Commercialisation could be dangerous

There is a growing movement in the West to legalise cannabis, with rumblings of the same in India. Having conducted medical research on cannabis at Yale University for several decades, we urge India to carefully weigh the risks and benefits of cannabis before blindly following suit with the West.

In India, cannabis, also known as bhang, ganja, charas or hashish, is typically eaten (bhang golis, thandai, pakoras, lassi, etc.) or smoked (chillum or cigarette). Its potency depends on the content of its principal active constituent, tetrahydrocannabinol, though cannabis contains more than 500 other chemicals. In India, there is a tradition of using cannabis in many religious contexts. But although Ayurvedic texts refer to cannabis as a treatment for several maladies, what is often overlooked is that it is categorised as Upavisha Varga (sub poisonous), and its recreational use has been described as toxic.

Busting myths

There are many misconceptions about cannabis. First, it is not accurate that cannabis is harmless. Its immediate effects include impairments in memory and in mental processes, including ones that are critical for driving. Long-term use of cannabis may lead to the development of addiction of the substance, persistent cognitive deficits, and of mental health problems like schizophrenia, depression and anxiety. Exposure to cannabis in adolescence can alter brain development.

A second myth is that if cannabis is legalised and regulated, its harms can be minimised. With legalisation comes commercialisation. This comes at a cost which we have seen with tobacco and alcohol over the last century. The morbidity and mortality associated with tobacco and alcohol rank amongst the top 10 in terms of the global disease burden. Tobacco, too, was initially touted as a natural and harmless plant that had been “safely” used in South American religious ceremonies for centuries. The tobacco industry invented cigarettes for ease of use, altered the acidity of tobacco to make it less harsh, added other chemicals to improve its taste, mass-produced cigarettes, and sold them using sophisticated advertising. It manipulated knowledge about the adverse effects of tobacco despite being aware of these effects, and successfully staved off legal battles for decades. No amount of taxation of the tobacco industry can compensate for the health toll on billions of tobacco users over the last century. Despite knowledge of the risks of smoking, cigarettes remain legal and the tobacco industry continues to thrive. This also highlights the point that once out, the genie cannot be put back into the bottle.

It’s important to make a distinction between legalisation, decriminalisation and commercialisation. While legalisation and decriminalisation are mostly used in a legal context, commercialisation relates to the business side of things. The goal of commercialisation is to sell as much of the product, and the cannabis industry is steadily growing in the U.S. In fact, as the sale of tobacco products have shown signs of a decline in the West, some tobacco companies have entered the cannabis market. Altria, the maker of Marlboro cigarettes, has invested $1.8 billion (₹12,400 crore) in the cannabis grower Cronos Group. These commercial entities will bring their wealth of experience navigating the law, their successful marketing, their well-oiled lobbying, and deep pockets to influence the government to maximise profit and minimise risk to their commercial enterprise. In the U.S., cannabis is being incorrectly advertised as being “natural” and “healthier than alcohol and tobacco”. Commercial entities also understand that targeting the young assures them lifelong customers. A new array of cannabis products in the form of ice creams, sweets, and even soft-drinks are becoming available. The West also says that legalising and regulating cannabis will “undermine criminal markets”. Congress MP Shashi Tharoor echoed this view last year. Yet, as we have seen in Colorado, the black market has only increased.

Considering alternatives

In 1961, driven by Western nations, the UN sponsored an international treaty to prohibit the production and supply of drugs including cannabis. India resisted and negotiated exceptions, loopholes, and deferrals. It is ironic that the West is now legalising cannabis and other drugs. Given that some in India are clamouring for the same, the country should carefully consider all the risks, and consider alternatives. One, it could decriminalise cannabis but forbid commercialisation. Two, if India were to liberalise its policy on cannabis, it should ensure that there are enough protections for children, the young, and those with severe mental illnesses, who are most vulnerable to its effects. Finally, treatments for those who become addicted to cannabis should be offered.

Deepak Cyril D’Souza is Professor of Psychiatry at the Yale University School of Medicine and Jatinder Singh is a research fellow in the Department of Psychiatry, Yale University School of Medicine