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|Major Studies of Drugs and Drug Policy|
|Canadian Senate Special Committee on Illegal Drugs|
|Volume 3 - Public Policy Options|
Chapter 21 - Public policy options
The Committee recommends that the position of National Advisor on Psychoactive Substances and Dependency be created within the Privy Council Office; that the Advisor be supported by a small secretariat and that federal departments and agencies concerned by psychoactive substances second, upon request, the necessary staff.
National strategy sustained by adequate resources and tools
A federal policy and strategy do not in themselves make a national strategy. Provinces, territories, municipalities, community organizations and even the private sector all have a role to play in accordance with their jurisdiction and priorities. This is necessary and this diversity is worth encouraging. However, some harmonization and meaningful discussion on practices and pitfalls, on progress and setbacks, and on knowledge, are to be encouraged. Apart from there source-starved piecemeal action of the Canadian Centre on Substance Abuse, there are all too few opportunities and schemes to promote exchanges of this type. The current and future scale of drug and dependency-related issues warrants the Canadian Government earmarking the resources and developing the tools with which to develop fair, equitable and well-thought out policies.
Like the majority of Canadian and foreign observers of the drug situation, we were struck by the relative lack of tools and measures for determining and following up on the objectives of public psychoactive substance policy. One might not agree with the numbers-focused goals set out by the Office of National Drug Control Policy for the reduction of drug use or for the number of drug treatment programs setup and evaluated. However, we have to admit that at least these figures serve as guidelines for all stakeholders and as benchmarks against which to measure success.
Similarly, one might not feel totally comfortable with the complex Australian goal-definition process, whereby the whole range of partners from the various levels of government, organizations and associations meet at a conference every five years. However, at least those goals agreed upon by the various stakeholders constitute a clear reference framework and enable better harmonization of action.
The European monitoring system with its focal points in each European Union country under the European Monitoring Centre for Drugs and Drug Addiction umbrella might seem cumbersome; and the American system of conducting various annual epidemiological studies might appear expensive. We might even acknowledge that there are problems with epidemiological studies, which are far from providing a perfect picture of the psychoactive substance-use phenomena. However, at least these tools, referred to and used throughout the Western world, enable the development of a solid information base, with which to analyse historical trends, identify new drug-use phenomena and react rapidly. In addition, it allows for an assessment of the relevance and effectiveness of action taken. No system of this type exists in Canada, which is the only industrialized Western country not to have such a knowledge structure.
It is for these reasons that the Committee recommends that the Government of Canada support various initiatives to develop a genuine national strategy. Firstly, the Government should call a national conference of the whole range of partners with a view to setting out goals and priorities for action over a five-year period. This conference should also identify indicators to be used in measuring progress at the end of the five-year period. Secondly, the Canadian Centre on Substance Abuse needs to be renewed. Not only does this body lack resources but it is also subject to the vagaries of political will of the Minister of Health. The Centre should have a budget in proportion with the scale of the psychoactive substance problem and should have the independence required to address this issue. Lastly, a Canadian Monitoring Agency on Drugs and Dependency should be created within the Centre.
The Committee recommends that the Government of Canada mandate the National Advisor on Psychoactive Substances and Dependency to call a high-level conference of key stakeholders from the provinces, territories, municipalities and associations in 2003, to set goals and priorities for action on psychoactive substances over a five-year period.
The Committee recommends that the Government of Canada amend the Canadian Centre on Substance Abuse enabling legislation to change the Centre’s name to the Canadian Centre on Psychoactive Substances and Dependency; make the Centre reportable to Parliament; provide the Centre with an annual basic operating budget of 15 million dollars, to be increased annually; require the Centre to table an annual report on actions taken, the key issues, research and trends in the federal Parliament and provincial and territorial assemblies and legislatures; mandate the Centre to ensure national co-ordination of research on psychoactive substances and dependency, and to conduct studies into specific issues; and mandate the Centre to undertake an assessment of the national strategy on psychoactive substance and dependency every five years.
The Committee recommends that in the legislation creating the Canadian Centre on Psychoactive Substances and Dependency, the Government of Canada specifically include provision for the setting up of a Monitoring Agency on Psychoactive Substances and Dependency within the Centre; provide that the Monitoring Agency be mandated to conduct studies every two years, in co-operation with relevant bodies, on drug-use trends and dependency problems in the adult population; work with the provinces and territories towards increased harmonization of studies of the student population and to ensure they are carried out every two years; conduct ad hoc studies on specific issues; and table a bi-annual report on drug-use trends and emerging problems.
A public health policy
When cannabis was listed as a prohibited substance in 1923, no public debate or discussion was held on the known effects of the drug. In fact, opinions expressed were disproportionate to the dangers of the substance. Half a century later, the Le Dain Royal Commission of Inquiry on the Non-Medical Use of Drugs held a slightly more rational debate on cannabis and took stock of what was known about the drug. Commissioners were divided not so much over the nature and effects of the drug but rather over the role to be played by the State and criminal law in addressing public health-related goals. Thirty years after the Le Dain Commission report, we are able to categorically state that, used in moderation, cannabis in itself poses very little danger to users and to society as a whole, but specific types of use represent risks for users.
In addition to being ineffective and costly, criminalization leads to a series of harmful consequences: users are marginalized and exposed in a discriminatorily fashion to the risk of arrest and to the criminal justice system; society sees organized crime enhance their power and wealth by benefiting from prohibition; and governments see their ability to conduct prevention of at-risk use diminished.
We would add that, even if cannabis were to have serious harmful effects, one would have to question the relevance of using the criminal law to limit these effects. We have demonstrated that criminal law is not an appropriate governance tool for matters relating to personal choice and that prohibition is known to result in harm which often outweighs the desired positive effects. However, current scientific knowledge on cannabis, its effects and consequences are such that this issue is not relevant to our discussion.
Indeed available data indicate that the scale of the cannabis use phenomenon can no longer be ignored. Chapter 6 indicated that no fewer than 30% of Canadians (12to 64 years old) have experimented with cannabis at least once in their lifetime. In all probability, this is an underestimation. We have seen that approximately 50% of high school students have used cannabis within the past year. Nevertheless, a high percentage of them stop using and the vast majority of those who experiment do not go on to become regular users. Even among regular users, only a small proportion develop problems related to excessive use, which may include some level of psychological dependency. Consumption patterns among cannabis users do not inevitably follow an upward curve but rather a series of peaks and lulls. Regular users also tend to have a high consumption rate in their early twenties, which then either drops off or stabilizes, and in the vast majority of cases, ceases altogether in their thirties.
All of this does not in any way mean, however, that cannabis use should be encouraged or left totally unregulated. Clearly, it is a psychoactive substance with some effects on cognitive and motor functions. When smoked, cannabis can have harmful effects on the respiratory airways and is potentially cancerous. Some vulnerable people should be prevented, as much as possible, from using cannabis. This is the case for young people under 16 years of age and those people with particular conditions that might make them vulnerable (for example those with psychotic predispositions). As with alcohol, adult users should be encouraged to use cannabis in moderation. Given that, as for any substance, at-risk use does exist, preventive measures and detection tools should be established and treatment initiatives must be developed for those who use the drug excessively. Lastly, it goes without saying that education initiatives and severe criminal penalties must be used to deter people from operating vehicles under the influence of cannabis.
As for any other substance, there is at-risk use and excessive use. There is no universally accepted criterion for determining the line between regular use, at-risk use and excessive use. The context in which use occurs, the age at which users were introduced to cannabis, substance quality and quantity are all factors that play a role in the passage from one type of use to another. Chapters 6 and 7 identified various criteria, which we have collated in table form below.
Proposed Criteria for Differentiating Use Types
Period of useand intensity
Experimental / Occasional
A few times over lifetime
Mainlyin a group
A few joints
Less than one gram per month
A few times per month
Spread over several years but rarely intensive
Recreational and occupational (to go to school, to go to work, forsport…) Alone, in the morning
Under 16 years of age
Between 0.1 and 1 gram per day
A few times per week, evenings, especially weekends
Spread over several years with high intensity periods
Occupational and personal problems
No self regulation of use
Over one gram per day
More than once per day
Spread over several years with several months at a time of high intensity use
If cannabis itself poses very little danger to the user and to society as a whole, some types of use involve risks. It is time for our public policy to recognize this and to focus on preventing at-risk use and on providing treatment for excessive cannabis users.
The Committee recommends that the Government of Canada adopt an integrated policy on the risks and harmful effects of psychoactive substances covering the whole range of substances (medication, alcohol, tobacco and illegal drugs). With respect to cannabis, this policy shall focus on educating users, detecting and preventing at-risk use and treating excessive use.
A regulatory approach to cannabis
The prohibition of cannabis does not bring about the desired reduction in cannabis consumption or problem use. However, this approach does have a whole series of harmful consequences. Users are marginalized and over 20,000 Canadians are arrested each year for cannabis possession. Young people in schools no longer enjoy the same constitutional and civil protection of their rights as others. Organized crime benefits from prohibition and the criminalization of cannabis enhances their power and wealth. It is a well-known fact that society will never be able to stamp out drug use – particularly cannabis use.
Some might believe that an alternative policy signifies abandoning ship and giving upon promoting well-being for Canadians. Some might maintain that a regulatory approach would fly in the face of the fundamental values of our society. We believe, however, that the continued prohibition of cannabis jeopardizes the health and well-being of Canadians much more than the regulated marketing of the substance. In addition, we believe that the continued criminalization of cannabis undermines the fundamental values set out in the Canadian Charter of Rights and Freedoms and borne out by the history of a country based on diversity and tolerance.
We do not want to see cannabis use increase, especially among young people. Of note, the data from other countries that we compared in Chapters 6 and 20 indicate that countries such as the Netherlands, Australia or Switzerland, which have put in place a more liberal approach, have not seen their long-term levels of cannabis use rise. The same data also clearly indicate that countries with a very restrictive approach, such as Sweden and the United States, are poles apart in terms of cannabis use levels, and that countries with similar liberal approaches such as the Netherlands and Portugal are also at opposite ends of the spectrum, falling somewhere between Sweden and the United States. We have concluded that public policy itself has little effect on cannabis use trends and that other more complex and poorly-understood factors play a greater role in explaining the variations.
An exemption regime making cannabis available to those over the age of 16 would probably lead to an increase in cannabis use for a certain period. Use rates would then level out as interest wanes and as effective prevention programs are set up. This would then be followed by a roller-coaster pattern of highs and lows, as has been the case in most other countries.
This approach is neither one of total abdication nor a sign of giving up but rather a vision of the role of the State and criminal law as developing and promoting but not controlling human action and as stipulating only necessary prohibitions relating to the fundamental principle of respect for life, others and a harmonious community, and as supporting and assisting others and not judging and condemning difference.
We might wish for a drug-free world, fewer tobacco smokers or alcoholics or less prescription drug dependency, but we all know that we shall never be able to eliminate these problems. More importantly, we should not opt to criminalize them. The Committee believes that the same healthy and respectful approach and attitude should be applied to cannabis.
It is for this reason that the Committee recommends that the Government of Canada amend the Controlled Drugs and Substances Act to create a criminal exemption scheme for the production and sale of cannabis under the authority of a licence. Licensing and the production and sale of cannabis would be subject to specific conditions, that the Committee has endeavoured to specify. For clarity’s sake, these conditions have been compiled at the end of this section. It should be noted at the outset that the Committee suggests that cigarette manufacturers be prohibited from producing and selling cannabis.
The Committee recommends that the Government of Canada amend the Controlled Drugs and Substances Act to create a criminal exemption scheme. This legislation should stipulate the conditions for obtaining licences as well as for producing and selling cannabis; criminal penalties for illegal trafficking and export; and the preservation of criminal penalties for all activities falling outside the scope of the exemption scheme.
The Committee recommends that the Government of Canada declare an amnesty for any person convicted of possession of cannabis under current or past legislation.
A compassion-based approach for therapeutic use
In Chapter 9, we noted that cannabis has not been approved as a medicinal drug in the pharmacological sense of the word. In addition to the inherent difficulties in conducting studies on the therapeutic applications of cannabis, there are issues arising from the current legal environment and the undoubtedly high cost to governments of conducting such clinical studies.
Nevertheless, we do not doubt that, for some medical conditions and for certain people, cannabis is indeed effective and useful therapy. Is it more effective than other types of medication? Perhaps not. Can physicians currently prescribe cannabis at a known dosage? Undoubtedly not. Should persons suffering from certain physical conditions diagnosed by qualified practitioners be permitted to use cannabis if they wish to do so? Of this, we are convinced.
Regulations made in 2001 by the Health Canada, even though they are a step in the right direction, are fundamentally unsatisfactory. They do not facilitate access to therapeutic cannabis. They do not consider the experience and expertise available in compassion clubs. These regulations only govern marijuana and do not include cannabis derivatives such as hashish and cannabis oils.
It is for these reasons that the Committee recommends that Health Canada amend the Marihuana Medical Access Regulations in order to allow compassionate access to cannabis and its derivatives. As in the previous chapter, proposed rules have been compiled at the end of this chapter.
The Committee recommends that the Marihuana Medical Access Regulations be amended to provide new rules regarding eligibility, production and distribution of cannabis for therapeutic purposes. In addition, research on cannabis for therapeutic purposes is essential.
Provisions for operating a vehicle under the influence of cannabis
In chapter 8, we discussed the fact that research has not clearly established the effects of cannabis when taken alone on a person’s ability to operate a vehicle. Nevertheless, there is enough evidence to suggest that operating a vehicle while under the influence of cannabis alters motor functions and effects a person’s ability to remain in his or her lane. We have also established that the combined effects of cannabis and alcohol impair faculties even more than alcohol taken alone. Epidemiological studies have shown that a certain number of cannabis users do drive under the influence of the substance and that a large proportion of these people, mainly the young, appear to believe that cannabis does not impair their ability to drive.
This chapter also indicated that no reliable and non-intrusive road-side detection tools exist. Saliva-based equipment is a promising development but for the time being, provide random results. We have also established that a visualre cognition system, which has mainly been developed and assessed in the United States, is a reliable way of detecting drug-induced impaired driving faculties.
The Committee recommends that the Criminal Code be amended to lower permitted alcohol levels to 40milligrams of alcohol per 100 millilitres of blood, in the presence of other drugs, especially, but not exclusively cannabis; and to admit evidence from expert police officers trained in detecting persons operating vehicles under the influence of drugs.
Research on psychoactive substances, and particularly on cannabis, has undergone a boom over the past 20 years. The Committee was able to fully grasp the actual extent of this increase, since we faced the challenge of summarizing it. Not all research is of the same quality and the current political and legal climate governing cannabis hampers thorough and objective studies. Nevertheless, a solid fact base was available to the Committee, on which to base its foregoing conclusions and recommendations.
However, more research needs to be done in a certain number of specific areas. In Chapter6, we established that a lack of practical research on cannabis users has resulted in only a limited amount of information on contexts of use being available. It is also currently difficult to establish criteria on the various types of cannabis use in order to guide those responsible for prevention. The Committee suggests that cannabis use of over one gram per day constitutes excessive use and that between 0.1 and one gram per day equates to at-risk use. We also suggest that any use below 16 years of age is at-risk use. This is of course enlightened speculation, but speculation nevertheless, which remains to be explored.
In Chapters 16 and 17, we referred to the fact that we know very little about the most effective prevention practices and treatment. Here also, the current context hindered. As far as prevention is concerned, the more or less implicit “just say no ” message and the focus on cannabis use prevention are strategies that have been dictated by the prohibition-based environment. In terms of treatment for problem users, abstinence-based models have long been the dominant approach and continue to sit very poorly with harm-reduction-based models. Thorough assessment studies are required.
The Canadian Centre on Psychoactive Substances and Dependency must play a key role in co-ordinating and publishing the results of studies. The Centre does not have to conduct research itself. This can and indeed must sometimes be carried out by academics. The Health Research Institutes are also natural players. However, it is important to clearly identify a single central body to collect research information. This will enable the information to be distributed as widely possible and, we hope, used.
The Committee recommends that the Government of Canada create a national fund for research on psychoactive substances and dependency to fund research on key issues - more particularly on various types of use, on the therapeutic applications of cannabis, on tools for detecting persons operating vehicles under the influence of drugs and on effective prevention and treatment programs; that the Government of Canada mandate the Canadian Centre on Psychoactive Substances and Dependency to co-ordinate national research and serve as a resource centre.
Canada’s international Position
The Committee is well aware that were Canada to choose the rational approach to regulating cannabis that we have recommended, it would be in contravention of the provisions of the various international conventions and treaties governing drugs. We are also fully aware of the diplomatic implications of this approach, in particular in relation to the United States.
We are keen to avoid replicating, at the Canada-US border, the problems that marked relations between the Netherlands, France, Belgium and Germany over the issue of drugs-tourism between 1985 and 1995. This is one of the reasons that justifies restricting the distribution of cannabis for recreational purposes to Canadian residents.
We are aware of the fact that a significant proportion of the cannabis produced in Canada is exported, mainly to the United States. We are also aware that a considerable proportion of heroin and cocaine comes into Canada via the United States. We are particularly cognisant of the fact that Canadian cannabis does not explain the increase in cannabis use in the United States. It is up to each country to get its own house in order before criticizing its neighbour.
Internationally, Canada will either have to temporarily withdraw from the conventions and treaties or accept that it will be in temporary contravention until the international community accedes to its request to amend them. The Committee opts for the second approach, which seems to us to be more consistent with the tradition and spirit of Canadian foreign policy. In addition, we have seen that international treaties foster the imbalanced relationship between the Northern and Southern hemispheres by prohibiting access to plants, including cannabis, produced in the Southern hemisphere, while at the same time developing a regulatory system for medication manufactured by the pharmaceutical industry in the Northern hemisphere. Canada could use this imbalanced situation to urge the international community to review existing treaties and conventions on psychoactive substances.
Canada can and indeed should provide leadership on drug policy. Developing a national information and action infrastructure would undoubtedly be key to this. Canada must also play a leading role in the Americas. We believe that Canada enjoys a favourable international reputation and that it can promote the development of fairer and more rational drug – in particular cannabis - policies. We also contend that Canada should strive for the creation of a European Observatory-style Drug and Dependency Observatory for the Americas within the Organization of American States.
The Committee recommends that the Government of Canada instruct the Minister of Foreign Affairs and International Trade to inform the appropriate United Nations authorities that Canada is requesting that conventions and treaties governing illegal drugs be amended; and that the development of a Drugs and Dependency Observatory for theAmericas be supported by the Government of Canada.
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