Neither extreme prohibition nor extreme liberalism is a sensible drugs policy – on medical cannabis and elsewhere, let’s see what the facts say

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DURING the cold war, the term “domino effect” was popularised to describe how, if one country succumbed to communism, its neighbours would also topple. It is now being applied to another object of 1950s American paranoia: cannabis. Over the past 22 years, waves of reform have spread across the US, with state after state legalising medical cannabis in one form or another.

The UK is the latest domino to topple, or at least shift its position. After a public outcry over two children with severe epilepsy being denied cannabis oil, last week Home Secretary Sajid Javid announced that cannabis-derived medicinal products will soon be available on prescription. Exactly what this means remains hazy: health authorities have been asked to define what a cannabis-derived medicinal product is. The UK has already approved Sativex, an oral spray derived from cannabis plants, for treating muscle spasms in people with multiple sclerosis, although the National Health Service will not pay for it because it is not considered cost-effective.

The announcement is welcome progress towards an evidence-based system for regulating cannabis. New Scientist has long argued for such an approach for all drugs. Rigid prohibitionist ideology has not worked.


But evidence cuts both ways – and that for the effectiveness of medical cannabis is surprisingly thin (see “Medical marijuana: What you really need to know”). At the same time, there are dangers in allowing medical cannabis, not least that it could lead to back-door legalisation of recreational use without proper debate.

But at least we are now having the discussion, which should allow policy to be guided by science rather than dogma. If the tumbling of the medical cannabis domino sets in train a more rational debate across the board, let it fall.

This article appeared in print under the headline “Drug science before dogma”