Organised by Uruguay with the support of Canada, Colombia, Czechia, the Netherlands and South Africa
(…): Years ago, a side event like this would’ve been unlikely. The panel will share experiences in regulation in our countries.
Daniel Radío, National Drug Secretariat, Uruguay: Our country pioneered cannabis regulation but you may not know much about Uruguay. 2nd smallest country of the Americas. Southernmost capital of the continent. Democratic republic. Presidential system. The concept of non-penalisation of cannabis and other substances was not introduced in 2013, it was always been in force in our country. It’s not a temporary decision but represents a historical coherence for Uruguay, in line with our Constitution, which states in art 10 that private actions of individuals that do not attack public order or third parties are exempt from prosecution. The use of substances is part of this criteria. Regulators have recognised the rights of individuals to possess substances. Second important aspect to remember is that our perspective didn’t really lead to a greater scope, intensity or frequency of consumption in the country compared to neighbours. Uruguay has designed an alternative system. Regulated framework where the states regulates cannabis markets to reduce the harms derived from the illegal market, which not matter how we announce crackdowns, has achieved the control of the supply. Building on a preexisting clandestine market, controlled by criminal organisations, a legal regulation was introduced to establish clear rules to produce and access cannabis for different purposes (medical, industrial and adult / recreational). The goal is provide an option for accessing substances through non-illegal channels to ensure users do not get involved with criminal organisations. It establishes the creation of the IRCCA, a body in charge of regulation and control. Establishes a duty of educational campaign and awarness raising for young people on the risks, effects and potential harms, in collaboration with the Drugs Secretariat. Regarding non-medical, users must be at least 18 and access through: membership clubs, home growing and pharmacies. In July 2017, 4,000 registered buyers in pharmacies. The register has increased to 25,000 buyers. Today, 51,000 users registered to buy. We also have 15,000 cultivators domestically and many thousands of people engaged in membership cooperatives. According to our latest statistics, the number of users has been increasing as in other regions. How does the law impact this increase? The use of cannabis has been growing and in 2013 we started legalisation and there’s no reason to believe regulation interrupted that trend. It was not a positive or negative effect on consumption. The upward curve didn’t change its slope ‑no acceleration or deacceleration. When we break down by age, the greatest growth 26-36. Smaller increase in younger adults. The average starting went from 18 years to 20 in 2018. It’s a myth that people will be younger and younger as a result of legal regulation. Age of onset went up, actually. 40% of all cannabis users in our country are using one of the legal avenues. When we’re told that this does not affect trafficking —of course it isn’t over. But achieving this percentage is a feat. That means less human tragedies in relation to engagement in organised crime. Reduction in pressed cannabis coming from abroad. They prefer cannabis grown at home. Prices have gone down on that kind of cannabis so traffickers profit less from importing this cannabis. The regulation of cannabis is a relatively young public policy, adopted in 2013 and fully implemented in 2017. It’s a policy in progress; an opportunity to change paradigms. A huge responsibility. Huge adjustments to make. Our model appears to be more restrictive. We could be more flexible about registrations and quantitative limits. We need to have more varieties of cannabis available. More dispensaries. Non-residents must be able to access. Maybe different taxation too. As a community, we have a responsibility that people who decide to use cannabis do not need to rely on the informal market. The connection with the drug world is bad per se, not because of substances but because of the unsafe relationships it entails. The market generated jobs. A pioneering industry that can support evolving research, medical uses, industries. Legal regulation achieving 100% of the market would relay the informal market to a memory of the past, paving the way for an industry with a low health risk. Some people share a beer or fine wine. Some of us drink mate. Or in the Andes, coca leaf tea. Others share cannabis. In Uruguay, adult cannabis users are parents of all creeds. No different from someone in a book club, wine tasting, seeking good coffee. Their moral standing does not depend on the grams of cannabis they consume. As with other things that can be dangerous, like tobacco and firearms, it is possible to regulate and control adult cannabis use so that people can exercise their right. It’s not about changing, deceiving or seducing anyone. It’s about listening, and empowering our citizens.
Hanan Abramovici, Canada: Just some background information first. In October 2018, the Cannabis Act came into force and legalised and strictly regulated cannabis. The purpose is promoting public health and safety with respect to cannabis to protect youth and young persons, restrict inducements, providing for the legal production of a controlled supply, enhancing information about health risks to minimise them. Important to consider that it’s early days for Canada. We have a limited number of years since enactment. Also, there’s two phases —all types of cannabis (including edibles, extracts and topicals) were available only after 2019. Canadians effectively only had access to these until the beginning of 2020. The COVID-19 pandemic also hit, which had effects on people’s use patterns. The latest available data is from 2022. It’s only been 4.5 years since implementation from Phase I and 2.5 years for Phase II. In terms of the data. About youth cannabis use. The takeaway is that there’s been no change in past year use in youth. No change in daily/almost daily use. You can see it on the graph. Initial increase but then downward. The prevalence of use remains high. It’s always been high in Canada. Almost 30% of youth report past-year use. ⅕ reported daily/near-daily. Still pretty high but it was high before legalisation too. In terms of age of initiation for youth and perceived ease of access: nothing has changed – average is 14 years of age. No change in perceived ease of access but the data is from 2018-2019. In terms of consumption methods, smoking remains the primary consumption method for youth —but we observe a decrease in smoking and an increase in vaping and use of edibles. Shift in consumer preferences among young people. In terms of risk perception. More youth perceiving regular smoking and vaping carrying risk. Less perceive cannabis as a harmless substance. But decrease in awareness of public education —perhaps because of COVID-19 because it took over the attention among the population, so less was seen in public education. In terms of public health impacts, there has been a significant increase in hospitalisations and emergency department visits —but only a few provinces report on this (Alberta and Ontario, principally). This is mostly about children under the age of 5 because of accidental ingestion of edible products coming from illegal or unknown sources of cannabis. We don’t see an increase in hospitalisation of teenagers. In terms of the general population, there has been an increase in past year and past 3 months use. This increase extends previous trends as cannabis use has been on the rise in the general population. Increase in use in young adults 20-24 —higher in men. In terms of frequency of cannabis use among adults, what we see is that there’s no clear trend at this point in time. About 6% report daily or almost daily use. ¼ of past-year consumers report frequent cannabis use. In terms of consumption methods, similar patterns as in youth —with 1 difference: in adults, no change in vaping cannabis; there’s a high prevalence of smoking that’s decreasing and increase in edible use…but not in vaping. In terms of the sources of cannabis, the most prevalent source is the legal market —a considerable shift, from 2019 40% through legal sources, to 70% sourcing their cannabis from the legal market. This trend continues and is displacing the illegal market. Exception in men who are daily users and individuals with lower level of education. No change in cannabis-related hospitalisations among adults. There’s been an increase however in 3 jurisdictions (Ontario, Alberta, Yukon). Summing up: Youth cannabis use has remained stable; past year cannabis use among the general population has increased —extending an existing trend pre-legalisation; no change in proportion of daily/near daily consumers; risk perception of cannabis use has increased among young people; majority of consumers sourcing from the legal market; smoking cannabis has decreased while ingesting cannabis has increased; cannabis vaping among youth has increased. In terms of the limitations and data gaps: we have limited data, we’re still in early years and it can take up to 10 years to understand the full impact —so we have a lot of work in terms of surveillance and research. We need to strengthen data on cannabis poisoning as the systems are not disaggregating by source. We need better understanding of association between legalisation and mental health conditions. We need also more info on impact on different marginalised populations as well as different geographical locations.
Victor Sannes, Netherlands: The policy of drugs in our country we say it’s evidence based. BUt we keep in mind the balance between public health and law enforcement. It’s also pragmatic. We try to find ways that work. Cannabis policy is an example of this —including through unconventional ways. We make the distinction between soft (cannabis, NOS) and hard drugs (cocaine, heroin). This is at the heart of the ‘tolerance policy’, where cannabis supply is all illegal but tolerated sales in coffeeshops that are not prosecuted. We don’t prosecute the shops and the people with small amounts. The shops have to apply to certain rules, the AHOJGI —no advertising, no hard drugs, no public nuisance, no entry to young people, no large quantities, max stock of 500g, only to residents. Additional criteria can be added by local authorities. More than 500 coffeeshops —30% of municipalities. Most (more than 40%) in the 3 biggest municipalities, Rotterdam, Amsterdam, the Hague. It’s becoming hard for us to explain why supply is not tolerated but sales are. The criteria of maximum stock of half a kilo is a small quantity, which means that around the coffeeshops there are stocks all over neighbouring areas, which is an issue for security. The Coalition government in 2017 agreed to an experiment in legal cultivation and supply. Study the effects of this regulated supply chain on health, nuisance, safety, crime. We wanted to do this evidence based and scientific as possible. The Cabinet established a group of experts from police and public administration, suggesting how to carry out the experiment. We selected 10 municipalities and 10 non participating municipalities. As well as 10 growers with quality controls (no contamination, pesticides or biocides, accurately labelled) and there will be a scientific evaluation after 4 years. Preparation phase: growing cannabis and municipalities preparing for sale in coffeeshops. Transition phase: experimental regime for 4 years. The results will support political decision making. Within the experiment, attention has gone to prevention and education. We don’t seek to increase cannabis use. Drug use is harmful. In the Netherlands, cannabis is often smoked with tobacco and there’s compounded health risks. But the experience with tobacco shows us we can regulate to prevent: labelling, plain packaging —all these measures we learnt from tobacco control. But also obligations for the staff of shops: information, awareness of what they’re selling. The participating municipalities also involved in a prevention approach. We have completed the selection of municipalities —1 small and 9 larger. The parliamentary process is ready —experiment law in force. 10 growers, producers. The first one is growing and more is coming. The selection took longer than expected. Because we had a very careful process of selection to ensure that criminal organisations are not part of the experiment but rather to include growers who are not part of criminal organisations. We realised the track & trace system. Contracted consortium of researchers on scientific evaluation, every year monitoring reports and conducting a baseline. This is how we can find out whether this works. We are gathering data and will take the time to consider what the data says. At the end of this year and beginning of next one, we expect a beginning of the transition phase. We don’t want to jump to conclusions. Important to wait.
Luisa Fernanda Gomes Bermejo, Colombia: Colombia began in 2017 a licensing system. Five years of lessons, consolidating industry, learning about varieties grown in our territories. Colombia currently has a licensing system that allows cultivation and production of derivatives of cannabis to avoid fraudulent products. Cultivation and production of raw materials, which determine the type of licence. To plant and produce cannabis for export commercialisation or supply to manufacturing, licence for cannabis growing by the Ministry of Justice. To transform into derivatives, depending on psychoactives or non-psychoactives, by the Department of Medical Surveillance. Because there’s different authorities involved, in 2020, we launched the system of information which is a one-stop shop for the licensing system. The current law allows the secure use of cannabis and the plant, regulating the production, exportation and the production of finished and raw products; as well as industrial products. We also look at new possibilities like the adult use of cannabis prioritising rights and the protection of life. There’s several bills on this matter to regulate this and other uses. Colombia has been a pioneer in regulatory action. We want to support alternative uses as part of a national policy to overcome prohibition and focus on health, human rights and social justice. Supporting small and medium-sized producers especially in marginalised communities. We also seek to support research on the uses of all parts of the plants and optimising production. Cannabis offers the opportunity to export raw products or pharmaceutical products, which is a novelty as we tend to import our medicines. On the other hand, we are promoting access to quality information on the industrial, environmental and health benefits of the plant —eliminating stigma, focusing on prevention and harm reduction. Our country has advantages in terms of climate, new drug policy beyond prohibition as well as agricultural industry. The new drug policy implies a transit away from prohibition, into a regulatory framework that is just and responsible. Protecting life and decreasing damaging impacts of illegal industry. We seek total peace, and will integrate international experiences, as well as the involvement of all communities and territories —particularly those most affected by illegal drug industries and prohibition.