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Research Associate Queen's Centre for Health Services and Policy Research Queen's University Kingston, Ont.
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."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.
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Copyright 1995-2001, Canadian Medical Association. All rights reserved. ISSN 1488-2329
(e) 0820-3946 (p)
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. |
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