Transcript Our Relationship with Cannabis Law Reform

Our Relationship with
Recreational Cannabis
Law Reform
It’s complicated…
AMHO 3rd Annual Conference
May 26 2015
Introduction
Mike DeVillaer
CAMH & McMaster University
Suzanne Witt-Foley
MakingConnections4Health
Disclosure
We have never accepted funding from any
of the following drug industries:
• Tobacco
• Alcohol
• Pharma
• Illegal drug cartels
This Session
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about questions as much as answers
not just a presentation
facilitated discussion
active participation is essential
Objectives
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increase awareness of complexity
understand various reasons for change
explore key logistical issues
explore some potential models for reform
Getting Oriented to Recreational
Cannabis Law Reform
<< You
are here.
Current Status
of Cannabis Law Reform
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criminal justice approach not working
what to do?
reform experiences elsewhere
no assured results
lessons from current legal drug industries
Ontario Quick Stats
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14.1% of adults used in past yr
7.5% of adults report some harm
23.0% of youth used in past yr
3.0% gr. 7-12 report daily use
3.0% gr. 9-12 criteria for dependence
30,000+ admissions to addiction treatment
annually stating a problem with cannabis
Given that some people in
particular circumstances
experience harm, why are various
groups interested in liberalizing
cannabis laws?
Why liberalize?
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access to medicine
use without legal or financial risk
address social justice issues
economic opportunity for business sector
cost savings for govn’t from reduced
enforcement costs
• tax revenue for government
• increased revenue for drug education,
treatment & research
Competing Pressures
• address injustice
• protect public health
• provide new revenue for industry,
government & services
• satisfy public preference
Impact of liberalization on
prevalence of use, problems
• decriminalization does not lead to
increases in use or problems
• Amsterdam (hybrid of decriminalization &
legalization): initial increase in use; then
flattened
• Grow Your Own (GYO) provisions in
Alaska did not increase use
• most sites with legalization are too recent
to have adequate data
Holy Trinity of Drug Epidemiology
• increased access of a population to a
drug will increase use in that population
• increased use will lead to increased
problems in that population
Logistical
Issues
Types of Issues
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Power & Control
Legal
Industry Models
Manufacturing
Retail
Product Promotion
Taxation
Health Care
Power &
Control
Who Calls the Shots?
• who develops the regulations?
• flexibility of the regulations (ease of
changing)
• centralized/decentralized
• opt-out?
Legal
Issues
Minimum Age
• Colorado &
Washington: 21
• Ontario for
alcohol: 19
• rationale for a
higher or lower
minimum age?
Driving & THC Levels
• can’t be zero-tolerance
• detectable several
weeks after use
• Colorado: 5 nanograms
per milliliter of blood
Other Legal Issues
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adult buys for under-age user
use in public
amount possessed
possession of contraband
host liability for conduct of impaired guests
impairment at work
grow your own
Industry Models
Possible Industry Models
• monopoly vs competitive
• all phases ‘from seed to vape’ operated by
a monopoly
• cannabis only vs combined with other
(tobacco, alcohol or pharma)
Manufacturing
Issues
Packaging
 Loose-leaf product
vs. cigarettes, joints
 branding vs plain
packaging
 marketing research:
branded packaging
important
 warning labels
Product Innovation
• potency, concentrated product (oil)
• edibles a safety risk for children
• flavourings popular among young
for tobacco & alcohol
• Nova Scotia recently banned all
tobacco flavourings
• Ontario too?
Retail Issues
Specialized/Diversified Retail Outlets
Pot
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Us
sell cannabis only
same store as alcohol, tobacco, pharma
popular with consumers for convenience
convenience increases consumption
Drugs
Us
On-premises Use
(Bars & Restaurants)
• not in Colorado
• coffee shops in Amsterdam
Other Retail
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days & hours of operation
limit amount purchased
minimum age for servers
liable for customers who become impaired
smart serve training required
Other Retail (cont’d)
• outlet density – per population or
geographic area
• proximity to schools, playgrounds,
recreation, drug treatment facilities
Other Retail (cont’d)
• vending machines; home delivery services
• pricing controls: minimum pricing; bulk
discounts
• sales to non-Canada residents (cannabis
tourism)
Product
Promotion
Advertising, Marketing, Sponsorships
• should promotion be allowed at all ?
• restrict content: no cartoon characters,
animals, or celebrities or other images
attractive to children
• restrictions on location: eg. not near
schools, playgrounds, drug treatment
• fund counter-promotion campaigns
• promotion already widespread on internet;
cannot be contained
Taxation
As certain as death, the taxman
cometh…
• major draw for government
• taxes collected at federal or provincial
level
• by price or by weight
• black market implications
Impact on Health Care System
General Impact
• decriminalization has no impact on use of
social and health services
• legalization is uncertain
Impact of
legal recreational cannabis
on medical marijuana policy
• does medical marijuana become irrelevant?
• unless covered by health plan
• how likely is that ?
Impact on A&MH Treatment
Programs
• if legalization increases # users, then more
people with problems
• increased demand for service
• increase in cases & complexity of cases
Models for Reform
Public
Health
Social
Justice
Some Context
“Legalization, combined with strict health-focused
regulation, provides an opportunity to reduce the
harms” [from prohibition].
- CAMH Cannabis Policy Framework (2014)
“…there is a lot of policy space between traditional
prohibition and such commercial legalization.”
- Rand Corporation: Considering Marijuana
Legalization (2015)
Models
Punitive Decriminalization (CAMH & Rand)
Non-punitive Decriminalization (Rand)
For-profit Legalization (CAMH & Rand)
Not-for-profit Legalization (Rand)
Punitive Decriminalization
Model
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retain all prohibitions
reduce or stop enforcement
decrease penalties for minor offences
eliminate criminal records
charge a fine
Punitive Decriminalization
Advantages & Disadvantages
• ends most social injustice
• might still enable some discrimination &
harassment
• might deter people from accessing
treatment, harm reduction & education
• fines have no public health or social justice
purpose
Non-punitive
Decriminalization Model
• similar to punitive, but …
• no fines or other penalties for minor
cannabis-related offences
• eg. possession of small amounts
Non-punitive Decriminalization
Advantages & Disadvantages
• ends harassment & discrimination of users
• removes deterrence to use treatment, harm
reduction & education programs
• reduces resource draw on enforcement;
maybe on justice bureaucracy
• response to public use could be an
opportunity for education, harm reduction &
encouraging voluntary counseling
Legal For-profit Model
• private industry provides agriculture,
manufacturing, distribution, retail (seed to
‘vape’)
• government regulates: develops
legislation, provides licenses, monitors
compliance, punishes violators
• legal drugs (tobacco, alcohol, pharma) are
regulated now in Ontario & Canada
Legal Private For-profit
Context of Current Legal Drug Industries
• tobacco & alcohol biggest drug problems
• pharma is becoming increasingly serious
• 3 legal drug industries: tobacco, alcohol,
pharma (TAP)
• legacy of indiscriminate pursuit of profit
• disregard for public health & the law
Legal Private For-profit
Advantages & Disadvantages
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familiar model
regulation protects public health, but…
regulations not always evidence-based
lobbying: The National Cannabis Industry
Association (NCIA)
• government reluctant to compromise
industry revenue or tax revenue
Legal Private For-profit
Advantages & Disadvantages (cont’d)
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regulators not transparent
regulations not meaningfully enforced
small fines, small out-of-court settlements
little accountability
A 4th legal for-profit
drug industry?
Legal Not-for-profit Model
• operated by a government-appointed
authority holding a monopoly
• all components of the supply chain
• agriculture, manufacturing, distribution, retail
• seed-to-vape
Legal Not-for-profit
Advantages & Disadvantages
• alcohol monopolies protect public health
better than less-regulated models
• Board consists primarily of people with
expertise in public health
• mandate: meet existing demand within
public health framework
• priority: providing education & harm
reduction
Legal Not-for-profit
Advantages & Disadvantages (cont’d)
• surpluses fund new innovative ideas in
education, treatment, research
• not to govn’t general accounts
• reversibility – easier to go from monopoly
to commercial competitive than the
reverse
Some Final Thoughts
• TAP industries value revenue over rule of
law & public health
• regulation inadequate; public health
compromised
• TAP too powerful to convert to public
health model
• cannabis provides opportunity to try a
different kind of model
• will entrepreneurs & government forgo the
revenue opportunity?
More final thoughts…
The models that we find acceptable will
depend upon our values
– policy based upon public health & social
justice
– balanced with revenue for industry & govn’t
– Is latter a level playing field?
And another one…
• major advantage of legalization over
decriminalization is revenue
• more transparency on societal merits of
private interests trumping social welfare
• private wealth vs public health
Rand Report
“What kinds of organizations do we want
selling these intoxicants? Those
concerned only with profit, or those with a
greater goal of producing social benefit or
minimizing social harm?”
CAMH Framework
“It is critical that legal reform of cannabis
control be conducted with public health as
its primary objective and that the resulting
regulatory framework be carefully
protected from commercial and fiscal
interests.”
What Next?
Contact Us
Mike:
porticonetwork.ca/web/drug-ppp
Suzanne:
suzannewittfoley.com