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- Page navigation anchor for RE: Outcomes associated with nonmedical cannabis legalization policy in Canada: taking stock at the 5-year markRE: Outcomes associated with nonmedical cannabis legalization policy in Canada: taking stock at the 5-year mark
In their recent commentary, Fischer et al. provide a timely review of some of the impacts of cannabis legalization. We join these authors in celebrating the social justice benefits and associated public health dividends that accompany the reduction in arrests and stigmatization of Canadians who use cannabis. We also suggest that Canada’s cannabis use framework has not maximized opportunities to enhance the potential of nonmedical cannabis legalization among structurally-marginalized populations of people who use drugs (PWUD) during the ongoing drug overdose crisis.
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The intersection of cannabis legalization and the overdose crisis has reignited scientific interest into whether and how cannabis might help individuals at highest risk of overdose survive the contamination of the unregulated drug supply 1,2. Among PWUD, there is growing evidence that access to recreational and medical cannabis may have positive impacts via therapeutic and substitution effects 3. Our research among structurally-marginalized PWUD at highest risk of overdose in Vancouver’s Downtown Eastside neighbourhood has documented that approximately 75% of local PWUD report some form of therapeutic cannabis use and nearly 25% report cannabis use to reduce the harm of other unregulated drug use 3. Cannabis use has also been associated with improvements in behavioural and clinical risk factors for overdose among prospective cohort studies of PWUD, including lower rates of injection initiation among at-ri...Competing Interests: M-JM is the Canopy Growth professor of cannabis science at the University of British Columbia (UBC), a position created using unstructured arms’ length gifts to the university from Canopy Growth Corporation, a licensed producer of cannabis, and the Government of British Columbia’s Ministry of Mental Health and Addictions. He has no financial relationships with the cannabis industry. ZW has received research support from Doja & Tilray licensed producers of cannabis. The funders had no role in the in the writing of the manuscript, or in the decision to publish the manuscript.References
- Hayashi K, Milloy MJ, Lysyshyn M, et al. Substance use patterns associated with recent exposure to fentanyl among people who inject drugs in Vancouver, Canada: A cross-sectional urine toxicology screening study. Drug and alcohol dependence. 2018;183:1-6.
- Lake S, Walsh Z, Kerr T, et al. Frequency of cannabis and illicit opioid use among people who use drugs and report chronic pain: A longitudinal analysis. PLoS medicine. 2019;16:e1002967.
- Lake S, Nosova E, Buxton J, et al. Characterizing motivations for cannabis use in a cohort of people who use illicit drugs: A latent class analysis. PloS one. 2020;15:e0233463.
- Reddon H, DeBeck K, Socias ME, et al. Cannabis use is associated with lower rates of initiation of injection drug use among street-involved youth: A longitudinal analysis. Drug Alcohol Rev. 2018;37:421-8.
- Socias ME, Kerr T, Wood E, et al. Intentional cannabis use to reduce crack cocaine use in a Canadian setting: A longitudinal analysis. Addictive behaviors. 2017;72:138-43.
- Page navigation anchor for RE: Outcomes associated with nonmedical cannabis legalization policy in Canada: taking stock at the 5-year markRE: Outcomes associated with nonmedical cannabis legalization policy in Canada: taking stock at the 5-year mark
The authors describe reduced cannabis-related arrests as a success of cannabis legalization in Canada. However, this reduction could have been achieved with decriminalization decades earlier, much more efficiently, and probably more completely. At the very least, it could have been achieved expeditiously in 2016 as a legislated interim objective on the path to legalization.
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In the mid-1990s, The Liberal Party of Canada formally endorsed decriminalization of cannabis and introduced legislation towards that end (1). Despite the Party holding a majority government for a continuous decade, decriminalization did not happen. At the same time, many other nations and sub-national jurisdictions in the United States found a way. In Canada, cannabis users continued to be arrested for minor cannabis offences and suffer the consequences of life-long criminal records.
Fast-forward to June 2016. The federal New Democrat Party introduced a motion (including a viable legal framework) to the House of Commons to promptly decriminalize cannabis possession while the government continued to work towards legalization. Liberal and Progressive Conservative Party votes soundly defeated the motion (2).
We can apply a principle from emergency medicine: first, stop the bleeding. While the government took more than another two years to build the complex structure of a new legal, commercial drug industry, more Canadians received criminal records. The bleeding, in the case of cannabis l...Competing Interests: None declared.References
- 1. Erickson P, Hyshka E. Four Decades of Cannabis Criminals in Canada: 1970-2010. ALF 2010;2(4):1-14.
- 2. Canada, House of Commons. Opposition motion: Decriminalization of marijuana possession. Debates, 42nd Parl, 1st Sess, No 071 4368 (Hon. Geoff Regan) [Internet]. Ottawa: House of Common; 2016 (June 13) [cited 2023 Oct 13]. 1200 p.
- 3. CBC News. Marijuana task force to be led by former deputy PM Anne McLellan. CBC News [Internet]. 2016 Jun 30 [cited 2023 Oct 13]. Available from: https://www.cbc.ca/news/politics/liberals-marijuana-task-force-1.3659509
- 4. Health Canada. A framework for the legalization and regulation of cannabis in Canada: Final report of the Task Force on Cannabis Legalization and Regulation. [Internet]Ottawa: Health Canada; 2016 [cited 2023 Oct 13]. 51 p.