Starting to talk about pot

Bud, chronic, skunk,mull, ganja, dak, reefer, dope, pot, maryjane.

There’s no shortage of slang for this drug, but it’s a drug not often talked about. When it is, evidence is often discarded in lieu of myth, misconception and polarized positions.

We’re talking about cannabis, New Zealand’s favourite (illicit) drug. About half of us have tried it, and one in eight uses it regularly. But for all its popularity, cannabis receives scant attention from politicians, policy makers and the media. Instead, rightly or wrongly, we’ve invested much of our attention, resources and headlines into methamphetamine and the party pill phenomenon.

It has been hugely frustrating watching hours of politicians’ time spent debating, making laws, remaking laws, promulgating regulations and ignoring regulations for party pills. Hours have been spent by officials servicing ministers and MPs all het up about these pills, and this organisation has spent hours on policy analysis, health promotion and media advocacy on party pills. Then there’s the wads of money invested in party pill research, and so on.

To put it bluntly, party pills are undeserving of so much attention, and cannabis remains largely forgotten or ignored by this 48th Parliament.

The last time Parliament touched the issue was the Health Committee inquiry into the public health strategies related to cannabis use and its most appropriate legal status. The inquiry began in 2000, but was delayed by an election. Once the new committee carried over the inquiry and reported back in 2003, the coalition agreement between the Government and United Future meant that no change could be made to the legal status of cannabis, and little action was taken on other key recommendations.

It’s time law makers remembered this popular drug and started talking about it. Ignoring it doesn’t make the harm go away. It’s also time the addiction treatment, public health and drug policy sectors and wider public talk about cannabis again.

We aim to start this national conversation with these essays in which we’ve invited leading drug policy researchers, advocates and commentators to write about cannabis law and policy. Wayne Hall outlines the challenges in formulating cannabis policy, Simon Lenton discusses how penalty regimes may be used to reduce harm and Chris Fowlie puts the case for ending prohibition. Matthew Hooten canvasses political party positions on cannabis law reform and suggests there’s little chance of liberalisation in the short term. His essay is informed by a UMR Research poll showing no public appetite for law change. Michael B shares his experience of cannabis dependence.

While legal status gets the most attention in public and political discussions, the conversation needs to be about much more than that. Future editions of Matters of Substance will address drugs in schools, addiction treatment services, youth health and health promotion, and the role of the media in advancing policy discussions.

We want everyone to take part in this conversation: We invite your comment and feedback (you can post a response to each essay online – please read our Comments Policy first). Go here to register. 

The aim of this conversation is to:

provide accurate information about cannabis and its harms

encourage informed policy discussions and media coverage

identify priority issues and advance the most effective ways to address cannabis harm.

Cannabis policy challenges

In an ideal world, public policies towards cannabis would be informed by both evidence on the personal harms it causes and social and economic evaluations of the costs and benefits of alternative policies in minimising these harms. A paucity of both types of evidence is a major challenge to the development of such “evidence-based” policies towards cannabis use.

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There is a limited quantity and quality of research into the health effects of cannabis, but it is nonetheless possible to identify its most probable adverse health effects. These include: an increased risk of motor vehicle crashes if users drive while intoxicated; the development of dependence; increased respiratory symptoms; poorer mental health, including increased risks of psychosis and possibility of depression; and poorer adolescent development, including early school leaving and increased risk of using other illicit drugs.

There is less research into costs and benefits of cannabis policies because, internationally, a narrow range of policy approaches is available for evaluation. These generally involve marginal differences in penalties for cannabis use and possession (for example, imposing fines or counselling rather than imprisonment). The effects of these changes in penalties are likely to be small, and none has been detected in evaluations to date. Evaluations of the more controversial Netherlands cannabis policy – decriminalising personal cannabis use and small-scale retail sales in coffee shops – have come to different conclusions about its effects on rates of use.

Public debate about cannabis policy has often been radically simplified by the media. The public has been invited to believe either that cannabis use is harmless, and hence should be decriminalised (if not legalised), or that cannabis is harmful to health, and so its use should continue to be prohibited. As a consequence, public debate often presents highly polarised evaluations of the health effects of cannabis, with any rational discussion of its health risks the first casualty.

Proponents of prohibition have taken evidence of harms found among cannabis users at face value, ignoring any alternative explanations. Proponents of reform of the existing laws, by contrast, have discounted evidence of harm caused by cannabis use, while emphasising the social costs of enforcing cannabis prohibition.

Discussions of public policy towards cannabis should use consistent standards in appraising evidence of harm from cannabis use and cannabis policies. Good public policy on cannabis requires investments in epidemiological research on the long-term health consequences of its use and social science research on the costs and benefits of current and alternative policy options.

The epidemiological research need not be expensive if cannabis use is routinely asked about in prospective studies of adolescent development, as has been done in New Zealand or in longitudinal studies of adult health such as those in the USA. Another critical ingredient for policy progress is a wider public involvement in the debate. A more realistic understanding of the health effects of cannabis and the impact of cannabis policies requires less partisan appraisals than usually dominate media debates.

Better evidence on the harms of use and cannabis policies is important, but it cannot determine what cannabis policy we should have. In pluralistic social democracies like New Zealand and Australia, social policies in controversial areas like cannabis use must involve a search for a societal compromise that is the most acceptable to the most people (or least objectionable to the fewest). This is because cannabis policy must balance competing social values that are in conflict, namely, the individual freedom of adults to use cannabis, protecting the health of young people, reducing crime, minimising the societal costs of enforcing widely broken laws, and so on.

There is no consensus on what priority these competing social values should be given, so policy debates in democratic societies are and ought to be resolved by a deliberative political process. The political process should take into account evidence on both the harms caused by cannabis use and those that arise from the social policies we implement to prevent its use and resulting harm. This holds the greatest prospect of producing a cannabis policy that enjoys broad community support and best reduces related harm.

• Professor Wayne Hall is based at the School of Population Health, University of Queensland.

Time to end cannabis prohibition

The current high levels of use and the level of black market activity indicate that the current prohibition regime is not effective in limiting cannabis use. Prohibition results in high conviction rates for a relatively minor offence, inhibiting people’s education, travel and employment opportunities. Prohibition makes targeting education, prevention, harm minimisation and treatment measures difficult because users fear prosecution. It also facilitates the black market and potentially exposes cannabis users to harder drugs.

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So said the Health Select Committee’s report on the inquiry into the legal status of cannabis, in August 2003.

Whatever your take on the health effects of cannabis – and we all have our opinions – it is clear that prohibition has not worked, and a drugs policy re-think is in order.

If the aim of prohibition has been to prevent use, it has failed spectacularly. Despite having the highest cannabis arrest rate in the world, more New Zealanders use cannabis now than ever before. Half of New Zealanders are criminalised by this law. Eighty percent of 21-year-olds have tried cannabis. How many should be arrested before prohibition is judged a success?

Enforcement of cannabis prohibition by the police, courts and prisons cost taxpayers $56 million in 2000. While more than twenty million dollars is spent every year chasing ordinary Kiwis for small amounts of cannabis, treatment services and effective education are struggling or, in places, don’t exist. Furthermore, fear of arrest is the biggest barrier to those seeking help.

Though use is widespread in New Zealand, enforcement of drug laws impacts much harder on Maori, who are five times more likely to be arrested for cannabis than non-Maori.

The present law is a form of institutional racism. Its enforcement alienates police from society and causes enormous harm to the lives, careers and families of more than ten thousand people arrested every year.

Research confirms that drug laws have little effect, if any, on drug use rates, but they do increase or decrease the harms associated with use. Countries that have reformed their laws have not experienced increased use, but have spent millions of dollars less on law enforcement than countries where prohibition remains.

The Dutch, who have allowed the sale of cannabis to adults since 1976, have one-third the per capita usage of New Zealand. In the United Kingdom, teen cannabis use dropped after it was made a non-arrestable offence.

There is no difference in use between those Australian states who have decriminalised cannabis and those that continue to arrest users. The United States also shows no difference between the ten states – representing half the population – who decriminalised in the 1970s and those that did not. Recent analysis of cities in California, Colorado, Washington State and Oregon showed there was no influence of medical cannabis laws on the extent of illegal cannabis use. The researchers said that the “use of the drug by those already sick might ‘de-glamorise’ it and thereby do little to encourage use among others”.

The most commonly voiced concern about ending prohibition centres around the protection of children. However, problems in our schools or communities are made worse under current law, not better. Prohibition promotes a ‘forbidden fruit’ mentality, glamorising cannabis as a token of rebellion. Open and honest communication is made more difficult in an environment of guilt and persecution. The untaxed cannabis economy is worth hundreds of millions of dollars and controlled by whoever is prepared to break the law. Violence and intimidation rule the market, just as was the case under alcohol prohibition in 1930s America.

So what should be done about it?

If we are genuinely committed to harm minimisation, we should immediately repeal cannabis prohibition and investigate the failure of current drugs policy.

Let’s control the way cannabis is used and sold through appropriate regulations such as age limits, health warnings, dosage and packaging controls, marketing restrictions and so forth.

Let’s use cannabis excise taxes to provide effective education about drugs so that people can make responsible and informed choices, and fully fund treatment services for those who need them. Let’s provide enough resources to research the effect of any law changes.

Modern research shows cannabis is an effective and safe medicine for many conditions including cancer, HIV wasting syndrome, glaucoma, chronic pain, arthritis, multiple sclerosis, paraplegia and epilepsy. Let’s allow doctors and patients to decide what treatment is best for them, not politicians or police.

Given the spectacular failure of the current law, the burden of proof should be on prohibitionists to show why we should persist with this expensive and destructive mistake.

• Chris Fowlie is President of the National Organisation for the Reform of Marijuana Laws in New Zealand.

Reforming cannabis penalty regimes to reduce harm

Two ways some jurisdictions have tried to reduce cannabis-related harm is by changing the laws that apply to cannabis (de jure changes), or by modifying the way these laws are enforced by police (de facto changes).

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De jure changes can include prohibition with civil penalties, and partial prohibition. Under the former, possession and use remain illegal but civil rather than criminal penalties apply, and more severe sanctions are maintained for larger-scale possession supply offences. Such a system applies to cannabis use in 11 US states and four Australian jurisdictions – South Australia (1987), the Australian Capital Territory (1992), the Northern Territory (1996) and Western Australia (2004). Under partial prohibition, personal use activities are legal, but commercial activities are illegal. Examples exist in Columbia, Spain (where possession is only considered punishable if it is for consumption in public places) and Switzerland.

De facto de-penalisation can include prohibition with cautioning and/or diversion schemes (examples of which operate for a range of drugs in Italy, Portugal and Australia) and prohibition with an expediency principle. Under the latter, all drugrelated activities are illegal, but cases involving defined small quantities are not investigated or prosecuted. Examples of this system operate for cannabis in Belgium, Germany, Denmark and the Netherlands.

Although the published evidence evaluating the impact of cannabis policies is not large, caution needs to be exercised in its interpretation. The policy environment is a dynamic one where effects decay, and what is originally implemented changes over time. International comparisons are difficult, and results can be confounded by cultural, political, geographic and climatic differences. Cannabis law reforms often occur in locations with already high rates of use. Consequently, pre-post or longitudinal designs with ‘matched’ control locations are needed to identify true impacts. Any research evidence is at best indicative, as the actual impacts of any future cannabis policy reforms will depend on contextual factors and how the reforms are implemented. Therefore, it is important that changes to cannabis policy are evaluated, monitored and reviewed.

Most of the available published research has been done on moving from strict prohibition to prohibition with civil penalties. Taken as a whole, this research finds that removing criminal penalties for cannabis possession and use does not result in higher rates of cannabis use, but does reduce the adverse social impacts of conviction in terms of employment, further contact with the criminal justice system and so on. Savings in police and court resources can be considerable, but depend on the size of the jurisdiction and the way the schemes are implemented. There have been a small number of studies in the economics literature that have claimed that rates of cannabis use are higher in those states that have “decriminalised”.

However, because these studies have not taken into account rates of use prior to the legislative changes, it cannot be concluded that the higher rates of use were as a result of the legal changes, particularly as those states that reduce penalties often have higher rates of use beforehand. Yet there is more compelling evidence that rates of cannabis use would likely increase, especially among the young, if use was legalised.

Cautioning schemes where first-, second- or third-time apprehended cannabis users are required to attend education or treatment, rather than get a conviction, are in place in four Australian jurisdictions. While politically expedient and supported by the drug treatment sector, evidence of their effectiveness is thin. There is a concern that tying up treatment resources with this group may not be the best use of this valuable resource.

Questions remain about whether those diverted to treatment actually engage or may be more willing to do so in future. Also, given that only between two and five percent of cannabis users have contact with the criminal justice system in any one year, it is doubtful whether a system built around this group is ideal, even if we assumed that the majority of them had significant cannabis use problems.

Similarly, prohibition with civil penalties schemes can have unintended consequences depending on the scheme and how it is implemented. For example, the South Australian (SA) scheme has been shown to have a low rate (45 percent) of people paying their fines by the due date. In comparison, the Cannabis Infringement Notice Scheme implemented in Western Australia (WA) since 2004 has an overall rate of 65 percent, as those who fail to pay or attend an education session in lieu of fine risk having their driver’s licence cancelled.

Similarly, the SA scheme resulted in significant “net widening”, with the number being processed for minor cannabis offences increasing by 2.5 times after the scheme was introduced, due to the ease with which notices could be issued. While the WA scheme has resulted in some net widening, this has been modest, possibly because police are processing apprehended users at the police station where they are photographed and finger printed, rather than issuing the notices in the field, as intended by the scheme’s designers.

Socially and economically disadvantaged members of society, such as indigenous people, may be disadvantaged by new penalty options, just as they often are with existing criminal justice responses. Special effort needs to be made to monitor and address this.

The legislative changes in WA were about treating cannabis use as a health and social issue, rather than primarily one of criminal law. Importantly, this was not simply for the small proportion of cannabis users who are apprehended by police each year, but for the more than 90 percent who are not. Limited but growing evidence suggests that cannabis users may be more willing to voluntarily seek help for cannabis problems in an environment where civil rather than criminal penalties apply.

Yet legislative changes themselves at best only provide a context for reducing use and harm. If this is to be capitalised on, the penalty changes need to be accompanied by: balanced public education about cannabis, the law, the realistic risks and harms and how these can be reduced; and provision of a range of accessible, effective and attractive treatment options for those with cannabis-related problems.

• Associate Professor Simon Lenton is a Deputy Director at the National Drug Research Institute in Perth.

No chance of cannabis liberalisation in short term

The next 12 months will not be fruitful for those wanting a serious policy debate about possible changes to our cannabis laws, but there may be an opening for such a debate during the 2008–11 Parliament.

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Those wanting to lobby for policy change need first to understand the cardinal rule of politics: politicians care about nothing except getting elected and re-elected.

Most people suspect that this rule is true but they don’t understand the extent of it, and they can be shocked when initially confronted by its savagery. In fairness to our politicians, it could be argued that the rule is highly democratic in that it demands they reflect the will of the people. Politicians also justify themselves by saying that, unless they are elected and re-elected, they can do nothing to put in place their brilliant plans for our futures.

When it comes to cannabis, the basic political assumption is that the public is either conservative or indifferent on the question of law reform. Those in favour of liberalisation are seen as a minority of mostly youngish Green or Labour voters, or libertarian ACT or National voters, who take their policy guidance from the pro-legalisation Economist magazine. Neither of these groups is seen as swing voters, who politicians care most about because they ultimately decide elections.

This basic assumption may be discouraging for proponents of decriminalisation or legalisation and, in fact, may even overstate the public’s appetite for liberalisation of existing laws.

A brief poll carried out exclusively for the New Zealand Drug Foundation by New Zealand’s most-respected polling company, UMR Research Ltd, suggests that fully 25 percent of the population agree that existing laws should be made “a lot tougher”. Another 9 percent believe the law should be made “a little tougher”.

Toughening laws on marijuana
Using a 1-5 scale (1 means make the law a lot tougher, 5 means make the law more liberal and 3 means no change) to what extent do you think the current law on marijuana should be changed? (n=750). August 2007
	Percent
1 - Make the law a lot tougher	25
2 - Make the law tougher	9
Total "tougher"	34
3 - Make no change to the current law	46
4 - Make the law more liberal	8
5 - Make the law a lot more liberal	11
Total "more liberal"	19
Unsure	1

[Go here for the full survey results]

That means more than a third of the population say they want tougher laws. In contrast, just 11 percent say the law should be made “a lot more liberal”, and another 8 percent think it should be “a little more liberal”. Nearly half of us, 46 percent, believe there should be no change at all.

Most significantly, these proportions are relatively stable across income groups, gender and geography – although far fewer Wellingtonians than the national average want the law made tougher, reflecting how out of touch with the rest of the country the capital city often is.

When it comes to age groups, there is the expected general trend of people becoming more conservative as they get older. Interestingly, however, 20 percent of people under 30 say they want tougher laws.

There is no majority for liberalisation in any demographic group.

Professionals in the cannabis abuse and public policy industries argue that a simple polling question is not a sound basis on which to develop public policy, and they are right. But they are experts in a particular field, not politicians having to develop policy across the full range of topics and needing it to be popular in order to be elected. All our political parties will receive roughly the same polling data telling them that the net result from adopting a policy of more liberal cannabis laws will be to lose votes, and none of our important political parties has any room to lose votes over the next 15 months.

National is sitting on 50 percent support but with no obvious coalition partners. To be assured of becoming the government, it can’t afford to lose even a few percentage points.

Labour is now sitting in the low 30s. It knows that, should a poll be published giving it a result with a two at the front of it – even 29.9 percent, the media will talk of the risk of a “collapse”, and that such talk will become self-fulfilling, driving its support to levels from which it cannot recover.

The Green Party, usually seen as the most likely to push for liberalisation, sits at around MMP’s five percent threshold. Should it fall below five percent, it is out of parliament altogether, and its strategists believe that Nandor Tanczos’s association with cannabis law reform in previous elections cost it support from the sort of worried suburban mums that Sue Kedgley might otherwise appeal to.

The Maori Party draws its funding and many of its votes from more traditional Maori society, many of whom perceive that colonisation has poisoned their people with alcohol and tobacco. They will oppose anything that risks being seen as condoning the use of any drug. While the party’s leading figure, Tariana Turia, has said there should be a level of cannabis reform, she says she cannot support full legalisation. She will not want cannabis to be an issue for her party, which seeks every vote possible in order to hold the balance of power after the next election.

The centre parties, New Zealand First and United Future, reflecting their elderly and conservative voters, are staunchly opposed to liberalisation. The Jim Anderton and ACT parties do not count.

If advocates for liberalisation want to make progress politically, they will first need to convince the public, in order to shift the polls. Labour’s Electoral Finance Bill, however, will make it illegal for the New Zealand Drug Foundation or anyone else to effectively communicate with the public on this or any other political issue in 2008.

There is one opening ahead, however. Our likely next Prime Minister, John Key, has staked his political career on addressing the issue of the so-called “underclass”, reversing social exclusion and building social cohesion. Key knows that, when he is seeking re-election in 2011, he will be accountable against those goals.

In the lead-up to the 2011 election, our media will return to McGehan Close (which is in the Mt Roskill electorate of likely opposition leader Phil Goff) to interview Aroha Ireland, who Key took to Waitangi this year. The media will ask her and her neighbours what has changed in the three years Key has been Prime Minister. If the answers are not satisfactory, Key knows he will be a one-term Prime Minister.

Those who believe in the principle of harm minimisation rather than criminalisation have an opportunity to demonstrate to the new Prime Minister that reform of cannabis laws is necessary to break the influence of criminal gangs, allow effective treatment for drug abuse and improve the quality of information available to young people.

Reform advocates need to show Key that only by acting on this issue, will he be able to make progress in reducing the underclass. In short, they need to show Key how liberalisation will help him get re-elected, notwithstanding what he reads in the polls about public attitudes towards cannabis law reform.

Some will read this as a pessimistic assessment of New Zealand politics. But if it is true that liberalisation will help tackle wider social issues, then it should not be beyond the New Zealand Drug Foundation and others to make that case to help secure the social gains that are claimed. If those gains cannot be demonstrated conclusively to the new Prime Minister, then it is only right that any government should proceed cautiously.

• Matthew Hooton is Managing Director of Auckland public relations company Exceltium Ltd, and a prominent political commentator.

Cannabis and its veil of deceit

I awoke this morning to a flurry of colourful and fantastic insights for my story on cannabis. By the time I made it to my desk, all those wonderful ideas had dissolved like smoke in the wind.

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In so many ways, that sums up my 20 years of cannabis use.

From the start, I loved using cannabis because it opened my mind, heightened my senses and made me feel connected with the universe and the otherwise scary people that populated my world.

Gradually I set up my life around pot. Early on, I learnt to grow it because that kept the cost down. Inevitably, this led to a prosecution for cultivation. Along the way, I began to deal in pot (and other drugs) to ensure supply and help fund my own use.

When I was finally earning enough in my career to fund my habits, I surrounded myself with folk who supported my using; people who often found me more accessible, thoughtful, even useful, I suppose, when I was stoned.

At one point, I even had the landlord build a deck off my office so I only had to walk a couple of paces to have a smoke in privacy.

Most of my friendships were founded on drug use and my ability to supply. At first, I liked the needy nature of the supply relationship, but later on, I found it pathetic and embarrassing.

As I had my first smoke at breakfast, I knew there was a good chance that in an hour or so I would feel edgy, unfocused and indecisive, yet the lure of that wonderful first-up rush of warmth was just too much to resist. The sense of physical wholeness and the psychological shift that came from that first smoke overpowered my knowledge of the consequences.

In the end, my best friend turned on me. My mind had become closed and could barely function. The world had become a grey and foggy place, and my overwhelming paranoia had distanced me from everybody.

People couldn’t understand my using, and they found it difficult to understand my behaviour and even my words a lot of the time. My work became at best unpredictable, and my ability to have intimate relationships was negligible.

This was all from a drug that the press at the time suggested was not harmful. Apparently, it was neither physically nor psychologically addictive, and the only real harm was to the lungs. I so wanted to believe the “evidence”.

At about age 35, I decided that I needed to grow up, get a life and be like the folk around me who weren’t stoned, yet seemed to be leading pretty good lives. I began to want a life that didn’t have so many crutches.

I decided to stop smoking cannabis.

But stopping turned out to be a little trickier than I thought. First, there was the physicality of the whole process, the feeling of total discomfort in my being, an itchiness coupled with an inability to sit still, and an overwhelming sense that something was missing.

The psychological withdrawal could be summed up by the word “craving” – a complete and absolute obsession with cannabis 24 hours a day. No matter how much I drank or what other drugs I used, I couldn’t shake that obsession.

I realised then that I had a problem and that the problem was something I could not easily deal with.

Over the next few years, I would often swear off pot on a Sunday and by Wednesday – or maybe, if I was really lucky, Thursday – I would find that I was stoned, but with no real connection to how it had happened. This was a period of constant internal strife and struggle.

Seven years after my first attempt to put pot away, I surrendered to its power over me and, through treatment and support, found a way of living without my dear friend. I was given tools to help me live with the physical craving and mechanisms to deal with the overpowering mental obsession. In this way, I was able to walk though the withdrawal that dragged on for many months.

Ten years on and the veil that is my relationship with cannabis has been lifted. I am now able to see what I was like to the world and how I had short-changed myself by living that shrouded existence.

I have watched others close to me go along a similar path, and I’ve felt sad and powerless to help. But there has also been gladness that I am finally free of that grey, clouded, smoky world.

• To contact Michael about his story, please email cannabisveil@ihug.co.nz.

Pain, pot and politics

Is fear, prejudice and ignorance on the part of our decision makers denying many suffering New Zealanders the help and relief that medicinal marijuana use could provide? A mere whiff of the term seems enough to scatter the herd in the political fraternity.

The Misuse of Drugs (Medicinal Cannabis) Amendment Bill sponsored by Green Party Associate Health Spokesperson Metiria Turei would allow registered medical practitioners to prescribe cannabis to patients with specific serious medical conditions. The bill is due to be heard in Parliament in May.

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Sarah Daniell looks at the issues around the legalising of medicinal marijuana and the arguments put forward by both advocates and opponents.

Ancient medicine, anecdotal evidence and widespread consensus suggests that medicinal cannabis has value in treating people with serious conditions who may not respond to other drugs.

It is known to have benefited people who have cancer, HIV/AIDS, MS and other neurodegenerative diseases. Studies have shown it also helps paraplegics prone to body wasting, and sufferers of Tourette’s syndrome, epilepsy and motor neurone disease.

New Zealand may lead the world in many areas, but advocates of legalising medicinal marijuana say we lag behind the rest of the world on the issue. In Canada, the United States, the Netherlands, Germany and New South Wales in Australia, it is legal to use cannabis for strictly medicinal purposes. Despite its C-class status here, prosecutors take a tough line on cannabis which is supplied to relieve pain. In just one high profile case in 1998, Neville Yates, was convicted of using medicinal cannabis.

The law may be emphatically in favour of teaching medicinal users a harsh lesson, but it would seem the public of New Zealand is behind Turei. In July 2006, a 3 News/TNS poll showed 63 percent of New Zealanders would support a law change allowing doctors to prescribe cannabis as a painkiller. And on 22 November 2006, Turei herself tabled in Parliament a 3000-signature petition organised by NORML in support of a law change to allow the use of medicinal cannabis.

In a survey of 225 doctors in 2003, 32 percent indicated they would consider prescribing medicinal cannabis products if it were legal. Six percent said they had prescribed medicinal use of cannabis.

The biggest obstacles to medicinal cannabis, according to advocates, are politicians and prejudice.

Bruce Kilmister, of Body Positive, an organisation which supports people suffering from HIV/AIDS, has had many years at the coalface of the issue.

“Over probably 20 years I have watched as the AIDS pandemic has raged through various countries, including New Zealand. I’ve lost a partner to AIDS, I’ve seen many people die from AIDS and I have questioned the legitimacy of withholding what could be a comfort to those people suffering the physical effects of AIDS. I’m referring to nausea, body wasting and pain – pain through every part of the body from cancers or pneumonia.

“I defy anybody to compare or put the morality of medicinal marijuana up against the pain and suffering that people have. This is not for recreational or social use. I’m advocating medically prescribed marijuana for a medical situation for which there is no other form of relief.”

Metiria Turei believes prejudice is at the heart of the issue.

“We have a potentially useful medicine here and we are denying sick people because we have a prejudice about the nature of cannabis and recreational drugs. The opposition to the use of cannabis is not based on research or evidence, it’s based on prejudice and that cannot be justified in a so-called modern, democratic, liberal society.”

She says scientific evidence increasingly supports the benefits of medicinal cannabis.

“It’s been demonstrated in a number of studies to be useful for some conditions, particularly muscle spasm control for those who are paraplegic, and control of nausea and maintenance of appetite for those who have cancer or HIV, or who are taking other drugs that are causing those kinds of symptoms.”

Turei also refuses to accept that the issue is too ‘hard-basket’.

“We’ve been through these kinds of debates before. Abortion is one example, homosexual law reform is another. We’ve just had the civil union debate. We can tackle these issues sensibly.

“Hopefully the bill, or the discussion around the bill, will help people see these issues more clearly.”

But proponents of medicinal marijuana may not only be up against politics and prejudice. In July last year, New Scientist reported that while there was clear anecdotal evidence that medicinal cannabis works in some cases, results of clinical trials have been mixed. The problem is there’s no way of targeting the drug to a particular place, it said.

Experts at the Federation of Neuroscience Societies meeting in Vienna last July said the human body had its own endocannabinoid system which helps regulate pain, hunger and anxiety. Medicinal cannabis interferes with that system.

Kilmister rejects the notion that medicinal cannabis is a blunt tool.

“Where HIV/AIDS people are concerned we have always been on the cutting edge of science. I can’t begin to tell you the number of people who have died more from medication in the very early days, than the virus itself. They became the willing guinea pigs of the pharmaceutical industry in an attempt to stay alive.

“All I can say is I see what actually works. I do see people who are using marijuana for medicinal reasons and it works where everything else has failed. Most of the physicians we work with have no difficulty seeing their patients use marijuana when they have identified nothing else seems to work.

“They will simply turn a blind eye or even sometimes suggest to the person, ‘Have you tried this?’ knowing full well that it is illegal and knowing full well it could be the only form of relief for that person.”

Currently in Britain the only cannabis-based product which can legally be used is a treatment for MS - a nasal spray called Sativex. Cannabis derivatives supplied in a synthetic form may be the ultimate compromise for those in the medical community who cannot countenance patients smoking it for medicinal purposes. A spokesperson for the New Zealand Medical Council said it supported research and debate on the issue, but didn’t support people being allowed to smoke the substance as that came with other health issues.

But the problems with synthetic derivatives, says Turei, are the expense and time involved in research and the issue of efficacy.

“My concern is that the government may be committed to looking at pharmaceutically tested products as opposed to whole plant extracts, and I think that’s a real shame because the whole plant extract is shown to be more effective, and we end up with a system where medicinal cannabis is made really expensive and really difficult to access.”

In The Netherlands there is a strictly regulated system where agents grow cannabis. It’s tested to make sure it’s clean and doesn’t contain any contaminants and the genus of the plant is assessed. They know through testing and anecdotal evidence what kinds of plants are suitable for certain conditions and supply them on that basis.

Kilmister says if the public needs reassurance, it needs only to look to the United States.

“If ever there was a bastion of conservative attitude in terms of the medicinal or morality aspects of marijuana, the United States would be the absolute heart of it. Yet the US has accepted the legitimate, legal use of marijuana. It is prescribed with a health card that allows the patient, under the very strictest control, to secure marijuana for medicinal purposes – much to allay some of the concerns I briefly mentioned, particularly pain.

“It helps a great deal with other things such as appetite. Nausea destroys appetite and causes body wasting – all of those things which contribute to the on-march of the AIDS virus through the body could be allayed with the use of medicinal marijuana.

“When you are taking a barrage of medication, morning, noon and night, just simply to stay alive, that affects the whole psychology of a person. And to simply shift aside from that briefly, with the support of medicinal marijuana, not only defers the symptoms they’re suffering at the time but also gives them some slight relief.”

So what’s the guts of Turei’s Bill?

“The Bill is set up to allow a doctor to decide whether a patient would be helped by cannabis. They decide the best dosage and the patient applies to the Ministry of Health for an ID card which has dosage, how many plants they can grow, what condition the marijuana is for and the name of the prescribing doctor.

“That information is all passed on to the police so they know who medicinal users are. If the person is unable to grow the plants themselves, they can designate someone to do that for them and that agent becomes registered with the Ministry and the police as well.

“The card provides protection but only to the level specified. It must be done under medical supervision. The patient can access the plant very easily and cheaply because they can grow it themselves.”

Turei accepts that some doctors are against people smoking cannabis, but says there are other alternatives, such as a tincture, a vaporiser or ingesting.

Bruce Kilmister says he is unconvinced by pharmaceutical derivatives.

“We’ve looked very closely at the [cannabis derived] pill but our concern is that it takes too long to work. When a person needs relief they need it immediately. You don’t want to take a pill and wait for an hour when simple marijuana provides instant relief.

“If Turei’s Bill is adopted it would reduce the abuse of our members, many of whom are already living in poverty, purely on a pension. They cannot absorb the exorbitant costs that fuel the profits of the inappropriate growers and dealers. If legislation was passed that allowed for medicinal use only, and it was strictly controlled, I think it would improve the situation for many so that they would not be put further into the clutches of poverty, or risk real violence in dealing with people they would never normally associate with.

“The biggest obstacle is finding sufficient politicians with the fortitude and moral responsibility to meet this debate honestly and sincerely.”

• Sarah Daniell is a freelance journalist based in Auckland.

Sense and sinsemilla

"Skunk 25 times more potent than resin sold a decade ago" - so the recent headlines go, accompanied by articles reporting record numbers of young people requiring drug rehabilitation, and worrying statistics about their cannabis usage. But just how much stronger is ‘the devil's lettuce' these days, and is it causing more young people to need treatment? Marilyn Head looks to bring a little balance to a subject often fraught with exaggeration and over-simplification.

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When the USCGC WAGB-4 naval icebreaker nosed into Wellington Harbour at the height of the Vietnam war, there were plenty of kindred spirits ashore eager to show the Americans a bit of Kiwi hospitality. The Americans were equally liberal with their thanks, distributing largesse in the form of the Durban Poison and Panama Red dope they'd picked up on the way over.

"The ships were full of people who dodged the draft - basically they had a choice of going to jail or doing service on the icebreakers," says one of the volunteer Kiwi hosts, happily reminiscing about the improved product brought to Aotearoa courtesy of the US Coastguard.

"The stuff we got in New Zealand then was rubbish, but this was really strong dope and they were all into it. I remember being onboard once and hearing the Captain broadcast, "And I don't want any more smoking on parade!" But times have changed, according to the same source. New imported strains and concentration in the form of sinsemilla, the more potent unfertilised flowering heads, have replaced the leaf and head mixtures of old, and New Zealand green is no longer inferior in comparison. Indeed, some of it packs an unexpected punch.

"I was offered some stuff recently and one drag was too much, though I hadn't smoked in a long time so that may account for it," he says. "What's around now is definitely stronger than the mild stuff we used to smoke 30 years ago, though, even then, there'd be the occasional super-strong stuff."

That's hardly surprising. In a country largely dependent on primary produce and a world leader in agricultural research, it would be pretty odd if a little electric puha hadn't come in for some improvement. But how much stronger are today's varieties of cannabis sativa really, and, more importantly, does it matter?

That question, fuelled by some sensational reports of a 25- to 30-fold increase in THC (tetrahydrocannabinol), the active psychotropic ingredient in cannabis, gave rise to much debate in 2007. Antonio Costa, Director of the United Nations Office on Drugs and Crime (UNODC), histrionically advised the British government not to be "swayed by misguided notions of tolerance" for this "dangerous drug". The British Independent on Sunday carried this quote in its equally histrionic feature "Cannabis - An Apology", wherein it famously reversed its previously liberal stance in favour of decriminalising marijuana.

More disturbing, however, were reports of substantial increases in the number of people with cannabis related problems signing up to drug rehabilitation centres, high rates of cannabis use among juvenile offenders and young adults with psychosis, and evidence that cannabis use was starting at a younger age, increasing the risk of harmful patterns of use.

Now that the dust has settled, it may be useful to reflect on that debate and its impact on public health and drug policy, particularly with Metiria Turei's Member's Bill in the offing, which would amend the Misuse of Drugs Act 1975 and legalise cannabis for medicinal use. How valid are the claims that today's marijuana bears no resemblance to the mild hippie drug of choice thirty years ago, and can calls for its reclassification as a ‘hard' drug be justified?

Let's start with the science. Disregarding the significant problem imposed by dealing with an illegal substance and having to extrapolate evidence from a small proportion of confiscated products, inconsistently collected, stored and analysed over time by numerous different agencies, the data seem to show a small upward trend in THC levels, indicating a modest increase in potency in some cannabis products.

In 2005, the British Advisory Council on the Misuse of Drugs, for instance, reported little change in the strength of cannabis resin (hash) and imported herbal cannabis over the past two decades, but a two-fold increase in sinsemilla. Similarly, the THC content of indoor-cultivated herbal cannabis, including skunk, may have doubled from five to 10, or even tripled to 15, percent. That is hardly the 25-fold increase touted by some. And since indoor and homegrown cannabis is less likely to be detected and is far more widespread, the ‘average' must be derived from comparatively smaller and even less representative samples. Indeed, stepping up aerial surveillance to detect outdoor plantations in the 1980s and 1990s is often cited as the prime factor in driving cultivation indoors where new biotechnologies and complete environmental control have ultimately resulted in a fresher, stronger and more consistent product.

However, quibbling aside, there is no evidence to support claims of an across-the-board increase of the magnitude suggested, though sensational claims of super-strength dope are regularly invoked - in the 1960s, it was drug-crazed hippies synthesising THC, whereas today's demon is the high-tech production of genetically-selected sinsemilla "force-fed with fertilisers".

By comparing the least potent cannabis seized 30 years ago with the most potent today, it is possible, though illogical, to arrive at dramatic figures. But all this proves is that cannabis was, and still is, available in varying strengths.

Regardless of the average THC content of confiscated cannabis in any given year, high-powered premium varieties have always been available. Before prohibition, some were sold over the counter as patent medicines and tonics, and in the Netherlands, where cannabis is not banned, superstrong hash cookies are sold in cafés alongside milder ones. Interestingly, they are less popular. Thousands of years of cultivation have ensured a wide range of potencies and, while the development of sinsemilla, genetic selection and intensive indoor cultivation may have upped the average kick, that is not evidence that the range itself has increased.

The facts simply suggest that the average quality of cannabis has improved, just as the average supermarket apples are bigger, fresher and more blemish-free than those bought 30 years ago.

Doubling the psychotropic effect of a substance is likely, however, to be more contentious than doubling its vitamin C.

The standard user response, for which there is rather more anecdotal than scientific evidence, is that greater potency is not necessarily more dangerous because consumers tend to adjust their dose according to potency. Double strength dope, it is argued, could actually be more healthy because it reduces the amount of smoke one needs to inhale to get high. Similarly, the popularity of bongs and vaporisers to concentrate the hit and reduce or eliminate smoke inhalation suggests that the anti-smoking message is getting through.

There is a considerable difference between being high and being ‘wasted'. While most actually prefer the former, the concern is that users will readily habitualise to a stronger variety, which may make them more likely to move to stronger drugs.

Although there is no evidence for this, it raises some rather circular arguments about addiction/ dependence. While cannabis is not chemically addictive in the same way that heroin, amphetamines and nicotine are, it's clear that some people do develop a dependency - just as others depend on their early morning coffee or glass of wine with dinner but are not technically addicted. Whether such habits or dependencies impair health or competence, and to what extent opportunities to indulge them should be regulated, are key issues that are rarely addressed with any consistency.

There is a plethora of scientific research on the effects of cannabis, coffee and alcohol, variously interpreted as either beneficial or detrimental, yet the legal status and social response to each differ markedly.

For a minority of people, each of these substances can be troublesome, but only cannabis is illegal, which adds another dimension to concerns about those already marginalised through criminal offending and mental illness. Indeed, as Dr Sandy Simpson of Auckland Regional Forensic Psychiatric Services notes, criminal behaviour, mental illness and drug abuse are often so disastrously interwoven, that it is virtually impossible to extricate causal factors.

Leaving aside the question of whether changes in access, treatment and reporting practices have contributed to the figures for young people seeking treatment for cannabis related drug problems, there is suggestive evidence there has been an increase, though again it is difficult to discern a particular cause. In Britain, where it was reported that the numbers of young people in drug rehabilitation had nearly doubled in one year from 5,000 in 2005 to 9,500 in 2006, the use of cannabis amongst young people had actually gone down by almost a quarter in the past decade. But in Australia, which shows a similar increase, cannabis use appears to be rising.

It could hardly rise any more amongst juvenile offenders, however. The Australian Institute of Criminology reported in October 2005 that 94 percent of juvenile offenders had used cannabis, with 64 percent being regular users - a third more than those who regularly drank alcohol. Unfortunately, such statistics, coupled with neurological research exploring a tentative connection between cannabis use and psychosis, schizophrenia and depression, only served to fuel Australia's repressive National Cannabis Strategy the next year. Once again, rather than alerting authorities to the multiple factors contributing to antisocial behaviour and the possibilities of mitigating them in a highly vulnerable minority group, scientific research was used to justify continuation of the same failed policies - the ‘war on cannabis', recast as a hard drug, continues.

Though not a single clinical psychologist has cited cannabis as anything more than one factor in the cocktail of dysfunctional social interactions and mental health problems this group has suffered from, it remains the favourite scapegoat of the scientifically challenged, ensuring that resources that should be used to protect those at risk are channelled into largely ineffective enforcement and criminalisation of the young. Although there is a scandalous lack of research into what motivates people to start, stop or refrain from taking drugs, and the problematic behaviours associated with patterns of use, there is an equal paucity of research showing that prohibition has a deterrent effect. In New Zealand, cannabis related offences account for about 40 percent of all drug and anti-social offences, which comprise around 12 percent of crimes.

In spite of this, however, cannabis is freely available to high school students (and when they can waltz into tinny joints in their school uniform for ‘afternoon tea' and advertise it on Bebo, as one mother indignantly reported, one has to wonder how consistently the law is applied and to whom). Yet many young people are not interested in using it, and it is only problematic for some of those who do.

However, the consensus is that young people are starting to use cannabis at a younger age, more heavily and more regularly. Since these are identifiable risk factors, especially coupled with other social and psychological factors, there is real cause for concern that harmful patterns of use will become more prevalent.

The question is how to address this potential problem. The simplistic response would be to follow Australia's tough stance, which would be akin to its following George W's War on Terror - the same shonky reasoning, the same enhanced powers for the enforcers and the same massive fallout for innocent victims.

New Zealand's recent experience with the ‘Tuhoe Terrorists' and the extraordinary abrogation of human rights in the Immigration Bill are testimony to the ease with which we too can be caught up in rhetoric. Hence the danger of media misrepresentation and fear-mongering. It takes courage to swim against the tide, but a rational approach to cannabis use would be to accept that, as with alcohol, the drug is the constant, it's the human that is the variable, and legislate accordingly.

• Marilyn Head is a freelance writer based in Wellington.

Home away from drugs

At least two-thirds of people who have tried cannabis stop using the drug. Some of them seek help to stop. Chris Kalin describes the support provided by Auckland's Odyssey House and the therapeutic community model used there.

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Auckland's Odyssey House treats over 500 clients a year. There are about 125 clients in attendance over the course of any given month, and about 100 present at any given time. The clients are distributed between nine programmes (seven residential, two non-residential), of which the largest is the Adult Programme (35 percent of all clients). There is also a Family Centre, where clients may bring young children while they are in treatment, and special treatment programmes for those of school age.

The client population is relatively young. Average age on admission is 23, the median age 20 and the most common age is 16. Sixty percent are male and 40 percent female. Fiftyeight percent of the clients are European, 33 percent Ma-ori, four percent Pacific and five percent Asian. Europeans are slightly underrepresented compared with the New Zealand population as a whole, and there are three times more Ma-ori clients than could be expected based on their proportion of the general population, but only half the number of Pacific people we would expect, and only a third the number of Asians.

Almost all clients are multi-drug users. Excluding nicotine, the major problem substances are:

1. cannabis (70 percent of all clients)
2. alcohol (60 percent)
3. methamphetamines (36 percent)
4. amphetamines (8 percent)
5. all other substances combined (used by 25 percent of all clients).

Methamphetamine usage has grown slowly but steadily from 20 percent of all clients in May 2004 to 36 percent today.

The average waiting time for admission into an Odyssey programme is about four to six weeks. Most clients have more than one admission, and over the last 12 months, the average has been 1.6 admissions per client. The average time they remain in treatment is 5.25 months, but the effectiveness of the treatment is less dependent on time and more dependent on the treatment level reached.

The treatment model used at Odyssey House is called the Therapeutic Community Model. Therapeutic communities are based primarily on a social learning model. Participants are isolated from the influence of their previous peer groups, totally immersed into treatment and given peer counselling and support.

Theoretically, the community itself is the primary therapist, and four major philosophical issues are addressed:

1. Substance abuse and criminality are symptoms of a disorder of the whole person.
2. The disorder of the person consists of social and psychological characteristics that must be changed.
3. ‘Right living' refers to the morals and values that sustain recovery, and is the goal of treatment.
4. Recovery is a developmental learning process.

Addiction is not viewed as a sickness, but rather as a learned condition that can be changed. This is accomplished in a continuous atmosphere of constructive confrontation and feedback where community members confront each others' negative behaviour and attitudes and establish an open, trusting and safe environment where personal disclosure is encouraged and the deviant culture in the general population rejected.

Odyssey House Youth Services provides three programmes for young people who have drug problems and often more complex needs. The residential service caters for youth aged 14-17 years.

The Youth Day Programme runs each week day from 9am to 4pm. The aim is to work with young people and their supportive family and other networks to maintain a drug free lifestyle and support reintegration into education or vocational placements.

The community programme is mainly based in schools. This is an early intervention youth development programme designed to support young people and prevent them from being excluded from their primary support systems (schools).

From our experience of providing drug and alcohol treatment to young people within residential, day and community settings, the following themes have emerged.

A broad based, holistic approach that is able to address multiple issues for youth seems more effective than focusing on drug and alcohol use alone. It is important interventions help young people create a positive self identity that is separated from and not defined by cannabis use that, for many, appears to form an important part of their identity and status.

Utilising positive peer pressure seems an effective way to challenge young peoples' beliefs about cannabis use. An important part of treatment includes helping young people notice patterns and effects of use that are not immediately obvious. This, for example, includes helping youth notice reductions in motivation, times when they no longer participate in sports activities previously enjoyed, and the social and emotional behaviours that become solely focused on cannabis use.

Some of the key issues identified in our youth work indicate that cannabis use is normalised and sometimes glorified amongst youth culture. It is viewed as an accepted and harmless part of youth socialising.

Young people tend not to regard cannabis as unhealthy (particularly when compared with cigarette smoking). Young people often rationalise their use by focusing on the perceived benefits. Typical statements include: "It keeps me calm", "I don't get into fights when smoked up but fight when drinking alcohol", and "It helps me be good in class".

For female youth, one way to gain access to free, larger amounts, or better deals with cannabis is to engage in risky sexual behaviours.

There appear to be two main influences encouraging young people to first use cannabis. For many, their introduction is through immediate or extended families. For others, the main area of influence is their peer group.

There are numerous examples from our client group where they've been groomed by dealers to sell cannabis to other young people. Dealers sometimes give them incentives for regular weekly purchases and provide credit, which keeps young people trapped in a dealing/use cycle.

It is most important that we focus on the growing evidence around teenage cannabis use, early onset psychosis and other mental health vulnerabilities, and that we don't stigmatise young people. This creates barriers to them seeking immediate support or engaging with services for longer-term support.

It's not about youth culture - this is a family, community and broader society based issue.

• Chris Kalin is Chief Executive of Odyssey House Auckland

 

Caught with cannabis - A stoner or a scholar?

Incidents involving cannabis provide some of our best chances to foster students' success even while the important social and health issues involved are addressed, argues Trish Gledhill. The way we view and deal with these events can make all the difference in promoting young people's resilience, and the results can be quite surprising.

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Our views of young people, their risk taking and, by implication, their resilience drive the ways we respond to drug issues. When there is an incident, the student is typically seen as the problem and often described as being ‘at risk' or having complex needs. Adults tend to focus on the drug, dissecting the incident and speculating on reasons for its use. The more we discover, the more pervasive these issues seem. The student may be described as living in a dysfunctional family where "everybody smokes" and failing at school and in the community.

When drugs are involved at school, the initial reaction is typically about discipline and the so-called seriousness of the issue. Sadly, the focus is often on removing or ‘fixing' the ‘problem'. But perhaps there is another way of looking at young people during these events.

In these situations, young people's capacities usually go unnoticed, but actually, the young person is showing resilience. Intelligence, determination, resourcefulness and other talents keep young people safe and help them survive from day to day, but these factors are overshadowed when the focus is on their drug using behaviour alone.

Without ignoring high risk issues such as abuse, perhaps we should develop views of young people that highlight their potential and scenarios that inspire hope and optimism. Taking the camera as an analogy, perhaps we should widen the aperture and let in more light to help identify and validate young people's strengths in spite of their difficulties. Encouraging, supportive relationships that maintain high but realistic expectations support better outcomes. Resilience studies reveal that these approaches are more likely to open up pathways forward.

We can use events as opportunities to promote resilience. When cannabis is in the picture, there is an ideal chance to respond constructively and create these pathways. Schools, which have key roles in fostering resilience, significantly influence young people's futures.

Most schools are highly protective, providing accessible support and health services, with a range of opportunities to foster success. Young people agree with adults that, as well as being looked after, they need boundaries that convey expectations of success. So some caution is warranted to ensure we don't lower the bar by expecting less, ignoring issues, or overprotecting and removing opportunities for students to develop their own capacity. Reduced expectations of achievement permit, or even create, a picture of risk rather than resilience.

Interestingly, everyday events matter most to young people. They notice the small things, such as the teacher who recognises their potential. They favour inclusive rather than special services to maintain their identities as resilient young people.

When students are striving to manage the complexities of their lives, they tell us that they do not necessarily expect school to ‘take off the lid' and fix up these issues, but they do expect school to protect them when necessary and, most importantly, to do their job by providing opportunities to succeed. They want accessible support, but need opportunities to exercise their own strengths. As young people argue, the best drug education is not about focusing on problems, but about good information and encouragement to build capacity. It's often about giving young people what they need, with respect for their realities and their abilities.

Ideally we expect families to be included. However, sometimes youth just want a break from stressful home environments. When we discover that families are immersed in problems, it is important to determine who constitutes the main support systems for the student. If family is not available, it is vital that we maintain access to the one place that can provide visions of success. For some young people, this is best achieved by viewing school as a different world from home and community.

Students caught with cannabis tell us very clearly not to overreact over something that is often normalised in the community and in their environment. Students are often caught as a result of experimental use. Their stories illustrate the impact of school exclusion for offences that are often unrelated to educational activities and achievements.

Once a young person is labelled a drug user, it becomes very difficult for them to access other mainstream education. This single event can determine a trajectory of escalating problems leading to increased contact with troublesome peers, nonachievement, unemployment and possibly offending. Ironically, they have many good role models in adults with a history of cannabis use. Real and important issues, such as their mental health or social concerns, can be overlooked in the rush to over-reaction or over-protection.

Recently, I witnessed a young student appearing before a school board of trustees. As the incident was described and questions asked, the young woman sat with her head down, offering no explanation and demonstrating no willingness to address the incident or discuss her return to school.

The principal noticed this and began to outline her potential as a bright young woman. He gave examples of high achieving students who had similar backgrounds and abilities to her own. He also outlined the possible consequences of her actions. He acknowledged her resilience but emphasised how much she would need it to get through the next year ‘trouble free' and to manage peer relationships alongside significant family responsibilities. He portrayed hope and possibility far beyond her own expectation of leaving school early and unqualified.

The approach taken by the principal had far more impact than the threat of exclusion from school. When the promising vision was presented, the student visibly straightened in her chair, looked up and asked questions, becoming far more alert and engaged. This intervention was significant in providing a turning point to both reinforce boundaries and provide high expectations of potential.

Let's not, as a first response, remove young people from school, when it's one fundamentally protective system for young people. Let's not oversimplify the issues either. Young people's lives, like their school environment, can be complicated and hard work.

Some schools are an example to others, undertaking innovative and collaborative responses to drug issues. Schools should also be resourced to maintain organisational resilience, such as validation, strong agency support and robust information about these issues.

We can still address risk, responding with the best interests of the school and community at heart, while allowing students to strive. Let's be sure to view these events as opportunities to create a picture of potential in the young person's life.

As the educationalist Swadener maintains: "We must find the will and the character to view all children through the lens of promise."

• Trish Gledhill is the Executive Trustee of Kina Trust. She also sits on the board of trustees of a low-decile secondary school, and was recently elected as a member representative to the New Zealand Drug Foundation board.

When truth and balance go to pot

Now, more than ever, rational, balanced and informed debate on cannabis use is needed, so that legislation and cultural attitudes can be shaped by right understanding instead of panic and misinformation. Drug Foundation Director Ross Bell weighs some news stories in the balance and finds that coverage is often found wanting.

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Reefer Madness was a 1936 propaganda film describing what happened when pushers lured high school students into trying "marihuana". The tragic consequences included a hit and run accident, suicide, rape, weird orgies and a general descent into degradation, debauchery and despair.

The film was originally financed by a church group and had a clear message: Cannabis, the "smoke of hell" and "the devil's harvest", will inevitably lead to drug-crazed abandon, insanity and death.

Cannabis use has become much more widespread in the last 72 years. More than 50 percent of us have tried it at some stage, and those of us who haven't probably know plenty who have. Few today, even amongst pot's most vehement detractors, would argue for the full accuracy of the film's conclusions.

However, a more subtle form of reefer madness persists in the way the effects of cannabis use can be presented by the media. Alarming sounding statistics are often relayed with little attention given to context or negative research findings, and stories are run under shocking or sensationalist headlines.

An example of this is what happened with the Lancet meta-study on cannabis and psychosis published last July. The main report headline, that smoking cannabis increases the risk of schizophrenia by 40 percent, was very widely reproduced in covering media stories. However, the Lancet paper actually stated that the risk pertains to a small proportion of heavy users, and noted that it was related to quantity - the more you use, the greater the risk. It also suggested that 800 cases of schizophrenia would not have occurred if none of the UK's 6.2 million cannabis users had ever tried it.

These figures boil down to an estimated 0.00129% risk of schizophrenia for cannabis users, probably statistically similar to your chances of being hit by an Aston Martin while crossing the road in Cannons Creek.

The Lancet study's authors also admitted that, while a correlation between cannabis and schizophrenia was shown by their research, no causative link could be established.

The point here is not that the possible mental health risks associated with cannabis use should be trivialised - there is a possible link and it shouldn't be ignored - but rather that the prevailing message of the media coverage amounted to wild and inaccurate overstatement.

The next example followed closely on the heels of the Lancet story. A paper by New Zealand researchers appeared in the 31 July edition of the journal Thorax considering the relative impacts of cannabis and tobacco on a range of lung functions. The typical headline above stories reporting on the paper was "One cannabis joint as bad as five cigarettes" and, once again, the full extent of the research went largely unreported.

In actual fact (and in layperson's terms), the research found that:

• tobacco smoking reduced forced expiratory volume (FEV1) but cannabis smoking had no effect
• tobacco smoking reduced maximum mid-expiratory flow (MMEF) but cannabis had no statistically significant effect
• tobacco smoking had no effect on total lung capacity but cannabis increased it with marginal statistical significance
• tobacco smoking reduced carbon monoxide transfer, but cannabis had no effect.

The only test in which cannabis caused worse results than tobacco was in specific airways conductance (sGaw). The negative effect was of marginal significance for tobacco, while smoking cannabis reduced sGaw to the equivalent of smoking between 2.5 and five cigarettes (note the headlines only mention the maximum number).

A ‘novel finding' in the research was that those who used cannabis regularly had an "increased percentage of low density lung tissue" - something that also went largely unreported.

So, in every test but one, tobacco had negative effects while the effects of cannabis were statistically insignificant. But when it comes to the battle to capture readers, that single finding is sufficient to ignore the other findings and claim cannabis to be five times more damaging than tobacco.

At the start of May last year, Associated Press ran a story starting with the following paragraph.

"New findings on marijuana's damaging effect on the brain show the drug triggers temporary psychotic symptoms in some people, including hallucinations and paranoid delusions, doctors say."

The fact that cannabis sometimes produces paranoia and hallucinations is not new news, and I don't want to argue that these are good things. But calling them "damaging effect[s] on the brain" is potentially misleading. ‘Damage' implies permanent, harmful changes whereas the scans in question only reveal what was happening to the brains of the subjects when they were high, not what happened afterwards, or what their brains were doing a day later when they weren't high.

Our brains change temporarily all the time - when we eat chocolate, have sex or go for a run, for example. A temporary change in the brain is not the same as brain damage, and only a study that scanned the same people repeatedly over a long period of time could justifiably claim "physical evidence of the drug's damaging influence on the human brain".

Cannabis use may or may not lead to brain damage in some, but all this study proved was that it alters the brain while a user is under its influence. Admittedly, there's not much of a story in that, but journalists should wait for research that shows permanent damage before claiming it occurs.

Watching the media cover cannabis issues is both fascinating and frustrating. It's fascinating to see how quickly stories that fail to properly place science in context can be churned out and presented to an often uncritical public. It's frustrating in that now, more than ever, rational balanced and informed debate on cannabis use is needed, so that legislation and cultural attitudes can be shaped by right understanding instead of panic and misinformation.

Journalists, as influential shapers of public opinion, have a duty to show some restraint and a willingness to do deeper research so that they don't add further fuel to an already confused and emotional debate.

Let's return to the schizophrenia story as an example. How hard would it be to investigate a corollary or two such as whether schizophrenia rates have increased in line with cannabis use? After all, when tobacco smoking increased across the population, there was a corresponding rise in lung cancer prevalence.

Since the 1940s, percentages of people who have used cannabis have increased from single figures to around 50 percent in many places. Not all use it regularly, or even at all anymore, but if cannabis is more widely used, then any ailment it causes should also have increased. Five minutes on Google shows that this is not the case. In fact, some experts think schizophrenia rates may actually have fallen.

Furthermore, few journalists take the time to put their coverage of risk in context. A 40 percent increase in risk of schizophrenia would sound pretty scary to most, but to epidemiologists, it is not especially noteworthy. They usually don't find risk factors significant until the number hits at least 200 percent, and some major journals won't publish studies unless the risk is at least 300 percent.

Citing other research to help readers get a better understanding of risk magnitude could also be helpful and would be easy to do. A recent study by Johns Hopkins University, for example, found that alcohol can increase the risk of psychosis by 800 percent for men and 300 percent for women. Such a parallel would really help put the dangers of cannabis use into perspective.

The last option open to journalists with a bias for balance would be to cite research that disagrees with or questions the findings in the story they are covering. Leslie Iversen, author of The Science of Marijuana, for example, told the Times of London:

"Despite a thorough review, the authors admit that there is no conclusive evidence that cannabis use causes psychotic illness. Their prediction that 14 percent of psychotic outcomes in young adults in the UK may be due to cannabis use is not supported by the fact that the incidence of schizophrenia has not shown any significant change in the past 30 years."

Comments like these may not help sell papers to a public that prefers its issues to be clear cut, but the role and duty of the media is balance and truth, especially on issues where what we believe and the laws we make can seriously affect so many.

• Ross Bell is the Drug Foundation's Executive Director

This article acknowledges a debt to the following blogs:

• More shoddy reefer madness reporting of cannabis risks Transform Drug Policy Foundation, 31 July 2007
• Breaking news: Marijuana gets you high! Maia Szalavitz, 1 May 2007
• Will one joint really make you schizoid? Maia Szalavitz, 30 July 2007

 

(Black) Market forces

It’s a billion dollar business. Or is it? David Young explores the economics of cannabis and asks, if the nation is truly making a fortune from pot, where is the money?

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The garden is tended no better or worse than any of the neighbours’. The twodoor car parked out the front is tired but not a bomb. Matthew’s rented house, with its neat white painted door, doesn’t stand out in this laid-back, suburban street.

But in mid-2006, this small house was the talk of the neighbourhood. Police officers arrived with a search warrant in hand. They seized Matthew’s tools of trade – a set of scales and a cellphone – and charged him with dealing cannabis.

Think of the black market in marijuana and it’s likely you are conjuring images of something else. A run-down tinny house with a constant flow of customers. A pair of running shoes thrown over the power lines by way of advertisement. Gang members lurking in the shadows, controlling the proceeds and menacing competitors.

However, research suggests that 34-year-old Matthew is the more commonplace face of dope dealing. For eighteen years – through part-time jobs, studying and a lengthy stretch on the dole – he bought pot and sold smaller quantities to a select group of friends, keeping some for himself. “I wouldn’t have to worry about my power bill,” he says. “I’d get an ounce, sell four $100 bags or six $50 bags and pay the power bill that day.”

It wasn’t the lure of money that attracted Matthew to this job: it was love of the product. “I like smoking pot and I wanted to make sure I had a good supply, and the easiest way was to buy enough to sell some onto my friends.” He bought cannabis from two dealers, both of whom themselves had just five or ten clients.

Matthew counts himself unlucky to be caught – the police acted on a tip-off and thought they were raiding a methamphetamine seller, not busting a small-scale dope dealer. “They told me themselves that they’d wasted their time coming here.”

With police presenting incriminating text messages as evidence, he pleaded guilty and spent several months in prison.

Around the time Matthew was hauled before the courts, Massey University researcher Dr Chris Wilkins was publishing a paper that explored the structure of New Zealand’s illegalcannabis market.

Dr Wilkins, who works at the Centre for Social and Health Outcomes and Research, found that – as with other black markets in drugs – the industry forms a pyramid. At the top, there is a tiny number of people trading large quantities of drugs. At the bottom are the vast majority of dealers like Matthew who distribute to small groups of friends and acquaintances.

“That’s a way you control the risks,” Dr Wilkins says. “Instead of one person selling cannabis to 5,000 like a dairy [sells groceries], one sells to ten and those ten to another ten.”

According to Dr Wilkins’ research, dealers spent an average of $5,988 each on cannabis over the previous year. Half made a net financial gain and the other half a loss. “The profits earned from selling surplus cannabis were generally not of the magnitude to afford sports cars and luxury houses.”

Such small numbers are jarring when you consider media headlines that have put the size of the illegal cannabis market at $1–3 billion, or recall a 1998 Auckland University study that estimated Northland’s cannabis industry was earning at least $700 million a year – nearly twice as much as Northland’s entire dairy industry.

At $1 billion, cannabis would be as significant as all of New Zealand’s legal exports to the Pacific Islands, or a quarter the size of New Zealand’s entire legal horticulture industry.

If those sizeable estimates were correct, it would be safe to assume that cannabis is economically incredibly important to some communities.

The policy implications are unexpected. Quite apart from any other effects, decriminalisation could have a significant negative economic impact on vulnerable regions. Eliminating the risk of prosecution would drive the price of cannabis through the basement. After all, in a legal market, growing cannabis would not be difficult or expensive.

If the nation is truly making a fortune from marijuana, where is the money? Matthew certainly isn’t swimming in cash, and he doesn’t believe his suppliers are earning significant sums either.

Similarly, Denis O’Reilly, former Black Power member, chairman of the Waiohiki Charitable Trust and consultant community worker, hasn’t seen big money from dope in the communities he’s worked in.

“I still see these [growers and dealers] driving beat-up old Holdens and living in shitty flats, so what’s going on?”

O’Reilly is sceptical of cannabis economy estimates that are based on police estimates of the street value of seized plants.

“It’s an extrapolation from a faulty thing. That maths is done from the point-of-sale, and only a fraction of that translates back to some small town.”

Billion dollar estimates of the cannabis economy are reached by looking at the market’s ‘supply side’. Take the number of seized drugs, estimate the percentage of crop that this represents, and come out at a figure. The challenge is that the police are loathe to reveal their estimates of the proportion of drugs they seize. Dr Wilkins says the estimates involved are “murky”.

The researcher made the first attempt at a ‘demand side’ estimate of the cannabis black market’s value using 1998 National Drug Survey figures. He updated and honed his estimates using the 2001 survey. The survey reveals how many people acknowledge consuming cannabis and how much they consume in a year.

It’s not quite as simple as multiplying the figures by the number of people in New Zealand, though.

One complication is the amount of pot that isn’t paid for. Up to two-thirds of cannabis users report getting their drugs for free. Rather than indicating that some dealers are extraordinarily generous, this highlights the fact that a lot of people smoke socially.

Allowing for a certain amount of marijuana that wasn’t bought or sold, Dr Wilkins concluded in 2001 that the retail turnover of the cannabis black market was $131–249 million. To put this into context, New Zealanders spent $610 million on tobacco products and $1.2 billion on alcohol in the same year.

Wilkins acknowledges the survey results have limitations – consumption is likely to be under-reported.

“The reality is each method of estimation – supply and demand – has weaknesses and strengths,” he says. The best approach is to take a range from supply side and demand side estimates.

Even so, it appears likely the market is smaller than previous estimates and media ‘guesstimates’ suggest. This means that organised criminals gain less money from the illegal drug than previously imagined.

Dr Wilkins also explored how much cannabis buyers spend getting high. The policy implications are obvious: money spent on illegal drugs is not available for food, housing, healthcare or child support.

Nearly eight in ten cannabis buyers spent less than five per cent of their gross personal income on cannabis – about $4 per week. In contrast, a typical opiate user is said to spend $100 a day on their habit.

“For most cannabis buyers, the amounts spent would not ordinarily be associated with causing economic decline or precipitating criminal activity to obtain money,” Dr Wilkins concluded.

Matthew says his clients are “middleclass, employed career people. They spend $50, which is for them their café food money, their takeaway money, their pot money.”

Cannabis use has the biggest economic impact on people with the lowest incomes – in that group, one in ten smokers spent a fifth of their income supporting their habit. Both buyers and dealers who spent more than 10 per cent of their income on cannabis were four times more likely to be unemployed than the rest of the population.

“Someone with a heavy habit, yes, they’ll spend much of their budget [on marijuana], says O’Reilly. “That’s where you’ll get someone who’ll score an ounce off a cuzzy and break it into foils to sell off to satisfy their habit as well as make some money.”

Both Matthew and O’Reilly believe that many of those dependent on the industry are ‘ordinary’ people rather than organised gang members.

O’Reilly says: “I think it’s ‘mom and pop’ operations generally – pretty straight people having a hard time on the farm or living in a district where the economy is marginal, using it to pay the mortgage.”

Debate about cannabis decriminalisation is – rightly – framed as a health or legal issue. However, it’s important that policy makers understand what they are dealing with. Overstating the black market’s size is likely to weaken attempts to deal with its effects.

• David Young is a journalist based in Wellington.

High in the saddle: Cannabis-affected driving

New Zealand’s response to an apparent increase in drivers under the influence of cannabis seems likely to be more legislation and new penalties. But is this good policy, based on solid evidence? It might be, but Geoff Noller argues that the issues and evidence are complex and require much more discussion before we act.

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In October 2007, Otago University published research suggesting driving under the influence of cannabis (DUIC) may be more common and riskier than driving drunk. The release of this research coincided with the introduction of the Land Transport Amendment Bill (No. 4), which creates a new offence of driving while impaired by illegal drugs. Intuitively, we might consider this an example of evidence-informed policy. It seems reasonable that cannabis use impairs driving, and there is evidence of DUIC in New Zealand, hence legislation.

As with so much about cannabis, however, the actual situation is complicated, giving rise to a number of questions.

What does the evidence say about how cannabis affects driving? To what extent is it a problem in New Zealand? If it is a problem, what response would be most effective?

Attempting to answer the first question immediately reveals the issue’s complexity. There is vast literature on the negative consequences of drunk driving, but there is much less on driving under the influence of drugs in general (DUID). What exists is contested, particularly where cannabis is concerned.

DUID may be examined through epidemiological analyses or by laboratory and experimental means where impairment is assessed by assigning people to either drug taking or placebo/non-drug groups and having them perform certain tasks. With driving, these include cognitive tests (i.e. divided attention), coordination and testing reaction time.

One criticism of this type of study is that laboratory tests do not necessarily reflect actual driving conditions or drivers’ experience. While cannabis studies do find deficits in concentration, reaction time, spatial and temporal judgement and attention to peripheral stimuli, these effects are less marked in non-experimental settings, and more experienced cannabis users appear even less affected. Other studies suggest that, while cannabis does impair driving,users are more aware of their impairment and respond by driving slower and less aggressively. This isn’t usually the case with alcohol.

Some researchers claim that more accurate data may be gathered via epidemiological studies such as the one by Otago University, which focus on DUID prevalence amongst subpopulations. These studies aim to describe the magnitude of the problem or analyse it in terms of which drugs are over-represented in accidents.

Two ways of doing this are through ‘case-control’ studies, where injured and non-injured drivers are matched and compared for their drug use, and through ‘culpability’ studies, where injured or killed drivers are assigned blame, relative to their use or otherwise of different substances.

But these studies also leave the cannabis case unresolved. One review article indicated a range across studies suggesting 2.7–13.9 percent of drivers had used cannabis. However, the authors noted it is difficult to determine causality, as the relationship between injury or death and drug use is one of association.

Also, the psychoactive metabolite of cannabis degrades relatively rapidly, potentially before it can be identified,which might lead to underestimated impairment. Alternatively, the inactive parent molecule remains longer, potentially providing a false positive for impairment.

Adding to these difficulties is some curious data suggesting cannabis affected drivers are either at no greater risk or in fact are at less risk of an injury or fatal accident. This was the case in a large Australian study of 2,279 nonfatally injured drivers, which found cannabis-only subjects to be marginally less culpable than drug-free drivers.

In summarising the mixed data on cannabis-affected driving, a Canadian review noted that, while cannabis is the most commonly used illicit drug and there is evidence of it moderately impairing driver performance, epidemiological data fails to show it is a major contributor to traffic crashes.

Given New Zealand’s high prevalence of cannabis use, as well as research suggesting a high rate of intoxication while driving, it seems likely that DUIC is a significant issue.

Data from Massey University’s National Drug Survey 2001 noted an increasing trend to DUIC, particularly by youth. From 1998 to 2001, reported rates for those aged 15–17 years increased from 18 percent to 39 percent. This data supports the notion that, in some New Zealand subpopulations, DUIC is an accepted aspect of culture, but also that injury and possibly death may result, particularly where drivers are inexperienced or prone to risk taking.

How best to address these issues? An obvious response is legislation such as that currently before Parliament. Nonetheless, questions remain about its specifics. With cannabis, is impairment, or simply evidence of past use, to be acted on? How accurate are tests, and will particular populations, such as Mäori, be targeted?

Internationally, legislative responses to such questions have varied. In Sweden, there is zero tolerance for anyone identified as DUID, while Germany has instigated an upper limit for cannabis, similar to the commonly operating blood alcohol content (BAC). Supporters of zero tolerance claim any level is too high, given some evidence of impairment, and that, regardless, cannabis is illegal. However, the issue’s complexity implies that simplistic solutions may not provide the best outcomes.

In 2005, an international panel, having examined 140 studies, noted the advantages of having a BAC equivalent for cannabis, i.e. a BCC. With the evidence indicating that low levels of cannabis do not significantly elevate risk of accident and that drivers might test positive while not being impaired, zero tolerance and the potential consequence of criminalisation were described as counterproductive.

An interesting US study further supports arguments favouring a BCC. Researchers found that, where alcohol was more expensive and harder to obtain, and cannabis less interdicted (i.e. decriminalised for medical purposes), those aged between 18–24 would substitute cannabis for alcohol and that, in these circumstances, driver injury and death would reduce. In the reverse situation, with cannabis use more heavily penalised and alcohol seen as more attractive, driver injuries and fatalities increased. They concluded that, despite a potential increase of cannabis use resulting from decreased penalties, a net harm reduction would result.

This article has aimed to extend the conversation on cannabis into an area of recognised concern and one requiring practical response. The complexity of issues surrounding DUIC requires consideration based on evidence but also discussion. Though one legislative response might suggest zero tolerance for DUIC, other measures such as a maximum BCC combined with education may ultimately produce better long-term outcomes.

There are, however, barriers to implementing alternative policies. For example, education around the safe use of cannabis in a prohibition environment may be too difficult a nettle to grasp. Nonetheless, if we are unable to discuss these issues, we are likely to develop policies that, at best, have little impact on the problem or even make it worse.

A harm minimisation approach would suggest those with whom this conversation must occur are those most able to reduce the negative consequences of cannabis-affected driving – cannabis users themselves.

• Geoff Noller is a Dunedin-based researcher. He recently completed a PhD with Otago University’s Department of Psychological Medicine entitled Cannabis use in New Zealand: perceptions of use, users and policy.

No easy answers

CAYAD worker Denis O’Reilly has spent a lot of time around either alcohol or drugs in one way or another. In this short life story, he muses on the confused nature of our attitudes towards legal and illicit drugs.

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My dad, Dinny O’Reilly, was a kind and hardworking man who raised his six kids to be good and contributing citizens. We had a family business in Timaru, a service station that was open seven days a week. It was not only the focus of our family’s life, it also served as the fulcrum for an Irish Catholic community of neighbours and friends.

The link of the ‘Faith’ was one thing, but there were others too – a love of horseracing and a genetic predisposition towards alcohol in all its forms, but preferably good whisky. The tyre room, where dad repaired punctures and vulcanised tyres, was a de facto bar. The big tank where we tested tubes for leaks served as a useful beer chiller, and Dad’s friends and relatives would pop in and chat to him whilst he worked, and generally a beer or two would be consumed.

We’d always be well stocked with crates, and in the days of six o’clock closing, it would not be unknown for one of his mates to come down to the garage and grab a crate or two for replacement the next day. Dad would have bridled at the accusation of being a ‘sly grogger’, but I’m pretty sure that a licensing inspector may have come to that conclusion.

Timaru is a port town, and many ‘wharfies’ were amongst his customers and friends. Every now and then, there’d be conspiratorial discussion in the tyre room with one of the wharfies. The lube bay doors would be opened, a hulking Chevy would be driven in, and boxes of whisky would be unloaded.

Once, I can remember Dad, having consumed some of the ‘holy wather’ as he called it, putting bottles of whisky in a wheelbarrow and delivering orders to neighbours up and down the street. It was all done with a twinkle in the eye and the celebration of rebelliousness that is a mark of our race.

If you had accused him of being a ‘drug smuggler’, he would have roared with outrage. He hated drugs and all that they seemed to represent. When I was 18, I managed to score a little bit of hash. He found out, and the furore that followed made the current concern around the collapse of Wall St pale in comparison. I could have said Hail Marys forever and crawled around the Stones of Knock for the rest of my life and it would not have assuaged my guilt. If only it had been whisky!

Later in life, and living in Wellington, I moonlighted as a bouncer for some Greek nightclub owners. I had two children and a wife to care for, and my earnings were not enough to adequately care for their increasing needs.

Ten o’clock closing had just been introduced, and Jake the Muss stalked the streets. Large-scale drunken brawls were standard fare. Marijuana was starting to be used socially, and it didn’t take a degree in sociology to observe that some people were a lot nicer to deal with when they had been toking as opposed to drinking. In fact, when there was no dope around, we knew we were going to have a very heavy and violent night on the door.

Fast forward from the 1970s to the new millennium and the widespread use of methamphetamine. For the past five years, driven by the death of friends, I’ve worked really hard to build community resilience against this particular substance. In some quarters, there are now ‘P free’ zones where groups won’t tolerate the presence of methamphetamine.

A couple of weeks ago, there was a party amongst such a group. Because booze is legal, readily available, cheap, strong and so easily drinkable in the form of RTDs, it has again become the primary drug of choice.

The partygoers over imbibed, and a nasty fight broke out. People were injured, and property was damaged. Moreover, family turned against family, and it has taken a lot of körero to calm things down. In reviewing what had gone down, one of the peacemakers – a non-drinker – said to me, “Bro, this is getting like the 1970s again. I’m committed to our (no P) kaupapa but don’t you think we should just go back to smoking dope and lay off the booze?”

The received wisdom is that we take drugs for a variety of reasons: to cope, to self medicate, to forget our troubles and woes, to find structure, to give some theme and purpose to our lives, and for status – to be part of the scene.

At a societal level, we try to control drugs because of intoxication, addiction, impaired decision making, the potential to harm others and the need to look after ourselves.

The drivers to our drug taking are essentially psychological, which suggests we need health-based strategies to drive down demand. I don’t think there is much debate about that. But when it comes to controlling drugs – that is, reducing supply – we lose consensus.

There are powerful lobbies around the continued sale of legal drugs such as alcohol and tobacco. That’s because some people make lots of money out of them. Few people would argue about the harm done by consumption of alcohol and cigarettes but both are currently sold at corner dairies.

Despite the fact that 4,700 New Zealanders are said to die annually from smoking, a major political party has recently rejected the move to keep cigarettes out of sight on the basis that this would be an interference by ‘Nanny State’.

Yet, when it comes to those substances we deem illicit, regardless of any balanced scorecard assessing their respective harm impacts against alcohol and tobacco, we simply turn to prohibition, despite its proven ineffectiveness. The accelerating prison population reflects that fact.

Do illicit drugs cause harm? Absolutely. Do they cause worse harm than legal drugs? On balance, I’m not too sure. I don’t have any easy answers to the conundrum of legalisation or decriminalisation of particular substances. But I am my father’s son, and for some reason, my particular poison is legal and comes in a bottle.

• Denis O’Reilly is a social activist, coach, businessman and a Community Action Youth and Drugs worker with Consultancy Advocacy and Research Trust and Mokai Whänau Ora.

Beyond the cannabis stalemate

Despite cannabis being the most widely used illicit drug worldwide, it is rarely the focus of international drug policy control discussions. In light of this, The Beckley Foundation has released a report claiming prohibition is doing more harm than good and calling for urgent discussions on cannabis policy. If the ‘War on Drugs’ must continue, Rob Zorn asks, is it time we removed cannabis as one of its targets?

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At the United Nations General Assembly Special Session held in New York in June 1998, the international community agreed on a 10-year programme towards eliminating or significantly reducing illicit manufacture, supply and demand for drugs. The optimistic slogan under which the programme was agreed was ‘A drug free world – we can do it!’

In March 2007, the UN Commission on Narcotic Drugs met in Vienna to decide on issues of global drug control, and one can only guess at the levels of subdued unease delegates must have felt. The 10-year deadline was approaching but, since 1998, drugs had only become cheaper, purer and more readily available.

At that Vienna meeting, it was agreed that a high-level political gathering would be held in the spring of 2009 to review progress and to agree the way forward for the next 10 years. It is difficult to think of an optimistic slogan that could underpin this meeting given there has been no significant progress in controlling illicit drugs pretty much anywhere.

Influenced largely by the United States’ ‘zero tolerance’ policies, the 10 years of drug control efforts worldwide have mostly amounted to a ‘War on Drugs’ approach, with drug policy options for governments limited to little more than varying the severity of penalties for drug offences.

Cannabis is the most widely used drug in the world by far, with an estimated 160 million people using cannabis in 2005. Despite this, cannabis has received little direct attention in international drug policy discussions.

This, then, is the context in which UK think tank The Beckley Foundation convened a team of international drug policy experts, the Global Cannabis Commission, to prepare an overview of scientific evidence around cannabis and the policies that attempt to control it. Its report, Cannabis Policy, Moving Beyond Stalemate, was published in 2008, with the aim of bringing cannabis issues to the attention of policy makers and informing discussion at the 2009 United Nations Strategic Drug Policy Review meeting.

While acknowledging that cannabis is not a safe substance, the main thrust of the report is that policies introduced to control cannabis have had little impact on its prevalence and that most of the harms associated with it result from prohibition itself – particularly the social harms arising from arrest and imprisonment.

These findings will not be a surprise to those who have long felt something is seriously out of whack with cannabis laws worldwide.

As the report acknowledges, cannabis can have a negative impact on both physical and mental health. In terms of relative harm, however, it is considerably less damaging than alcohol or tobacco, both of which are freely available and legal. While there have only ever been two deaths worldwide attributed to cannabis, alcohol and tobacco cause literally millions of deaths each year.

More than half the arrests for drugs worldwide are for minor cannabis offences and, suggests the Commission, the damage done by criminalising these minor offenders appears to far outweigh the damage cannabis causes to individuals or society.

In addition to the substantial government resources needed to enforce prohibition, very large secondary costs and suffering result at a personal level. For example, a criminal conviction for cannabis possession can exclude an individual from certain jobs and activities, and arrest can impose humiliation. Cannabis users can be drawn into the criminal world and, in countries where data are available, arrest rates are sharply higher for minority and socially disadvantaged groups.

The report makes several recommendations towards improved cannabis policy, ranging from the mild (police giving low priority to enforcing cannabis laws) through to decriminalisation and legalisation.

In a decriminalised system, offenders could be processed outside the justice system, fines would be low and counselling and education could be offered instead of imprisonment.

If cannabis was made legal, governments could use a variety of mechanisms to regulate it such as taxation, availability controls, minimum legal age for use and purchase, labelling and potency limits. This would greatly increase harm minimisation possibilities such as delaying onset of use until early adulthood and encouraging users to avoid driving after taking cannabis. However, as the report states: “That which is prohibited cannot be regulated.”

The report favours a decriminalised, regulated market in cannabis as the best option, but it acknowledges that those working for decriminalisation, legalisation or any significant reform face an uphill battle.

Firstly, the UN drug control conventions require cannabis use to be an offence (although there is debate over the interpretation of this and the flexibility allowed by the conventions). States that have begun relaxing cannabis laws can therefore expect to be pressured at the UN level. The Netherlands, for example, has been rebuked by the European Union, the United Nations Office of Drugs and Crime, the USA and other countries who say its relaxed cannabis policies undermine international collaborative efforts to reduce illicit drug use, production and trafficking.

A second problem will be in generating sufficient political will to bring about legislative change. There are two reasons for this. Firstly, there is vocal opposition in most jurisdictions to relaxing drug laws by those who say legalisation will encourage increased cannabis use and lead to experimentation with harder drugs. Secondly, popular opinion usually supports retention of prohibition, and in most democratic countries, the majority of politicians’ views will reflect the majority of the population’s.

Therefore the report’s call for a re-think on policy so that it becomes grounded on an evidence-based scale of harm may largely be falling on deaf ears. In the UK, for example, cannabis was downgraded from Class B to Class C when Tony Blair was Prime Minister, making police unlikely to arrest people carrying small amounts and moving Britain closer to the ‘relaxed nation’ category. However, Home Secretary Jacqui Smith has pledged to reclassify the drug to Class B to avoid “risking the future health of young people”. This is despite having read the Commission’s report and accepting most of its other recommendations.

Nevertheless, the report outlines four possibilities for governments seeking to make cannabis available in a regulated market in the context of existing international conventions.

The first option is to follow the Dutch model, which technically meets the letter of the law while allowing de facto access to cannabis. Secondly, a nation may simply ignore the conventions, though any government following that route must be prepared to withstand substantial international pressure, the report warns.

A third option would be to denounce the 1961 and 1968 conventions and then re-accede with reservations respecting cannabis. Finally, along with other willing countries, a state could negotiate a new cannabis convention on a supranational basis.

“We wanted to facilitate an informed debate and then… present some options on what individual countries could do,” co-author Benedikt Fischer, a professor of health sciences at Canada’s Simon Fraser University, told the Edmonton Sun.

“I will say to [Canadian Prime Minister] Mr Harper that, even from a conservative policy point of view, there are many, many good reasons to not be content with the status quo of cannabis use control in this country.

“It costs a lot of money, it’s very ineffective and it’s counterproductive.”

We’re now more than 10 years on from the UN General Assembly’s declared intention to bring about a drug-free world, and they clearly haven’t done it. When it meets again this year, surely alternatives to prohibition will have to be considered. But current conventions have kept cannabis illegal in all countries, and these will not be reversed overnight.

The best we can probably hope for is that a process will be started to change the international drug control conventions to allow a state to implement its own cannabis control strategies within its own borders.

It will be interesting to see what happens, but somehow we’re unlikely to see the assembled delegates accepting the slogan: ‘A drug free world – we’re not even going to try’.

• Rob Zorn is a Welington-based writer.

The Global Cannabis Commission report, Cannabis Policy: Moving Beyond Stalemate is avaliable at The Beckley Foundation website, www.beckleyfoundation.org.