Cannabis policy: status and recent developments

Cannabis policy: status and recent developments

Under international laws, cultivation, supply and possession of cannabis should be allowed only for ‘medical and scientific purposes’. In general, possession of the drug for personal use should be a crime, to deter use, and most countries make this punishable by imprisonment. In recent years, however, several jurisdictions have reduced their penalties for cannabis users, and some have permitted supply of the drug, allowing us to observe different control models and their consequences. Policy discussions are complicated by conflicting claims — decriminalisation or legalisation, medical or recreational use, policy success or failure — and this page aims to clarify some issues.

How is international cannabis policy developing?

Background

While international laws oblige countries to impose criminal penalties for supply of drugs for non-medical purposes, some jurisdictions are creating exceptions. A system of cannabis supply has been illegal but tolerated in the Netherlands since the 1970s. ‘Medical marijuana’ was legalised by popular vote in California, in 1996, to treat symptoms including chronic pain. As there is no objective test for pain, public access to legal smokable cannabis became a formality. In Europe, since the late 1990s, decriminalisation and harm reduction policies had less negative impact than had been feared. The 2008 economic recession forced cuts to law enforcement budgets. In 2012, with medical cannabis available in 18 US states, voters in the states of Colorado and Washington approved systems of cannabis supply for recreational, not just medical, use. In the following year, the government of Uruguay passed a law to establish a system of supply via pharmacies and social clubs. More US states have legalised cannabis since then.

Terminology

The terms ‘depenalisation’, ‘decriminalisation’ and ‘legalisation’ are often used in the drug control debate. These terms are briefly distinguished as follows.

Depenalisation: something remains a criminal offence, but is no longer punished, e.g. now the case may be closed.

Decriminalisation:  an offence is reclassified from criminal to non-criminal. It remains an offence and may be punished by the police or other agencies, rather than a court.

Legalisation:  there is a move from a prohibited behaviour (criminal or not) to a permitted behaviour. This is usually used to describe supply, rather than possession, of drugs.

The video ‘What is decriminalisation?’ provides more detailed explanation.

Policy in Europe

Cannabis policy models in Europe

Personal possession

While all EU Member States treat possession of cannabis for personal use as an offence, over one third do not allow prison as a penalty for minor offences (see map below). In many of the countries where the law allows imprisonment for such cannabis possession, national guidelines advise against it. More details are available at Penalties at a glance.

Figure: Penalties in laws: possibility of incarceration for possession of cannabis for personal use (minor offences)

Models of legal supply

No national government in Europe supports legalisation of cannabis sale for recreational use, and all countries have prison sentences for illegal supply. However, several draft laws have been proposed to national parliaments in the last few years, as well as some initiatives in regions or cities that were rejected at national level.

Coffeeshops

In the Netherlands, coffeeshops are outlets for the sale and (often on-site consumption) of cannabis, which started to appear in the 1970s. They are licensed by the municipality, and about two-thirds of Dutch municipalities do not allow them. There were 591 coffeeshops in 2014, with nearly one third in Amsterdam; numbers have been falling since 2000. Sale and personal possession is punishable by imprisonment under Dutch law, but coffeeshops are tolerated provided they adhere to strict criteria published in a directive of the public prosecutor. However, there is no toleration of production of the stock, creating a legal anomaly known in the Netherlands as the ‘back door problem’.

Cannabis social clubs

In a number of European countries, groups of users have formed ‘cannabis social clubs’. They claim that, in principle, if cultivation of one cannabis plant is tolerated for one person’s use, then 20 plants together might be tolerated for a club of 20 people. No national government in Europe accepts this, though some regions in Spain have attempted to pass regulations to limit the proliferation of such clubs. In 2015, the Spanish Supreme Court clearly stated that ‘organised, institutionalised and persistent cultivation and distribution of cannabis among an association open to new members is considered drug trafficking’.

Young Europeans’ views on drug control

One of the few comparable surveys of the strength of public opinion in the European Union is the Flash Eurobarometer, which interviews approximately 500 young people (aged 15–24) in each country. In 2011 and 2014, young people were asked for their opinions on drugs. More than half of the respondents were in favour of banning the sale of cannabis, rather than regulating it, but that proportion declined over the period, from 59 % to 53 %.

Further reading

Policy outside Europe

Cannabis policy models outside Europe

Overview

Four basic models of legal cannabis production and supply are now operating. Some jurisdictions allow more than one of these models.

1. Taxed, commercial supply. Many licensed growers supply many licensed retail outlets. This is the model in Colorado, Washington State, Alaska and Oregon, and it is the model approved in 2016 in California, Maine, Massachusetts and Nevada.

2. Government supply. The government contracts a limited number of growers and controls supply through outlets. This is one of three models in Uruguay.

3. Permitting home grow (and giving small amounts). No tax, no sales outlets. This is the only model in Washington DC, and one of three models in Uruguay. Home grow is also permitted in seven of the eight American states with commercial supply models; only Washington State does not allow it.

4. Social clubs. A group of people grow cannabis in a collective and use it. No tax, no sales outlets. This one of three models in Uruguay.

The ‘Further reading’ section contains links to scientific reports on these models, where available. More details can be found in our Legal supply of cannabis: recent developments

However, these are not the only models possible. The article ‘The 10 Ps of marijuana legalization’ outlines the many different possible choices when designing a model of legal cannabis supply.

Key characteristics of the US legal context:

  • State laws can be passed by initiative or referendum, rather than parliamentary debate.
  • ‘Medical’ cannabis had been legal and openly available for several years before recreational use was permitted.
  • Direct-to-consumer advertising of prescription medicines is permitted.
  • The right to ‘commercial freedom of speech’ limits the state’s ability to regulate advertising.

Further reading

News updates on cannabis policy

You can find below objective information on cannabis policy changes. The news is limited to key news events, such as when a major policy decision is taken or a significant report is released. The news updates below concentrate on policies where cannabis is clearly used for recreational purposes. 

Register for email updates

Since 2017, herbal cannabis and cannabis oils have been offered for open sale in health food shops or specialist shops in several EU countries, including France, Italy, Luxembourg and Austria. Sales have taken place based on the claim that these products have little or no intoxicating effect and therefore are not controlled under drug laws. The EMCDDA network of national legal correspondents recently addressed this issue.

What do international drug control laws say?

The UN drug control conventions state that unauthorised sale of ‘cannabis flowers’ and ‘extracts and tinctures of cannabis’ should be subject to criminal penalties in national drug control laws. Cannabis flowers and extracts usually contain the two cannabinoids THC and CBD, but the percentage of each can vary greatly, by plant variety and by growing technique. THC can cause intoxicating effects, while CBD has been associated with health benefits, though there is little evidence for most conditions that have been studied. The WHO expert committee on drug dependence recently recommended that pure CBD should not be listed under the drug conventions.

Do EU regulations apply?

The EU common agricultural policy subsidises growing certain varieties of the cannabis plant for industrial uses, provided their THC content does not exceed 0.2 %. The EU also has several directives and regulations that might address the sale of low-THC products, including standardised definitions of medicinal products, herbal medicines, food and food supplements, cosmetics, general product safety etc. As classification is usually decided by national regulatory bodies, depending on the country, a cannabis product could potentially be classified as a medicine, a food or a consumer product.

Are national responses similar?

Member States’ responses to open sale can range from stating that plant-derived THC- or CBD-containing products are cannabis extracts, and therefore subject to criminal penalties, to stating that some of those products have insignificant psychoactive properties and are therefore at low risk of misuse and unlikely to pose a threat to public health, and so do not require any licence for trade.

First, countries differ in their response towards low-THC products. Some countries state that a product containing less than 0.3% or 0.2% THC is not controlled under drug laws. For others, an unlicensed product must not contain any THC at all. But these quantitative limits may also come with conditions, such as ‘originating from an authorised variety of cannabis’, ‘if not viable for narcotic purposes’, ‘if not misused’.

In addition, countries have developed different responses towards products containing CBD. There seem to be few quantitative limits to CBD but more conditions. The legality of marketing the product may depend on the source of the CBD, it may depend on the format of the product, and it may depend on how the product is presented.

What do these products contain?

National forensic analyses of ‘low-THC’ cannabis herb in Italy, Luxembourg and Austria found that they were indeed low in THC. However, some products sold as ‘high in CBD’ have been found to contain levels of THC that may cause intoxication, which some users would not expect.

In Uruguay, the Institute for Regulation and Control of Cannabis (IRCCA) released a report on the national regulated market, based on data up to 5 June 2018.

After the market was legalised in 2013, resident users could register for only one of three ways to obtain cannabis: home growing, communal growing (social club), or buying state-grown cannabis from pharmacies (which only started to sell the drug in July 2017). Cannabis sold in pharmacies initially had a potency of 2.5 % THC and 6-7 % CBD, though this changed in December 2017 to 9 % THC and 3 % CBD. It is sold in 5-gram sachets for UY$200 [EUR 5.80], and users may buy 40 grams per month. As of June 2018, some 958 kilograms of cannabis had been sold in this way.

Who is buying?

Uruguay has a population of 3.5 million. The report shows that 35 246 people are registered to obtain cannabis; 8 583 by home growing, 24 324 for pharmacy purchases and 2 339 as members of 91 clubs (averaging 26 members per club). About three-quarters (18 981, or 78 %) of those registered for pharmacy purchase have actually made purchases. Comparing these numbers to a 2014 population survey of cannabis use, it is estimated that 24 % of those who had used the drug in the previous year in Uruguay get their cannabis from the legal market. However, IRCCA estimates that each home-grower and club member shares with two other users, and each pharmacy buyer shares with one, and in this way the policy reaches some 55 % of the users in the country. Males account for 73 % of the pharmacy purchasers and 76 % of the home-growers. Around 80 % of those registered for home grow or pharmacy purchases are aged between 18 and 44, with home-growers slightly older on average. Around two-thirds of those registered for pharmacy purchase are in employment.

Is cannabis available everywhere?

Eight out of 19 regions in the country have pharmacies selling cannabis. The region of the capital city, Montevideo, accounted for 57 % of the registrations for cannabis sold in pharmacies, as well as 45 % of the clubs, but only 32 % of the home-growers.

Read the full report (in Spanish) >>

Today cannabis is sold openly in 573 ‘coffeeshops’ operating in 103 of the 380 municipalities in the Netherlands. While local authorities have tolerated the sale of cannabis under certain conditions in these outlets for many years, the supply of the drug to the coffeeshops is not officially permitted. This has created an illicit market in cannabis production and wholesale distribution. In October 2017, the Dutch government declared its intention to permit an experiment on the legal supply of cannabis to coffeeshops to be carried out in up to ten medium to large-sized municipalities. The trial should examine impacts on public health, crime, public safety and nuisance, and the municipalities should be varied in size and location. On 9 March 2018, the minister of Justice and Security and the minister for Health, Welfare and Sport described the plans for this experiment in a letter to the Dutch parliament.

The experiment is to be carried out in three phases:

  1. Preparation: entry into force of the law, designation of growers and municipalities, and a research consortium established;
  2. Experiment: a four-year period of production and delivery to coffeeshops;
  3. Completion: restoring the situation to how it was before, over about six months.

An independent advisory committee, reporting by the end of May 2018, will help to define such details as how the cannabis is cultivated, monitoring and enforcement systems, and the criteria to select municipalities. The ministers’ letter to the parliament included several initial questions to the advisory committee. After the summer break, the committee will nominate the municipalities for selection.

The draft law, required to allow deviation from the drug control act, will be presented to the parliament before the summer break. The draft has already been sent for consultation to key stakeholders including the association of municipalities, the college of attorneys general, and the council for the judiciary. The law will be accompanied by an order in council which will set out the more detailed requirement of cannabis cultivation and sales.

The results of the trial will be independently evaluated.

In the Netherlands, an estimated 16.1 % of young adults had used cannabis in the last year, compared with 13.3 % in Germany, 10.1 % in Belgium and 22.1 % in France.

Letter to parliament (Dutch)
Questions to advisory committe (Dutch)

On 22 January 2018, Vermont became the ninth US state to legalise possession of cannabis for recreational purposes, when Governor Phil Scott (Republican) signed House Bill 511 (Text of Act as passed by House and Senate). The law will take effect on 1 July 2018. Vermont is the first state to legalise by an initiative of the elected legislature, rather than one drafted and voted by the public, as Vermont’s laws do not permit such ballot initiatives. The legislation, however, only permits home growing and personal possession. Commercial production, distribution and sale are not allowed. Washington, D.C. has a similar law.

The new law permits personal possession of up to 1 ounce (28.5 g) of herbal cannabis or 5 g of cannabis resin, and two mature cannabis plants and four immature plants per household. Minor breaches and public consumption are civil offences, but chemical extraction (e.g. by butane) and supply to minors are crimes. A new advisory commission will examine possible commercial models, road safety and education and prevention strategies, and report to the Governor by 15 December 2018. The main rationale for legalisation is to combat disparities in enforcement of drug laws towards ethnic minorities.

According to SAMHSA surveys 2014–2015, 20.8 % of Vermont adults (age 12+) had used cannabis in the last year; the fourth highest rate in the United States, behind Washington DC (23.9 %), Colorado (23.6 %) and Alaska (22.3 %). The highest comparable rate in the European Union (age 15–64) is 11 %, in France.

New federal direction

The Vermont law was signed despite the 4 January announcement by the US Attorney General, Jeff Sessions, repealing ‘previous nationwide guidance specific to marijuana enforcement’ (1). The new announcement reiterates that Congress has determined that ‘marijuana is a dangerous drug and that marijuana activity is a serious crime’. It then reminds prosecutors how to exercise discretion in using their finite resources, ‘to weigh all relevant considerations, including federal law enforcement priorities set by the Attorney General, the seriousness of the crime, the deterrent effect of criminal prosecution, and the cumulative impact of particular crimes on the community.’ While this is a symbolic political statement, it remains to be seen how it will be implemented.

(1) The previous guidance had reduced federal prosecution of state programmes regulating medical, recreational cannabis and financial actions related to cannabis

In November 2016, the US state of Maine voted to legalise the cultivation, production, sale, taxation and use of cannabis. Personal use is now permitted, but a bill to implement the regulations for trade was vetoed on 3 November 2017 by the State Governor, Paul LePage.

Three months after the vote for legalisation, the state government passed a law (LD 88) to permit personal cultivation and use. The same law delayed legalisation of commercial production, retail sales and taxation until February 2018, to allow legislators to finalise administrative rules such as licensing. Those administrative rules were drafted by the 17-member Joint Select Committee on Marijuana Implementation, in a bill (LD 1650) that was passed by both state Houses on 23 October 2017. This bill has now been vetoed.

In his veto letter, the State Governor cited concerns about:

  • lack of consistency with the state’s existing medical cannabis system,
  • tax revenue possibly not covering the costs of implementation of the regulatory system, and
  • unrealistic deadlines for executive action that may result in hastily crafted legislation.

Most fundamentally though, he was concerned that the bill was in direct conflict with US federal law:

The Obama administration said they would not enforce Federal law related to marijuana, however the Trump administration has not taken that position. Until I clearly understand how the federal government intends to treat states that seek to legalize marijuana, I cannot in good conscience support any scheme in state law to implement expansion of legal marijuana in Maine. If we are adopting a law that will legalize and establish a new industry and impose a new regulatory infrastructure that requires significant private and public investment, we need assurances that a change in policy or administration at the federal level will not nullify those investments.

In this situation, the provisions of the law of January 2017 prevail, and purchase from a retail outlet should become legal from 1 February 2018; even if licensing details remain undefined. Legislators may submit a new proposal in January 2018.

As part of the legalisation in Washington State that took effect in July 2014, the state legislature instructed the Washington State Institute of Public Policy (WSIPP) to publish periodic evaluations looking at factors in (at least) six named areas. These should inform a benefit-cost evaluation of the law.

On Friday 1 September, WSIPP published its report for 2017. The report lists preliminary findings for:

  • cannabis use by youth (2016 data) and adults (2015 data),
  • cannabis use treatment admissions (2016 data), and
  • drug law offence convictions (2016 data).

Data for other areas have yet to be obtained, or have been obtained but not yet fully analysed.

The analysis compares (a) the different counties within the State, noting per capita cannabis sales; and (b) Washington State with other similar states. Sales data do not represent all legal cannabis supply; home growing is allowed in Washington State for authorised medical (but not recreational) use. However, the medical and non-medical markets were integrated in July 2016, and now distinguishing the two is nearly impossible.

Drug use rates

In schools, use has been stable or fallen slightly, and cannabis is viewed as more difficult to access. There was no evidence that the amount of legal cannabis sales in a county affected cannabis use among school students, though 8th-graders in districts with more sales per capita were significantly less likely to report smoking cigarettes.

For adults, cannabis use has increased, whereas heavy alcohol use and cigarette use have remained stable or fallen. Those aged 21 and older living in counties with more sales per capita were significantly more likely to report current use (last 30 days) and heavy use (on 20 or more of the past 30 days). By contrast, those aged 18–20 living in counties with more sales were significantly less likely to report use of cannabis in the past 30 days, but the likelihood of heavy use was unaffected.

Treatment demand

The number of state-funded admissions for cannabis use in Washington has been falling since 2008, and continues to do so. However, for those who were not referred by criminal justice, cannabis use admissions only started to decline in 2011. There is no evidence that the legalisation caused this change, or that the amount of sales in a county affected the number of cannabis abuse treatment admissions.

Convictions for cannabis possession

Cannabis possession remains illegal for those under 21. Nevertheless, misdemeanour cannabis possession convictions for this age group began to decline in 2012, reaching approximately half the level they had been over the previous 10 years. There was no evidence of effects of retail sales rates on convictions.

Report is available here: http://www.wsipp.wa.gov/ReportFile/1670/Wsipp_I-502-Evaluation-and-Benefit-Cost-Analysis-Second-Required-Report_Report.pdf
Technical appendix is available here: http://www.wsipp.wa.gov/ReportFile/1671/Wsipp_I-502-Evaluation-and-Benefit-Cost-Analysis-Second-Required-Report_Technical-Appendix.pdf

As legislators depart for their summer break, in two US states that do not have the ability to pass laws by popular vote, draft laws (‘bills’) for cannabis legalisation have yet to win approval.

In Vermont, House Bill S.22 proposed a model similar to that adopted in Washington DC. Sale of cannabis would not be permitted, but it would be legal to possess and use a small amount (1 oz, 28 g of cannabis herb or 5 g of cannabis resin) and to cultivate plants screened from public view (two mature and four immature per ‘dwelling unit’). As the House preferred home growing and the state Senate preferred a system of commercial retail, this bill was a compromise; it established a Marijuana Regulatory Commission, which would take six months to elaborate a framework for possible retail sale. The bill was approved by the state Senate in April and by the House in May. However, at the end of May the state governor vetoed the bill, sending it back for a rewrite as he considered that it lacked adequate safety measures. There was the possibility that it could be addressed in a special session in July, but this did not happen.

In Delaware, House Bill 110 proposed a model similar to that adopted in the state of Washington. Its stated aims included promoting individual freedom, raising revenue, and allowing law enforcement to focus on violent and property crimes. To protect public health, it would regulate cannabis like alcohol (licensed sales, age limits, product testing). It would allow possession of up to 1 oz (28 g) of cannabis herb, and create a system of licensing for shops to sell it, but home growing would not be allowed. It was put forward in March and approved by committee in May, but as the bill introduced new criminal penalties, it required a two-thirds vote in both houses of the General Assembly to pass. This did not seem likely, and by the beginning of July, the bill was not advanced for a full vote. However, the legislature created a task force that would consider key concerns such as impaired driving and consumer safety, and this should report back by January 2018 for the next session of the General Assembly.

According to SAMHSA NSDUH studies, Vermont has one of the highest rates of cannabis use out of all the states, with 20.8 % of adults reporting use in the last year. Delaware reported a considerably lower rate, with 13.1 %. For comparison, the range across the 50 states is 8.6–23.9 %.

On 19 July 2017, sales of cannabis started at pharmacies in Uruguay. This is the final step of operationalising the 2013 law that legalised cannabis consumption and sale to over-18s for recreational use. The law permits three supply systems: home cultivation, communal grows without profit (social clubs with a membership of maximum 45 persons per club), and sales through pharmacies. Consumers must be registered, and should be Uruguayans or residents, so there can be no sales to tourists. Subscribers to any one system are not permitted to use another.

Since the 2013 law, home cultivation and social clubs became established quite quickly. Current registrations show nearly 7 000 home-growers and 63 clubs. However, the system of pharmacy supply suffered various delays, firstly due to the need to find appropriate and secure premises to grow the cannabis, then to address pharmacies’ concerns regarding sale. To date, only 16 pharmacies out of approximately 1 200 in the country have agreed to stock recreational cannabis. Some 5 000 people have subscribed for pharmacy purchase, and approximately 60 % live in the capital city.

Cannabis strains available

Two strains of cannabis herb are available; the indica hybrid Alfa I (2% THC, 7% CBD), and the sativa hybrid Beta I (2% THC, 6% CBD). The cannabis will be sold in packets of 5 g, though 10 g packets may be introduced later, with clear warnings printed on the packaging. The price is fixed at USD 1.30 per gram, of which USD 0.90 goes to the state producer. Identification and purchase history will be tracked by fingerprint scanners at registered pharmacies, enforcing the maximum purchase of 40 g per month.

Consumption patterns in Uruguay

Uruguay has a population of 3.4 million. In 2014, 9.3 % of 15- to 65-year-olds had consumed cannabis in the last year — a rate that has been climbing steadily since 2001. This is comparable to the highest national rates in the EU of 9.2-9.5 % as shown by Italy, the Czech Republic and Spain, only exceeded by France at 11.1 %. The above registration numbers suggest there is a long way to go before supply meets demand. However, it is possible that this is deliberate in order not to over-produce.

Press release from the Instituto de Regulación y Control del Cannabis (Spanish, external website) >>=>

Following a manifesto pledge and subsequent report by an expert panel, on 13 April 2017 the Federal Minister of Justice of Canada proposed two draft laws (‘bills’). Bill C-45 proposes the ‘Cannabis Act’ to provide legal access to cannabis, and to control and regulate its production, sale and use. While the Cannabis Act proposes several regulations, it also leaves many aspects to be decided at the level of the provinces; this is also how Canada regulates alcohol. Bill C-46 re-defines the criminal offence of driving after consuming drugs or alcohol.

Key points from the draft Cannabis Act include:

  • The stated objectives of the Act are to protect young people, deter illicit activities, and reduce the burden on the criminal justice system.
  • The minimum age to purchase cannabis products is 18, though provinces may choose to increase this. Sales to under-age buyers may be punished by up to 14 years in prison.
  • The maximum amount that can be possessed by an adult in public is 30 grams of dried cannabis, or its defined equivalent in other forms; possession of cannabis from illicit sources is prohibited. Breaches of these laws are punishable by penalties ranging from a fine to 5 years in prison.
  • Up to 4 cannabis plants, no more than 1 metre high, may be grown by adults in any one residence; more may be punished by up to 14 years in prison.
  • The government may establish a tracking system for monitoring production and distribution. Illegal distribution is punishable by up to 14 years in prison.
  • There is no federal retail system proposed; provinces may establish their own retail systems. If no system is established in a province, federally licensed producers may deliver orders by post or courier, as is already the case with medical cannabis.
  • Sales will be of fresh and dried cannabis and oils, as well as seeds and plants. There are no federal regulations on THC content. The sale of edible products will be permitted only after other regulations have been developed.
  • It will be illegal to sell cannabis or an accessory packaged or labelled in a way that may appeal to young people. Promotion is generally limited to information in adult-only environments and is prohibited in media outside Canada.
  • Laws relating to smoking will now generally apply to cannabis also.

Key proposed changes to drug driving laws include:

  • The test for ‘impairment’ will no longer be based on physical coordination tests; screening devices will be approved, to allow law enforcement at the roadside to test for the presence of drugs.
  • There will now be three basic drug-related offences: driving with more than the defined lower blood-drug concentration; driving with more than the defined higher blood-drug concentration; driving with more than the defined concentration of drug and alcohol mixed in the blood.
  • The precise legal levels for substances in the blood will be defined later.

Cannabis Act, Bill C-45 2017 (130 pages) (external link)
Drug driving, Bill C-46 2017 (26 pages) (external link)

Following the legalisation of recreational cannabis in the US state of Colorado at the end of 2012, the state Senate mandated a report every two years on changes in cannabis use patterns, relevant scientific evidence and adverse health events. The second such report was presented to the Colorado state bodies on 30 January 2017. Some trends cover legalisation of medical cannabis from 2000, and its commercialisation from 2009 (see report for details).

This 300-page report is comprehensive, yet easy to read. Section 1 on changing use patterns contains analyses of five surveys of different populations (adults, adolescents etc.), and highlights ‘major findings’ for each. Section 2 outlines the results of a review of the scientific literature on relevant topics such as cancer, cardiovascular effects, driving, mental health effects, reproductive effects and unintentional exposures in children. It summarises evidence for each topic as substantial, moderate, limited, mixed or insufficient; it also provides clear ‘Public health statements’ and ‘Public health recommendations’. Section 3 contains analyses of data from the poison and drug centre and visits to hospitals in Colorado, again highlighting ‘major findings’ for each analysis.

Findings specific to Colorado included:

  • According to two different surveys, 13 % or 17 % of adults used cannabis in the last month in 2015 (the highest national rate in the EU is 7 %, in France). This rose to 26 % of those aged 18–25. Last-month use has been rising since 2006. An estimated 6 % of adults in Colorado used cannabis daily (the highest national rate in the EU is 3 %, in Spain).
  • About 38 % of students aged 14-18 have ever used cannabis (the highest national rate in the EU is 37 %, among 15- to 16-year-old students in Czech Republic), with nearly all usually smoking (87 %), rather than vaporising (5 %) or ingesting (2 %). In Colorado, rates of use in this age group fluctuate from 2005 to 2015. The rate of last month use is nearly identical to the US national average.
  • There were 1688 ‘human cannabis exposure’ phone calls to the Rocky Mountain Poison and Drug Center (RMPDC) between 2000 and 2016. Call volume significantly increased following commercialisation of medical cannabis in 2009, then further following the legalisation of commercial recreational cannabis in 2014. The number of calls decreased slightly in 2016.
  • There were 529 cannabis-related calls to the RMPDC between July 2014 and December 2016. Of these, 203 related to edible products and 199 to smokeable products. Regarding children aged 0–8, 60 calls related to edible products and 28 to smokeable products.
  • From 2000 until September 2015, there were increasing trends in the rates of cannabis-related hospital visits and emergency department visits. The rate of hospital visits continued to climb in 2015, but the rate of emergency department visits fell slightly compared to 2014.

Link to report: https://www.colorado.gov/cdphe/marijuana-health-report

In Canada, on 13 December 2016 the government-appointed Task Force on Cannabis Legalization and Regulation published its final report, which had been delivered to the ministers of justice, health and public safety on 30 November.

The Task Force was appointed on 30 June 2016 to prepare the ground for fulfilment of Prime Minister Trudeau’s 2015 election promise to legalise, regulate and restrict access to cannabis. It comprised nine members and was headed by Anne McLellan, a lawyer who has held several key ministerial posts. It was guided by a government discussion paper which set out nine public policy objectives, including protecting young people and keeping money from organised crime. The Task Force established its own guiding principles: protection of public health and safety, compassion, fairness, collaboration, a commitment to evidence-informed policy, and flexibility. The 112-page report is based on five months of consultation (nearly 30 000 online submissions and over 300 written submissions). The recommendations aim for a public health approach while minimising unintended consequences. The Task Force prefers the scientific term cannabis to marijuana.

The government is not obliged to accept any recommendations of the Task Force’s report.

In Canada, an estimated 24 % of Canadians aged 15 to 24 years of age have used cannabis in the last year (only three out of 28 EU Member States have a similar or higher prevalence of use among the same age-group, and the EU average is 16 %). Personal possession of cannabis (up to 30 grams) is a criminal offence punishable by up to 6 months imprisonment. The legal system is federal, although provinces and territories may have their own variations of some laws, for example the age limit to purchase alcohol may be 18 or 19. Medical cannabis has been available since 1999. Over time the regulations have evolved from initially providing individual exemptions to enable patients to possess cannabis for their personal consumption for medical reasons, to a system of federal licensing that allows patients, with the support of their physicians, to obtain cannabis from one of 36 licensed producers, to cultivate their own cannabis or to designate someone to cultivate it on their behalf. It may be distributed by mail or courier. While not legal federally, some cannabis wellness clubs and ‘dispensary’ shops have existed for several years in some regions.

Key aspects of the recommendations include:

  • A purchase age of 18 (or provincial alignment with that for alcohol)
  • Plain packaging with THC and CBD levels clearly marked
  • Prohibition of any product ‘appealing to children’ such as edible sweets
  • Tax levels based on potency, to encourage development of lower-potency strains
  • Government-regulated production, with seed-to-sale tracking system
  • Provincial-regulated wholesale distribution (similar to the local government alcohol distribution networks) and retail; possible mail-order for remote communities
  • Minimal co-location of cannabis sales with alcohol and tobacco products
  • Designated places for social consumption but not with alcohol
  • 30 g personal possession, four plants per private residence with max height 100 cm
  • Penalties to be proportionate, non-criminal and criminal
  • Further research to establish appropriate drug-driving limits
  • A surveillance and monitoring system with programme evaluation every five years

It was not part of the mandate to make recommendations related to Canada’s international legal commitments.

In the United States, a system of ‘ballot initiatives’ allows citizens to directly propose and vote on draft laws in about 24 of the 50 states. Proposals for legal systems of cannabis cultivation and sale, for recreational use, had been rejected in California (2010), Oregon (2012) and Ohio (2015), and passed in Colorado and Washington State (2012), Alaska and Oregon (2014). The accepted systems are private commercial models of supply, and all built in some way on pre-existing commercial models of cultivation and sale of cannabis for medical use. Under these systems, although personal use was legalised quickly, it has usually taken 1 to 2 years for licensed shops to appear, due to the need for detailed implementing regulations and issuing of cultivation and sales licences. A law allowing home grow and consumption, but no sale, was passed in Washington DC in 2014.

While voting for the next US president on 8 November 2016, citizens also voted for commercial models of recreational cannabis supply in five states. Voters in Arizona rejected the proposal (Proposition 205) with 52 % against. For the other states, the results are as follows:

State California Maine Massachusetts Nevada
Text of law Proposition 64 Question 1 Question 4 Question 2
Votes in favour 56% 50.2 % (there may be a recount) 54% 54%
Limit to personal possession 28.5 g
4 g concentrate
71g 28.5 g
5 g concentrate
28.5 g
3.5 g concentrate
Limit to home grow per person 6 plants 6 plants, 12 in one residence; with ID tags on each plant 6 plants, 12 in one residence 6 plants, 12 in one residence; not within 25 miles (40 km) of retail store
Personal use permitted from 09.11.2016 Date dependent on governor approval after recount 15.12.2016 01.01.2017

These models of supply are similar to those in place in the four states that already permit recreational cannabis: they permit taxed commercial sale; they supplement pre-existing commercial medical cannabis systems; collective growing of ‘personal’ quotas, known in Europe as social clubs, is not permitted. But there are developments.

First, in three of the states, the laws already establish a limit of personal possession of cannabis concentrates — resin or other products — while earlier laws as originally voted did not (some states have added it later).

Secondly, they make provision for places to smoke or consume cannabis other than in private property. This is significant as otherwise tourists are not able to find a place to consume the drug, because of smoking bans in the shops and hotel rooms and a general ban on cannabis use in public. Indeed, this conundrum is thought to be a factor behind the increased demand for edible cannabis products such as sweets, chocolate and drinks. Of the four earlier states, only Alaska had provision for licensed consumption areas, but one year later no licenses have yet been issued.

Loading