Pubdate: Thu, 06 Sep 2001
Source: Canadian Medical Association Journal (Canada)
Copyright: 2001 Canadian Medical Association
Author: Craig Jones
Bookmark: (Cannabis - Canada)


Thirty years after the publication of the LeDain Commission report,1 
editorial opinion at CMAJ has arrived at the same opinion: "the real harm 
[of marijuana] is the legal and social fallout [editorial]."2 In 1995 The 
Lancet editorialized that "the smoking of cannabis, even long term, is not 
harmful to health."3 Two years later the New England Journal of Medicine 
called for the reclassification of cannabis under American law4 and George 
Annas wrote in the same journal that "marijuana is unique among illegal 
drugs in its political symbolism, its safety, and its wide use."5

It is worth remembering that cannabis was prohibited in Canada only because 
Emily Murphy managed to create a moral panic around the association of 
cannabis with Blacks and Mexicans. Cannabis prohibition - as in the Opium 
Act of 1908 - was from the outset a strategy for the political suppression 
of selected racial groups.6

In the 30 years since the LeDain Commission report was released, thousands 
of young Canadians have been incarcerated. One of the unintended 
consequences of incarceration is growing into a full-blown public health 
catastrophe. In the mid 1990s the Correctional Service of Canada instituted 
urinalysis testing to enforce a zero-tolerance drug policy.

The inmates did the logical thing, from their viewpoint; they migrated to 
the use of drugs that cleared the body in less time than cannabis. The 
drugs of choice came to be heroin and cocaine.

As a result of needle sharing, our federal prisons have become incubation 
centres for HIV and hepatitis C.7 Canada's drug control strategy, a 
decaffeinated version of the American "war on drugs," produces more 
pathology than it prevents.8

Most inmates eventually get out of prison, and thus the potential for a 
public health disaster can no longer be denied.

Recent events at the Kingston Penitentiary suggest that the Correctional 
Service of Canada may be looking for a face-saving alternative to its 
unworkable zero-tolerance drug strategy.

Here is an opportunity for the bold stride the CMAJ editorial says is 
needed: CMAJ ought to call for the vigorous expansion of harm reduction 
programs across Canada and in particular within our prisons.

Unfortunately, however, the drug war needs marijuana's prohibited status 
because without it the "drug problem" collapses from a social crisis 
involving several million Canadians and requiring more police and more 
prisons, to a situation involving a handful of hard-core addicts whose 
sickness can be reduced and confined, as the experience of Holland, 
Switzerland and Germany demonstrates.9

Cannabis in its numerous forms is an efficacious treatment for a number of 
conditions, as the Chinese claimed as long ago as 2737 BCE,1 with 
considerably fewer side effects for many people than other treatments.10 
Marijuana could compete with established brand medications that are backed 
by powerful global economic, social and political forces and their 
legislative allies.

Thus there are at least 2 powerful obstacles to the decriminalization of 
marijuana, both arising from the vested interests that have grown up and 
taken hold under prohibition. Still, CMAJ is to be congratulated: better 
late than never.

Craig Jones, Research Associate

Queen's Centre for Health Services and Policy Research

Queen's University Kingston, Ont.


1. The report of the Canadian Government Commission of Inquiry into the 
Non-Medical Use of Drugs. Ottawa: Information Canada; 1972.

2. Marijuana: federal smoke clears, a little [editorial]. CMAJ 

3. Deglamourizing cannabis [editorial]. Lancet 1995;346(8985):1241. [MEDLINE]

4. Kassirer JP. Federal foolishness and marijuana.

N Engl J Med 1997;336(5):366-7. [MEDLINE]

5. Annas GJ. Reefer madness: the federal response to California's 
medical-marijuana law. N Engl J Med 337(6):435-9.

6. Giffen PJ, Endicott S, Lambert S. Panic and indifference: the politics 
of Canada's drug laws. A study in the sociology of law. Ottawa: Canadian 
Centre on Substance Abuse; 1991.

7. Ford PM, Pearson M, Sankar-Mistry P, Stevenson T, Bell D, Austin J. HIV, 
hepatitis C and risk behaviour in a Canadian medium-security federal 
penitentiary. Q J Med 2000;93:113-9.

8. Johns CJ. Power, ideology and the war on drugs: nothing succeeds like 
failure. New York: Praeger; 1992.

9. Grapendaal M, Leuw E, Nelen H. A world of opportunities: life-style and 
economic behaviour of heroin addicts in Amsterdam. New York: State 
University of New York Press; 1995.

10. Grinspoon L, Bakalar JB. Marihuana as medicine: a plea for 
reconsideration. JAMA 1995;273(23):1875-6. [MEDLINE]
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