Pubdate: Mon, 21 Dec 2015
Source: Globe and Mail (Canada)
Copyright: 2015 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Jurgen Rehm
Page: A14

MOVE TO LEGALIZE POT SHOULD START BY LIMITING SPREAD OF DISPENSARIES

Our new federal government has made it clear that legalized marijuana
is just a matter of time. A visitor to Canada would be forgiven for
believing legalization has already taken place: Cannabis dispensaries
have been popping up across the country, especially in the past few
months.

Many of these dispensaries are geared toward providing cannabis to
people with a prescription from their doctor. But recent reports from
Toronto show that many dispensaries sell cannabis with little more
than the customer's signature on a waiver form. Although illegal, the
outlets seem to be operating more openly, presumably on the assumption
that if legalization is coming, enforcement will leave them alone.
Thus far, with a few exceptions, they seem to be right.

There is good evidence to support cannabis as an effective treatment
for a small number of conditions, most notably nausea and vomiting,
spasticity and certain types of pain. But the popularity - and now the
availability - of medical cannabis has far outpaced the evidence base.
The legal status of cannabis is partly to blame: Criminalization has
stunted our ability to conduct rigorous clinical trials. For now, many
of the common claims behind medical cannabis (for example, that it is
an effective treatment for anxiety, depression or post-traumatic
stress disorder) remain untested.

There are health risks to using cannabis - fewer, it is true, than for
alcohol or tobacco, but every year, about 300 deaths in Canada are
caused by cannabis (mainly due to traffic injuries). As well, at least
75,000 people are treated each year for cannabis-use disorders. And
the developing brains of adolescents are particularly vulnerable to
marijuana-related harms.

Prohibition of cannabis actually exacerbates these health problems and
adds social harms such as criminalization of users. The best way to
mitigate these harms is through legalization with strict regulation.
But the spread of unregulated cannabis dispensaries leaves Canada in
an awkward position with respect to marijuana and its legal status. It
facilitates and legitimizes a number of "medical" uses of cannabis for
which there is at present no empirical basis. It also threatens to
derail an evidence-informed approach to cannabis regulation by
pre-empting it entirely.

Cannabis, like alcohol, is no ordinary commodity. From decades of
experience with alcohol, we know that where and how a substance is
sold matters a great deal from a health and safety perspective. For
legalization of marijuana to be beneficial, there must be limits on
availability and controls on price. Higher-potency formulations and
products designed to appeal to youth should be curtailed. Marketing,
advertising and sponsorship should be prohibited. We also know that
this health-focused approach is most effectively implemented and
maintained through retail systems that are publicly owned and operated.

Legalization can be beneficial, but only if it is conducted with
public health as the primary and overriding objective. The federal
government should be applauded for its commitment to a health-focused
approach to cannabis policy, and its commitment that Canada will lead
the world in establishing a regulatory approach that gets it right.
Taking action to limit the spread of dispensaries is a necessary first
step. Otherwise, by the time new marijuana regulations are introduced,
a commercially oriented system will already be in place.

Jurgen Rehm is director of social and epidemiological research at the 
Centre for Addiction and Mental Health, Toronto.
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MAP posted-by: Matt