Transform: Regulated drug markets in practice - Cannabis

Aus „After the War on Drugs: Blueprint for Regulation„, Transform Drug Policy Foundation, Lizenz: Creative Commons ‘Attribution Non-Commercial Share Alike’

5 Regulated drug markets in practice

5.3 Cannabis

(See also: 3.1.1 Legal cannabis production, page 35, and Appendix 2, page 206).
A large body of literature, research and real world experience can be drawn on to help plot out legal models for cannabis supply and use. In fact, for a drug covered by the UN conventions, cannabis already uniquely spans the drug control spectrum, with examples of almost all regulatory approaches in evidence around the world. These run from extreme prohibition to quasi-legal regulated supply and use. Of particular relevance is the Netherlands’ experience with its unique ‘coffee shop’ system, a de facto legal licensing of supply and use that has been running since 1976. On one level, the system has problems. A primary issue is the so-called ‘back door problem’; that is, the fact that while both possession and supply from the coffee-shops is tolerated, with the former being effectively legal and the latter licensed, cannabis production itself remains illegal.

This means that coffee shops are forced to source it from an illicit market place. This paradoxical situation is due primarily to the constraints of the UN conventions to which the Netherlands is a signatory. The fact that the Netherlands’ de facto legal supply is unique amongst its immediate geographic region has also caused problems of ‘drug tourism’ at its borders, with substantial numbers of buyers entering the country solely for procurement. The Netherlands’ pragmatic approach has also made them the subject of concerted political attacks and critique from reform opponents on the international stage.

Nonetheless, the licensing models for the coffee shops themselves are well developed. They demonstrably function effectively and without significant problems. Where specific problems have emerged policy has evolved, regulations have been introduced or tightened, and some coffee shops have been closed. Of course, this has not been achieved without some controversy. However, the overall success of the approach has, since its mid-70s introduction, led to growing support from key domestic audiences including the police, policy making and public health bodies, and the general public.

International comparisons are fraught with methodological problems; nonetheless, it is striking that the Netherlands does not have higher levels of use than neighbouring countries, who do not share its tolerant approach and licensed outlets, undermining the simplistic notion that legal availability is the key factor in determining prevalence of use. Certainly, the nightmare scenarios often put forward by opponents of legal regulation have failed to materialise.

More recently, California and other US states have developed medical cannabis supply models. These schemes are often largely indistinguish- able from the regulated supply models proposed here for non-medical use. Indeed, somewhat controversially, a proportion of the ‘medical’ supply has clearly become a de facto non-medical supply infrastructure.62 Analysis of cannabis health risks have historically become confused with, and distorted by the political debate over the drug’s legal status. Viewed objectively, however, the risks associated with cannabis use are well understood and have been exhaustively chronicled. There are particular risks associated with heavy frequent use (especially of stronger/more potent varieties), use by non-adults, use by those with certain mental health problems, and smoking related lung damage— especially when smoked with tobacco.

Acute and chronic toxicity, and propensity for dependence to emerge are both low relative to most other commonly used drugs, including tobacco and alcohol. Most cannabis use is moderate, occasional and not significantly harmful, suggesting that, as elsewhere, the attention of regulators and policy makers needs to focus resources on the minority of users who do, or are likely to experience real problems. Despite the obvious differences, the nature and extent of cannabis use means that, more than any other currently illicit drug, it lends itself to the lessons learnt from alcohol and tobacco control. As such, the WHO Framework Convention for Tobacco Control (which could almost be adapted for cannabis merely by switching the words, see: page 106), and the WHO guidance on alcohol regulation, provide a sound basis for cannabis regulation models.

Proposed discussion model for regulation of cannabis

basic regulatory models

> The basic models would involve various forms of licensed sales, for consumption on premises or for take-out—these would be conditional on controls outlined below, and would not preclude a potential pharmacy sales model.

> A regulated market model (see: page 27) might be an appropriate incremental step as legal supply infrastructure and outlets were established. A key task of any regulatory body would be to manage supply so as to prevent the emergence of branded products and limit all forms of profit driven marketing and promotions.

> Freed from the distorting influence of the non-medical use debate, prescription models supporting medical use of cannabis, or its derivatives, could develop based on evidence. They would assume a much lower profile than is currently the case. controls over the product

Dosage and preparation:

> Controls could manage the strength/potency of herbal or resin form cannabis, based on relative proportions of active ingredients (that is, ratio of THC [tetrahydrocannabinol] to CBD [cannabidiol]). Maximum and minimum % content could be specified.

> Controls could be put in place to cover potentially toxic contaminants: for example, pesticides, fertilisers, or biological agents such as fungus.63

> Different types of cannabis products from different producers could still be identified by name and producer, perhaps with an ‘appellation d’origine controllée’ style certification. Generic cannabis products could also be available, subject to the controls outlined above.

> Cannabis prepared for oral consumption (e.g. in cakes or brownies) would need to be sold in appropriately labelled standardised units, based on product weight and active ingredient content/strength per unit. There are particular issues around the difficulty in dosing/self-titrating when cannabis is eaten.

> In much of Europe there is a strong association between the use of tobacco and cannabis which are often smoked together. Legal outlets could be in the forefront of addressing this health concern, helping bring about the cultural and attitudinal changes which would minimise cannabis related tobacco use.

Price controls

> Fixed unit prices or minimum/maximum prices could be specified—with taxation included on a per unit weight or % basis.

> Stronger or more potent preparations could have higher prices/tax rates specified.

> It is likely that prices would be similar to or marginally lower than current illicit market prices. Prices are relatively low anyway, and the need to de-incentivise illicit production and sale is less pressing than with many other drugs.

Packaging controls

> Tamper proofing – where appropriate.

> Childproof containers (medical pill bottles/canisters).

> Standard labelling—contents (strength/potency), units, health warnings, use by dates etc. Licensed purchaser details as appropriate. Sales for use on premises would not necessarily have the above requirements. controls over the vendor/supply outlet

Advertising/promotion

> Cannabis use is embedded in much popular culture. Cannabis products and product iconography are generally non-branded and generic, so a blanket prohibition of anything that might constitute promotion or advertising of cannabis would therefore be impractical. Reasonable controls on exposure to children and young people may be easier to put in place, but would remain difficult to globally define and enforce. However, best practice and evidence from existing controls already widely applied to references to drugs—legal and illegal—in youth media and advertising can be more widely applied.

> Clear lessons can be learnt from experiences with restrictions on promotions and marketing of alcohol and tobacco. Areas where cannabis advertising promotion controls are more realistic include:

> Advertising for venues for commercial sales could be limited both in content and scope—for example, to specialist publications, or adult only venues. A complete ban on advertising for promotion of venues is not realistic. Dutch coffee shops are not allowed to advertise but do to some extent—the prohibition in practice acts as a moderating influence, rather than a total ban.

> Restrictions could be placed on appearance and signage of venues/outlets. In the Netherlands, coffee shops are not allowed to make external references to cannabis, or use related imagery. Rastafari imagery, a palm leaf image, and the words ‘coffee shop’ have become the default signage.

> Restrictions could be placed on advertising for certain types of paraphernalia that contain drug references.

Location/density of outlets

> Zoning controls could be exercised by local licensing authority in a similar fashion to licensing of outlets for alcohol sales. Controls could also be exercised over size and type of outlets. This is the case in the Netherlands where, for example, some municipalities do not permit coffee shops (leading to some internal domestic ‘drug tourism’), and others have closed coffee shops near to schools. This latter seems excessive in a dense urban environment, and is probably more politically motivated— controls similar to those already used to manage bars/off licenses would be adequate in such cases.

Licensing of vendors/suppliers—general

> Broadly similar to licensing of commercial alcohol vendors/ licensees.

> Additional requirement for relevant health and safety training of vendors—for example, to restrict sales to those already intoxicated, offer advice on services, etc.

> Shared responsibility re: public nuisance in immediate environment, litter, local enforcement costs.

> Outlets would, initially at least, be limited to sale/consumption of cannabis only. In the Netherlands prohibition of sale of all other drugs, including alcohol, is a non-negotiable licence condition.

> All vendors would be required to promote responsible, safer use, and prominently provide drug information and information on relevant drug services.

> Venues also offering food or live music would come under the same local regulatory infrastructure, security and health and safety requirements.

> Permitted hours of opening would be determined by the local licensing authority.

> The Dutch coffee shops are restricted to holding less than 300g on the premises at anytime. This is largely designed to control illicit ‘back door’ supply; such limits would probably not be necessary for licensed premises under a legal regulated production scenario.

Volume sales/rationing controls

> Restrictions on bulk sales could be put in place, establishing a reasonable threshold for personal use. A 5g limit operates in the Netherlands. There is nothing to prevent multiple purchasing from different outlets; however, the general ease of cannabis availability means that such multiple purchasing is a marginal issue. controls over the purchaser/user

Age access controls

> Vendors would be required to enforce age controls though an ID system—precise age of access would be locally determined but they would likely be in line with local alcohol and tobacco access age limits. In the Netherlands the age limit for coffee shops is 18.

Degree of intoxication of purchaser.

> Vendors would be required to refuse sales to those clearly intoxicated according to a clear set of guidelines. Drunkenness would be the most obvious concern. licences for purchasers/users

> The Netherlands’ experience suggests that licences to buy are probably unnecessary. However, they might usefully be deployed in certain scenarios, either as part of an incremental roll out process, or where specific problems arose. For example, in the Netherlands a residents only condition on sale is being introduced in some locations to deal with cross border trade issues, and there has also been recent discussion about making coffee shops members only.

Limitations in allowed locations for consumption

> Zoning laws familiar from alcohol control could designate public spaces, or areas with potential public order issues, as non-smoking areas. These laws would support and build on local ordinances concerning public intoxication or disorderly conduct.

> Pre-existing restrictions on smoking in indoor public spaces would also apply to cannabis smoking.64 As with tobacco, smoking in public venues could only take place on open air terraces or similar. Such a prohibition, involving civil or administrative sanction rather than a criminal offence, could be used to encourage less harmful forms of cannabis consumption. Vaporisers—which do not generate smoke and are not associated with the specific smoke related cannabis risks—could be exempted from no-smoking ordinances.65

Alternative Drogenpolitik

Transform: Regulated drug markets in practice – Cannabis