit distribution networks which are often the sources for these other drugs.
Should cannabis be singled out for blame? Is it true that it constitutes the first step in the progression? Does it necessarily mark the beginning? Is it a necessary or sufficient link? While it is true that a certain proportion of cannabis users try LSD and a smaller proportion of users may eventually use amphetamines (drugs which present serious nsks), it is not possible to say that cannabis use contributes to this phenomenon.
ARGUMENTS AGAINST LEGALIZATION
The number of users will double. This statement is probably reasonable. A large number of people replying to our questionnaires admit that they would use cannabis if it were legal. There is no doubt that legalization would be quickly followed by a large increase in the number of users, but can we assert that this growth would continue? Some would try cannabis and return to alcohol and tobacco. Others would take it, as is largely the practice now, when it is at hand-that is, only when the occasion arises.
Another drug; is hardly needed; there are too many already. To this I reply that the use of cannabis is already established; legalization will not introduce it to us.
The use of psychotropic drugs should be discouraged. Imprudent or excessive use of most drugs entails grave consequences to the individual, to the family, to society. We cannot eliminate the use of psychotropic drugs in Canada. We should therefore use the weapon of education as fully as possible rather than the penal code. It seems much wiser to base our hopes and efforts on a program of objective information for young and old and on the appropriate education to create the desire for moderation and self-control. Legalization would facilitate education-and personal and social control.
Persons dependent on hashish would not be satisfied wifth marijuana and would continue to support a significant illicit market. Hashish is more prevalent than marijuana in many areas of Canada only because it is a more convenient product to distribute illegally. We have no evidence that a significant proportion of cannabis users have developed a firm commitment to hashish, as opposed to a reasonably potent form of marijuana.
Importation of foreign supplies would be necessary. Recent botanical research in Ottawa indicates that potent marijuana can be grown in Canada. Although additional agricultural research would be required for efficient large-scale production, it is clear that no importation would be necessary to meet Canadian demand.
The production of a standardized product would be impossible. While there are still some significant questions to be resolved regarding optimal storage conditions for various cannabis preparations, there is growing evidence that the issue of shelf-life (cannabinoid degradation with time) need not be a major problem with natural marijuana. A product with a moderate, uniform level of Delta-9 THC could be reliably produced by blending marijuana from a high THC strain with low potency material-either marijuana or a semisynthetic cellulose material, as has been developed for tobacco cigarettes. Alternatively, a stable form of pure THC might be impregnated on an inactive carrier material. The production of a standard hashish preparation would present greater practical difficulties than marijuana, but should not be ruled out.
With legalization, there is a strong possibility that the number of regular users will increase and that the effects of cannabis intoxication will be observed in a greater number of people. It is also expected that a certain number of cannabis users would go on to other hallucinogens and would make greater use of barbiturates, tranquilizers and alcohol, as well.
The probable consequences of legalization seem to me to be less harmful than the evils of prohibition. Prohibition is very expensive economically socially and morally. It undermines the educative value of the law. The majority of my colleagues, though they would remove the prohibition against simple possession, do not take into account that the necessity of dealing in an illegal market will foster criminality among users.
A moratorium, which would serve only to postpone the decision which cannabis presses on this country, would not be in keeping with the information which we have taken so much trouble and time to accumulate.
I believe that it is not acceptable to claim that it is enough to "decriminalize" cannabis use. An important economic activity is developing in this country and would continue to develop without controls on price, on quality or on the involvement of organized crime ("decriminalization" of cannabis use alone would inevitably expand the illicit market and encourage this involvement). Cannabis users would continue to be supplied by distributors who will doubtless sell more dangerous products at the same time. Users would have to learn to deal with this situation with no assistance from society or its laws.
The federal government should remove cannabis from the Narcotic Control Act, as the Commission recommended in its Interim Report.
The federal government should immediately initiate discussions with the provincial governments to have the sale and use of cannabis placed under controls similar to those governing the sale and use of alcohol, including legal prohibition of unauthorized distribution and analogous age restrictions. Furthennore, this government-distributed cannabis should be marketed at a quality and price that would make the 'black market' sale of the drug an impractical enterprise.
The federal government should initiate a program fo develop efficient practical methods for cannabis production and marketing in Canada. A standard form of natural marijuana would seem to be most feasible at this stage, but hashish and synthetic preparations should also be explored.
The federal government should initiate prospective multidisciplinary epidemiological research to monitor and evaluate changes in the extent and patterns of the use of cannabis and other drugs, and to explore possible consequences to health, and personal and social behaviour, resulting from the controlled legal distribution of cannabis.
All stages of the production and marketing of cannabis should be conducted by the federal and/or provincial governments.
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