CANNABIS :

OUR POSITION FOR A CANADIAN PUBLIC POLICY

REPORT OF THE SENATE SPECIAL COMMITTEE ON ILLEGAL DRUGS

SUMMARY

Chairman: Pierre Claude Nolin

Deputy Chairman: Colin Kenny

SEPTEMBER 2002

Committee Members

SENATORS

Senator Tommy BANKS

Senator Sharon CARSTAIRS, P.C. (ex officio)

Senator Colin KENNY, Deputy Chair

Senator Noel A. KINSELLA (ex officio)

Senator John LYNCH-STAUNTON (ex officio)

Senator Shirley MAHEU

Senator Pierre Claude NOLIN, Chair

Senator Fernand ROBICHAUD, P.C. (ex officio)

Senator Eileen ROSSITER

STAFF

Clerk: Blair Armitage

Assistant Clerk: Daniel Charbonneau

Assistant Clerk: Adam Thompson

Director of Research: Daniel Sansfaçon

Research assistants :

Gérald Lafrenière

Chantal Collin

François Dubois

Barbara Wheelock

Communication Advisors :

Jean-Guy Desgagné

David Newman

Diane Boucher

Administrative Assistants:

Nicole Bouchard

Martine DeLaunière

Brigitte Martineau

Krista Durrell

Glossary of key terms

Abuse

Vague term with a variety of meanings depending on the social, medical and legal contexts. Some equate any use of illicit drugs to abuse: for example, the international conventions consider that any use of drugs other than for medical or scientific purposes is abuse. The Diagnosis and Statistical Manual of the American Psychiatric Association defines abuse as a maladaptive pattern of substance use leading to clinically significant impairment or distress as defined by one or more of four criteria (see Chapter 7). In the Report, we prefer the term excessive use (or harmful use).

Acute effects

Refers to effects resulting from the administration of any drug and specifically to its short term effects. These effects are distinguished between central (cerebral functions) and peripheral (nervous system). Effects are dose-related.

Addiction

General term referring to the concepts of tolerance and dependency. According to WHO addiction is the repeated use of a psychoactive substance to the extent that the user is periodically or chronically intoxicated, shows a compulsion to take the preferred substance, has great difficulty in voluntarily ceasing or modifying substance use, and exhibits determination to obtain the substance by almost any means. Some authors prefer the term addiction to dependence, because the former also refers to the evolutive process preceding dependence.

Agonist A substance that acts on receptor sites to produce certain responses.

Anandamide

Agonist neurotransmitter of the endogenous cannabinoid system. Although not yet fully understood in research, these neurotransmitters seem to act as modulators as THC increases, the liberation of dopamine in nucleus accumbens and in the cerebral cortex.

At-risk use Use behaviour which makes users at risk of developing dependence to the substance. Cannabinoids

Endogenous receptors of the active cannabis molecules, particularly Delta 9-THC. Two endogenous receptors have been identified: CB1 densely concentrated in the hippacampus, basal ganglia, cerebellum and cerebral cortex, and CB2, particularly abundant in the immune system. The central effects of cannabis appear to be related only to CB1.

Cannabis

Three varieties of the cannabis plant exist: cannabis sativa, cannabis indica, and cannabis ruredalis. Cannabis sativa is the most commonly found, growing in almost any soil condition. The cannabis plant has been known in China for about 6000 years. The flowering tops and leaves are used to produce the smoked cannabis. Common terms used to refer to cannabis are pot, marijuana, dope, ganja, hemp. Hashish is produced from the extracted resin. Classified as a psychotropic drug, cannabis is a modulator of the central nervous system. It contains over 460 known chemicals, of which 60 are cannabinoids. Delta-9-tétrahydrocannabinol, referred to as THC, is the principal active ingredient of cannabis. Other components such delta-8-tétrahydrocannabinol, cannabinol and cannabidiol are present in smaller quantities and have no significant impacts on behaviour or perception. However, they may modulate the overall effects of the substance.

Commission on narcotic drugs (CND)

The Commission on Narcotic Drugs (CND) was established in 1946 by the Economic and Social Council of the United Nations. It is the central policy-making body within the UN system for dealing with all drug-related matters. The Commission analyses the world drug abuse situation and develops proposals to strengthen international drug control.

Chronic effects

Refers to effects which are delayed or develop after repeated use. In the report we prefer to use the term consequences of repeated use rather than chronic effects.

Decriminalization

Removal of a behaviour or activity from the scope of the criminal justice system. A distinction is usually made between de jure decriminalization, which entails an amendment to criminal legislation, and de facto decriminalization, which involves an administrative decision not to prosecute acts that nonetheless remain against the law. Decriminalization concerns only criminal legislation, and does not mean that the legal system has no further jurisdiction of any kind in this regard. Other, non-criminal, laws may regulate the behaviour or activity that has been decriminalized (civil or regulatory offences, etc.).

Diversion

The use of measures other than prosecution or a criminal conviction for an act that nonetheless remains against the law. Diversion can take place before a charge is formally laid, for example if the accused person agrees to undergo treatment. It can also occur at the time of sentencing, when community service or treatment may be imposed rather than incarceration.

Depenalization

Modification of the sentences provided in criminal legislation for a particular behaviour In the case of cannabis, it generally refers to the removal of custodial sentences.

Dependence

State where the user continues its use of the substance despite significant health, psychological, relational, familial or social problems. Dependence is a complex phenomenon which may have genetic components. Psychological dependence refers to the psychological symptoms associated with craving and physical dependence to tolerance and the adaptation of the organism to chronic use. The American Psychiatric Association has proposed seven criteria (see Chapter 7).

Dopamine

Neuromediator involved in the mechanisms of pleasure.

Drug

Any chemical agent that alters the biochemical or physiological processes of tissues or organisms. In this sense, the term drug refers better to any substance which is principally used for its psychoactive effects. Also used to refer to illicit rather than licit (such as nicotine, alcohol or medicines) substances.

European Monitoring Centre on Drugs and Drug Addiction (EMCDDA)

The European Monitoring Centre was created in 1993 to provide member states within the EU objective, reliable and comparable information on drugs, drug addictions and their consequences. Statistical information, documents and techniques developed in the EMCDDA are designed to give a broad perspective on drug issues in Europe. The Centre only deals with information. It relies on national focal points in each of the Member States.

Fat soluble

Characteristic of a substance to irrigate the tissues quickly. THC is highly fat-soluble.

Gateway / Gateway Theory

Theory suggesting a sequential pattern in involvement in drug use from nicotine to alcohol, to cannabis and then to “hard” drugs. In regard to cannabis, the theory rests on a statistical association between the use of hard drugs and the fact that these users have generally used cannabis as their first illicit drug. This theory has not been validated by empirical research and is considered outdated.

Half-life

Time needed for the concentration of a particular drug in blood to decline to half its maximum level. The half-life of THC is 4.3 days on average but is faster in regular users than in occasional users. Because it is highly fat soluble, THC is stored in fatty tissues, thus increasing its half-life to as much as 7 to 12 days. Prolonged use of cannabis increases the period of time needed to eliminate it from the system. Even one week after use, THC metabolites may remain in the system. They are gradually metabolised in the urine (one third) and in feces (two thirds). Traces of inactive THC metabolites can be detected as long as 30 days after use.

Hashish Resinous extract from the flowering tops of the cannabis plant transformed into a paste.

International conventions

Various international conventions have been adopted by the international community since 1912, first under the League of Nations, then under the United Nations, to regulate the possession, use, production, distribution, sale, etc., of various psychotropic substances. Currently, the three main conventions in force are the 1961 Single Convention, the 1971 Convention on Psychotropic Substance and the 1988 Convention against Illicit Traffic. Canada is a signatory to all three conventions. Subject to countries’ national constitutions, these conventions establish a system of regulation where only medical and scientific uses are permitted. This system is based on the prohibition of source plants (coca, opium and cannabis) and the regulation of synthetic chemicals produced by pharmaceutical companies.

International Narcotics Control Board (INCB)

The Board is an independent, quasi-judicial organization responsible for monitoring the implementation of the UN conventions on drugs. It was created in 1968 as a follow up to the 1961 Single Convention, but had predecessors as early as the 1930s. The Board makes recommendations to the UN Commission on Narcotics with respect to additions or deletions in the appendices of the conventions.

Intoxication

Disturbance of the physiological and psychological systems through substance use. Pharmacology generally distinguishes four levels of intoxication: light, moderate, serious and fatal.

Joint

Cigarette of marijuana or hashish with or without tobacco. Because joints are never identical, scientific analyses of the effects of THC in their use are more difficult, especially to determine the therapeutic benefits of cannabis and to examine its effects on driving.

League of Nations

International organisation organization of Sstates until in existence until 1938; now the United Nations.

Legalization

Legislating under a regulatory system the culture, production, marketing, sale and use of substances. Although no such provision currently exist in relation to "street-drugs" (as opposed to alcohol or tobacco which are regulated products), a legalization system could take two forms: free of state control (free markets) and with state controls (regulatory regime).

Marijuana

Mexican term originally referring to a cigarette of poor quality. Has now become a synonym for cannabis in popular language usage.

Narcotic

Substance which can induce stupor or artificial sleep. Usually restricted to opiates. Sometimes used incorrectly to refer to all drugs capable of inducing dependence.

Office of National Drug Control Policy (ONDCP) USA

Created in 1984 under the Reagan administration, the Office is under the direct authority of the White House. It coordinates US policy on drugs. Its budget is currently US $18 billion.

Opiates

Substance derived from the opium poppy. The term opiate excludes synthetic opioids such as heroin and methadone.

Prohibition

Historically, the term most often refers to the period of national interdiction of alcohol sales in the United States between 1919 and 1933. By analogy, the term is now used to describe UN and State policies aiming for a drug-free society. Prohibition is based on the interdiction to cultivate, produce, fabricate, sell, possess, use, etc., some substances except for medical and scientific purposes.

Psychoactive substance

Substance which alters mental processes such as thinking or emotions. We prefer to use this term as it is more neutral than the term “drug” and does not refer to the legal status of the substance.

Psychotropic substance (see also psychoactive)

Used synonymously with psychoactive substance, however the term refers to drugs primarily used in the treatment of mental disorders, such as anxiolytics, sedatives, neuroleptics, etc. More specifically,the term refers to the substances covered in the 1971 Convention on Psychotropic Substances.

Regulation

System of control specifying the conditions under which the cultivation, production, marketing, prescription, sales, possession or use of a substance are allowed. Regulatory approaches may rest on interdiction (as for illegal drugs) or controlled access (as for medical drugs or alcohol). Our proposal of an exemption regime under the current legislation is a regulatory regime.

Tetrahydrocannabinol (D9-THC)

Main active component of cannabis, D9-THC is highly fat-soluble and has a lengthy half-life. Its psychoactive effects are modulated by other active components in cannabis. In its natural state, cannabis contains between 0.5% to 5% THC. Sophisticated cultivation methods and plant selection, especially female plants, lead to higher levels of THC concentration.

Tolerance

Reduced response of an organism and increased capacity to support the effects of a substance after a more or less lengthy period of use. Tolerance levels are extremely variable between substances, and tolerance to cannabis is believed to be lower than for most other drugs,including tobacco and alcohol.

Toxicity

Characteristic of a substance which induces intoxication, i.e., “poisoning”. Many substances, including some common foods, have some level of toxicity. Cannabis presents almost no toxicity and cannot lead to an overdose.

United Nations Drug Control Program (UNDCP)

Established in 1991, the Program works to educate the world about the dangers of drug abuse. The Program aims to strengthen international action against drug production, trafficking and drug-related crime through alternative development projects, crop monitoring and anti-money laundering programs. UNDCP also provides accurate statistics through the Global Assessment Programme (GAP) and helps to draft legislation and train judicial officials as part of its Legal Assistance Programme. UNDCP is part of the UN Office for Drug Control and the Prevention of Crime.

World Health Organization (WHO)

The World Health Organization, the United Nations' specialized agency for health, was established on April 7, 1948. WHO’s objective, as set out in its Constitution, is the attainment by all peoples of the highest possible level of health. Health is defined in WHO’s Constitution as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.





Introduction

The Senate Special Committee on Illegal Drugs addressed the question of drugs just as everyone else does, with the same preconceptions, attitudes, fears and anxieties we all share. Of course, we had at our disposal the 1996 study our colleagues conducted on government legislation dealing with illegal drugs, which had enabled them to hear a number of witnesses over several months. We also knew at the outset that research expertise would be available to us, but it is still difficult to overcome attitudes and opinions that we have long taken for granted. Whether one is in favour of enhanced enforcement or, on the contrary, greater liberalization, opinions often resist the facts and in a field such as this the production of facts, even through scientific research, is not necessarily a neutral undertaking. We, like you, have our prejudices and preconceptions. Together we must make the effort to go beyond such predispositions. That is one of the objectives of this report.

The public policy regime we propose expresses the fundamental premise underlying our report: in a free and democratic society, which recognizes fundamentally but not exclusively the rule of law as the source of normative rules and in which government must promote autonomy as far as possible and therefore make only sparing use of the instruments of constraint, public policy on psychoactive substances must be structured around guiding principles respecting the life, health, security and rights and freedoms of individuals, who, naturally and legitimately, seek their own well-being and development and can recognize the presence, difference and equality of others.

We are aware, as much now as we were at the start of our work, that there is no pre-established consensus in Canadian society on public policy choices in the area of drugs. In fact, our research has shown us that there are few societies where there is a broadly shared consensus among the general public, let alone between the public and experts. We are well aware, perhaps more so than at the outset, that the question of illegal drugs, viewed from the standpoint of public policy, has a broad international context and that we cannot think or act in isolation. We know our proposals are provocative, that they will meet with resistance. However, we are also convinced that Canadian society has the maturity and openness to welcome an informed debate.





Part I – General Orientation

Chapter 1 – Our mandate

“That a special committee of the Senate be struck to examine:

· the approach taken by Canada to cannabis, its preparations, derivatives and similar synthetic preparations, in context;

· the effectiveness of this approach, the means used to implement it and the monitoring of its application;

· the related official policies adopted by other countries;

· Canada's international role and obligations under United Nations agreements and conventions on narcotics, in connection with cannabis, the Universal Declaration of Human Rights and other related treaties; and

· the social and health impacts of cannabis and the possible consequences of different policies;

That the special committee consist of five senators, three of whom shall constitute a quorum;

That the Honourable Senators Banks, Kenny, Nolin, Rossiter and (a fifth Senator to be named by the Chief Government Whip) be named to the committee;

That the committee be authorized to send for persons, papers and records, to hear witnesses, to report from time to time, and to print from day to day such papers and evidence as may be ordered by it;

That the briefs and evidence heard during consideration of Bill C-8, An Act respecting the control of certain drugs, their precursors and other substances and to amend certain other Acts and repeal the Narcotic Control Act in consequence thereof, by the Standing Senate Committee on Legal and Constitutional Affairs during the 2nd Session of the 35th Parliament be referred to the committee;

That the documents and evidence compiled on this matter and the work accomplished by the Special Senate Committee on Illegal Drugs during the 2nd Session of the 36th Parliament be referred to the committee;

That the committee be empowered to authorize, if deemed appropriate, the broadcasting on radio and/or television and the coverage via electronic media of all or part of its proceedings and the information it holds;

That the committee present its final report no later than August 31, 2002; and that the committee retain the powers necessary to publicize its findings for distribution of the study contained in its final report for 30 days after the tabling of that report;

That the committee be authorized, notwithstanding customary practice, to table its report to the Clerk of the Senate if the Senate is not sitting, and that a report so tabled be deemed to have been tabled in the Senate.”

The Committee's mandate is a continuation of the evolution of drug legislation passed by the Parliament of Canada in 1996, the Controlled Drugs and Substances Act. While this legislation was being studied by the Sub-Committee on Bill C-7 of the Standing Committee on Health of the House of Commons in 1994 and 1995, the vast majority of witnesses were highly critical of the bill. The most common criticisms concerned three points: first, the lack of basic principles or an expressed statement as to the purpose of the act; second, the fact that the bill perpetuated the prohibition system of the 1920s, and third, the absence of any emphasis on harm reduction and prevention criteria. Despite the amendments made by the Sub-Committee of the House, the testimony heard by the Senate Committee was equally critical. Witnesses noted that the Act did not categorize drugs on the basis of the dangers they represented, that it did not contain any specific, rational criteria and that it was impossible, particularly in view of the Act's complexity, to determine how it would be implemented in practice. All of these criticisms led that Senate Committee to "propose energetically" the creation of a Joint Committee of the House of Commons and the Senate that would review all Canadian drug legislation, policies and programs. However, the 1997 federal election intervened. Senator Nolin, convinced of the need for action and faced with the inaction of the House of Commons, tabled his first motion in 1999 - that a Senate Committee be struck and given a mandate to examine the legislation, policies and programs on illegal drugs in Canada. The motion was adopted by the Senate in April 2000.

However, that Committee was dissolved by general election of October 2000, and was restruck on March 15, 2001, with an amended mandate: the scope of its work was now restricted to cannabis “in its context”. We chose to interpret this sentence broadly.

Chapter 2 – Our Work

At the Committee's public hearings, the Chair presented the research program as follows:

“In order to fully satisfy the mandate conferred upon the committee, the committee has adopted an action plan. This plan centres around three challenges. The first challenge is that of knowledge. We will be hearing from a wide variety of experts, both from Canada and afar, from academic settings, the police, legal specialists, medical specialists, the government sector and social workers. (…)

The second challenge, surely the most noble challenge, is that of sharing knowledge. The committee hopes that Canadians from coast to coast will be able to learn and share the information that we will have collected. In order to meet this challenge, we will work to distribute this knowledge and make it accessible to all. We would also like to hear the opinions of Canadians on this topic and in order to do so, we will be holding public hearings in the spring of 2000 throughout Canada.

And finally, the third challenge for this committee will be to examine and identify the guiding principles on which Canada's public policy on drugs should be based.”

In view of our mandate, including an obligation to provide Canadians with objective and rigorous information, we have emphasized rigour and openness throughout the entire process, an approach that was all the more important as opinions on all sides of the illegal drugs issue are strong and often categorical. But rigour is not enough. For the information to reach Canadians, we could not reserve it for our exclusive use, hence the second principle that guided us: openness. From the outset, we insisted that all our work be made available as soon as possible on our Web site and we entered into direct dialogue with our fellow citizens as well as with experts.

The Committee approved a research program divided into five major axes of knowledge, sub-dividing each one into specific issues:

Ø the socio-historical, geopolitical, anthropological, criminological and economic issues of the use and regulation of cannabis;

Ø the medical and pharmacological aspects of the consumption, use and regulation of cannabis;

Ø the legal aspects from a national perspective;

Ø the legal and political issues in an international perspective; and

Ø the ethical issues and Canadians' moral and behavioural standards.

In an attempt to answer these questions in the most effective and economical manner possible, the Committee agreed to perform two tasks concurrently: conduct a research program and hear expert witnesses–complementary activities. We asked the Parliamentary Research Branch and other researchers to produce syntheses and analyses of the relevant literature. In all, the Committee received 23 reports and benefited from summaries of work conducted in other countries, including attendance at international conferences. In all, the Committee held more than 40 days of public hearings in Ottawa and 10 other Canadian communities, hearing more than 100 witnesses from all backgrounds, from across Canada and abroad.

The second component of our program of work was to examine public opinion. That meant we had two closely related responsibilities. The first was a duty to inform, indeed, to educate. We hope those who are offended by that term will pardon our presumption, but we are convinced that on public policy topics that are societal issues, it is the duty of political leaders to transmit information that educates, not merely convinces. The level of knowledge about drugs, even about cannabis, perhaps the best known drug, is often limited and clouded by myth. Our second responsibility in taking public opinion into account was to go out and discover it. We did so in three ways. We publicized our work as widely and as openly as possible to enable everyone to learn about it and react to it. Many chose to write us, although they were relatively few compared with the number of people in this country. We commissioned a qualitative public opinion study. The focus groups conducted across the country as part of that study are described in detail in Chapter 10. We also held public hearings in eight communities across the country, enabling citizens to come and tell us what they thought, what they knew and what they had experienced.

In order to be able to interpret all this knowledge and come to conclusions and recommendations, the third component of our work focussed on guiding principles.

Chapter 3 – Guiding principles

It has now been thirty years since the Royal Commission of Inquiry on the Non-Medical Use of Drugs, the Le Dain Commission, studied issues similar to those we are studying today. Its report on cannabis, whose scientific conclusions on the effects of the drug were generally accepted by all members of the Commission, led to three reports: a majority report by three of the members, and two minority reports. Each expressed a different concept of the role of the State and of criminal law, and the roles of science and ethics in the choices that had to be made. Having examined each of these subjects, we have elected to set down the guiding principles that clarify the concept we have of the roles that the state, criminal law, science and ethics must play in the development of a public policy on cannabis.

Ethical considerations take us through what is, that is the realm of facts, to the realm of what should be, what would be desirable, moving from recognized facts to standards, then more importantly to values and finally to the means of passing on and above all implementing these values. This is why ethics was our first subject. As a guideline, we have adopted the principle that an ethical public policy on illegal drugs, and on cannabis in particular, must promote reciprocal autonomy built through a constant exchange of dialogue within the community.

We always find ourselves in paradoxical situations where, to a certain degree, each person has the free will to make decisions and makes free decisions for himself, while at the same time rules are established in order to regulate interaction with others, a complex and more or less formal, but appropriate approach. The goal of governance is freedom, and not control. It is a question of defining the goals of society through policies and programs of action that are then implemented through systems and processes and upheld by those who govern that permits the encouragement and affirmation of those goals for human action. The law, as a vehicle of choice of governance, does not merely express rules or limitations passed for the benefit of and on behalf of citizens, but seeks a reciprocal process of building social relationships through which people, citizens and governments, can constantly adjust their expectations of behaviour. We therefore accept as a guiding principle for governance that all of the means the State has at its disposal must work towards facilitating human action, particularly the processes allowing for the building of arrangements between government of the citizenry and governance of the self.

On the whole, the legal basis of the criminal law is weak where the prescribed standard first, does not concern a relationship with others and where the characteristics of the relationship do not establish a victim and a perpetrator able to recognize his/her actions; second, has to find its justification outside fundamental social relationships; and third, results in the form of enforcement, the harmful effects of which undermine and challenge the very legitimacy of the law. Where criminal law is involved in these issues, the very standard prescribed by the law turns the perpetrator into the victim and tries to protect him from himself, something it can do only by producing a never-ending stream of knowledge that remains constantly out of his reach. In this context only offences involving significant direct danger to others should be matters of criminal law.

The Committee’s Report - especially the second part - puts great emphasis on research-based knowledge. This focus is an attempt to do justice to the knowledge that has been developed over the past few decades. We considered it important and indeed necessary to give it detailed consideration. Indeed, the Committee recommends that the drive to acquire knowledge on specific issues we deem important be continued. We do not claim, however, to have answered the fundamental question of why people consume psychoactive substances, such as alcohol, drugs or medication. We were indeed surprised, given the quantity of studies conducted each year on drugs, that this area has not been covered. It is almost as if the quest for answers to technical questions has caused science to lose sight of the basic issue!

Scientific knowledge cannot replace either personal reflection or the political decision-making process. It supports those processes, science’s greatest contribution to public drug policy. Our guiding principle is that science, which must continue to explore specific areas of key issues and reflect on overarching questions, supports the public policy development process.

These principles have guided our interpretation of the available information as well as our choice of recommendations; the reader should always keep them in mind when reading our report.

Chapter 4 – A changing context

This chapter puts the Committee's work in context. In recent years, in fact, in the past few months, events of some significance have taken place; some directly linked to illegal drugs, others far removed from them. Obviously, September 11 comes to mind. In social and political terms, the claims of medical users, of recreational users, within the changing context of drug use and, more generally, inter-generational conflict, have to be taken into account. Legislation passed in the aftermath of September 11, some provisions of which could affect police drug investigations, the fight against organized crime and the trial of the Hells Angels in Quebec, must also be taken into account. In legal terms, court decisions have had a direct effect on medical use and a decision will be rendered in the next few months by the Supreme Court on recreational use. In international terms, the fragility of the UNDCP and the development of a continental drug policy for the Americas are relevant to an understanding of certain issues that may even overdetermine national policy. Finally, globalization and the more extreme forms of economic liberalism have been factors too, primarily in western societies but worldwide as well, in the increase of addictive behaviours, be they the use of drugs or other substitutes for social life.

Part II – Cannabis: Effects, types of use, attitu des

Chapter 5 – Cannabis: from plant to joint

This chapter first describes the cannabis plant and the various forms in which it becomes a consumer drug. We then take a brief look at the geographical origin of the cannabis plant and the routes along which it circulates in the modern world, noting at the same time current modes of production (soil-based and hydroponic) that have developed in certain regions of Canada. We then describe the pharmacokinetics of the cannabis plant, in particular its main active ingredients, and their metabolism in the body.

Available information on cannabis markets is weak and contradictory. Since 1997, the RCMP’s annual reports on drugs suggest that 800 tons of cannabis circulate in Canada each year. Yet, many people told us that cannabis production has increased significantly and that cannabis has become more available than ever in this country. Data on the economic value of the cannabis market are no more reliable. We noted that:

Ø The size of the national production has significantly increased, and it is estimated that 50% of cannabis available in Canada is now produced in the country;

Ø The main producer provinces are British Columbia, Ontario and Quebec;

Ø Estimates of the monetary value of the cannabis market are unreliable. For example, if 400 tons are grown yearly in Canada, at a street value of $225 per ounce, the total value of the Canadian production would be less than $6 billion per year, less than the often quoted value of the BC market alone;

Ø An unknown proportion of national production is exported to the United States; and

Ø A portion of production is controlled by organized crime elements.

We heard many alarmist comments on the increased level of active ingredient (THC) in cannabis, however, it is currently impossible to estimate the average content of cannabis available in the market. More sophisticated growing methods have likely contributed to increasing the THC concentration. We observed that:

Ø In its natural state, cannabis contains between 0.5% and 3% THC. Sophisticated growing methods and genetic progress have made it possible to increase THC content in recent years, but it is impossible to estimate the average content of cannabis available in the market; it is reasonable to consider that content varies between 6% and 31%.

Ø THC is fat soluble and readily spreads in the innervated tissues of the brain; it reaches a peak in the blood plasma in less than nine minutes and falls to approximately 5% after one hour.

Ø The body is slow to eliminate THC and inactive THC metabolites can be detected in urine up to 27 days after use in the case of regular users.

Ø Psychoactive effects generally last two to three hours and may last as many as five to seven hours after use.

Who uses cannabis? How do the patterns of use in Canada compare to those in other countries? In what context is cannabis used? Why? What populations are most vulnerable? What are the social consequences of cannabis, specifically on delinquency and criminal behaviour? Most important, what trajectories do cannabis users follow, specifically with respect to consumption of other drugs?

At the very least, partial answers to these questions are prerequisite to establishing policy on a substance. In Canada, knowledge of patterns and contexts of cannabis use verges on the abysmal. In the early 1980s, the USA, the United Kingdom, and Australia introduced monitoring systems for the general population and the student population. In the last five years, a number of European countries have introduced data collection systems as part of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Canada, by contrast, has carried out only two epidemiological general population surveys specific to drugs (in 1989 and 1994), and only some provinces conduct surveys of the student population, using different methods and instruments that preclude data comparison. Furthermore, few sociological or anthropological studies are conducted on the circumstances or context of illegal drug use, specifically for cannabis. The result is that our pool of knowledge on users and characteristics of use is sorely lacking.

We have no explanation for this situation, at least no satisfactory explanation. In the 1970s, following up on the work done by the Le Dain Commission, Canada could have set up a trend monitoring system. In the 1980s, when Canada’s Anti-Drug Strategy was adopted, to which the federal government allocated $210M over five years, a data collection system could well have been created. The fact that it was not could be due to an absence of leadership or vision, a fear of knowing, the division of powers among levels of government, or the absence of a socio-legal research tradition within the departments responsible for justice and health. In fact, all of the above are probable factors. Whatever the case, it is our contention that this situation, unacceptable by definition, requires timely remedial action. We must resign ourselves to working with the scarce Canadian data available, and, more significantly, the virtually non-existent comparable data. We will also look at studies and data from other countries.

The chapter is divided into four sections. The first covers consumption patterns in the population as a whole, then specifically in the 12-18 year age group and compares the patterns in various countries. In the adult population we observed that:

Ø The epidemiological data available indicates that close to 30% of the population (12 to 64 years old) has used cannabis at least once;

Ø Approximately 2 million Canadians over age 18 have used cannabis during the previous 12 months, approximately 600,000 have used it during the past month, and approximately 100,000 use it daily. Approximately 10% used cannabis during the previous year; and

Ø Use is highest between the ages of 16 and 24.

For youth in the 12-17 age group, we observed that:

Ø Canada would appear to have one of the highest rates of cannabis use among youths;

Ø Approximately 1 million would appear to have used cannabis in the previous 12 months, 750,000 in the last month and 225,000 would appear make daily use; and

Ø The average age of introduction to cannabis is 15.

The second section looks at what we know about reasons for and details on use, including origins and cultural differences. The third section deals specifically with cannabis user trajectories, including escalation. We have observed the following:

Ø Most experimenters stop using cannabis;

Ø Regular users were generally introduced to cannabis at a younger age. Long-term users most often have a trajectory in which use rises and falls;

Ø Long-term regular users experience a period of heavy use in their early 20s;

Ø Most long-term users integrate their use into their family, social and occupational activities; and

Ø Cannabis itself is not a cause of other drug use. In this sense, we reject the gateway theory.

The fourth and last section covers the relationship between cannabis use and delinquency and crime. Based on research evidence, we concluded that:

Ø Cannabis itself is not a cause of delinquency and crime; and

Ø Cannabis is not a cause of violence.

Chapter 7 – Cannabis: Effects and Consequences

When it comes to cannabis, one hears anything and its opposite. While in some areas more research is needed and in others research results are contradictory, there exists nevertheless a strong basis of information contradicting many of the myths that continue to be perpetuated.

This chapter is divided into five sections. The first is a collection of statements on the presumed effects of marijuana that the Committee heard or became aware of through its research. The following three sections examine the acute effects of cannabis, followed in turn by the physiological and neurological consequences, the psychological consequences and the social consequences. Then, because of its significance and the central place it holds in social and political concerns, we turn our attention specifically to the question of any possible dependence arising from prolonged use of cannabis.

With respect to the effects of cannabis, the Committee observed that:

Ø The immediate effects of cannabis are characterized by feelings of euphoria, relaxation and sociability; they are accompanied by impairment of short-term memory, concentration and some psychomotor skills; and

Ø Long term effects on cognitive functions have not been established in research.



The Committee has distinguished between use, at-risk use and excessive use. Quantities used, psychosocial characteristics of the users and factors related to use contexts and quality of the substance all come into play to explain the passage from one category to the other. On at-risk use, the Committee observed that:

Ø Most users are not at-risk users insofar as their use is regulated, irregular and temporary, rarely beyond 30 years of age;

Ø For users above 16, at-risk use is defined as using between 0.1 to 1 gram per day; and

Ø Available epidemiological data suggests that approximately 100,000 Canadians might be at-risk users.

Ø The Committee feels that, because of its potential effects on the endogenous cannabinoid system and cognitive and psychosocial functions, any use in those under age 16 is at-risk use.

With respect to excessive use we observed that:

Ø More than one gram per day over a long period of time is heavy use, which can have certain negative consequences on the physical, psychological and social well-being of the user. According to the epidemiological data available, there is reason to believe that approximately 80,000 Canadians above age 16 could be excessive users;

Ø For those between the ages of 16 and 18, heavy use is not necessarily daily use but use in the morning, alone or during school activities;

Ø Heavy use can have negative consequences for physical health, in particular for the respiratory system (chronic bronchitis, cancer of the upper respiratory tract);

Ø Heavy use of cannabis can result in negative psychological consequences for users, in particular impaired concentration and learning and, in rare cases and with people already predisposed, psychotic and schizophrenic episodes;

Ø Heavy use of cannabis can result in consequences for a user’s social well-being, in particular their occupational and social situation and their ability to perform tasks; and

Ø Heavy use of cannabis can result in dependence requiring treatment; however, dependence caused by cannabis is less severe and less frequent than dependence on other psychotropic substances, including alcohol and tobacco.

Chapter 8 – Driving under the influence of cannabis

If there is one issue, other than the effects of cannabis use on young people or the effects of substance abuse, that is likely to be of concern to society and governments, then it is certainly the effect of the use of cannabis on the ability to drive a vehicle. We are already familiar with the effects of alcohol on driving and the many accidents involving injuries or deaths to young people. In spite of the decreases in use noted in recent years, one fatal accident caused by the use of a substance is one accident too many.

Next to alcohol, cannabis is the most widely used psychoactive substance, particularly among young people in the 16-25 age group. Casual use occurs most often in a festive setting, at weekend parties, often accompanied by alcohol. People in this age group are also the most likely to have a car accident and are also susceptible to having an accident while impaired.

Cannabis affects psychomotor skills for up to five hours after use. The psychoactive effects of cannabis are also dependent on the amount used, the concentration of THC and the morphology, experience and expectations of users. But what are the specific effects of cannabis on the ability to drive motor vehicles? What are the effects of alcohol and cannabis combined? And what tools are available to detect the presence of a concentration of THC that is likely to significantly affect the psychomotor skills involved in vehicle operation?

This chapter is divided into three sections. The first considers the ways of testing for the presence of cannabinoids in the body. The second analyzes studies on the known prevalence of impaired driving, in both accident and non-accident contexts. The third and last summarizes what is known about the effects of cannabis on driving based on both laboratory and field studies. As in the other chapters, the Committee then draw its own conclusions.

The Committee feels it is quite likely that cannabis makes users more cautious, partly because they are aware of their deficiencies and compensate by reducing speed and taking fewer risks. However, because what we are dealing with is no longer the consequences on the users themselves, but the possible consequences of their behaviour on others, the Committee feels that it is important to opt for the greatest possible caution with respect to the issue of driving under the influence of cannabis.



Given what we have seen, we conclude the following:

Ø Between 5% and 12% of drivers may drive under the influence of cannabis; this percentage increases to over 20% for young men under 25 years of age;

Ø Cannabis alone, particularly in low doses, has little effect on the skills involved in automobile driving. Cannabis leads to a more cautious style of driving. However it has a negative impact on decision time and trajectory. This in itself does not mean that drivers under the influence of cannabis represent a traffic safety risk;

Ø A significant percentage of impaired drivers test positive for cannabis and alcohol together. The effects of cannabis when combined with alcohol are more significant than is the case for alcohol alone;

Ø Despite recent progress, there does not yet exist a reliable and non intrusive rapid roadside testing method;

Ø Blood remains the best medium for detecting the presence of cannabinoids;

Ø Urine cannot screen for recent use;

Ø Saliva is promising, but rapid commercial tests are not yet reliable enough;

Ø The visual recognition method used by police officers has yielded satisfactory results; and

Ø It is essential to conduct studies in order to develop a rapid testing tool and learn more about the driving habits of cannabis users.

Chapter 9 - Use of marijuana for therapeutic Purposes

There has been renewed interest in the issue of the use of marijuana for therapeutic purposes in recent years, particularly in Canada. In the wake of an Ontario Court of Appeal ruling which found the provisions of the Controlled Drugs and Substances Act to be unconstitutional pertaining to the therapeutic use of marijuana, the federal Minister of Health made new regulations in July 2001 that give people with specified medical problems access to marijuana under certain conditions.

However, the scientific community, the medical community in particular, is divided on the real therapeutic effectiveness of marijuana. Some are quick to say that opening the door to medical marijuana would be a step toward outright legalization of the substance.

But none of that should matter to physicians or scientists. It is not a question of defending general public policy on marijuana or even all illegal drugs. It is not a question of sending a symbolic message about “drugs”. It is not a question of being afraid that young people will use marijuana if it is approved as a medicine. The question, and the only question, for physicians as professionals is whether, to what extent and in what circumstances, marijuana serves a therapeutic purpose. Physicians should have to determine whether people with certain diseases would benefit from marijuana use and weigh the side effects against the benefits. If they do decide the patient should use marijuana, they then have to consider how he or she might get it.

This chapter is devoted to the history of the use of marijuana for therapeutic purposes and the status of contemporary knowledge of marijuana and synthetic cannabinoids. We then give a brief account of compassion clubs and other organizations that supply marijuana for therapeutic use, as well as various public policy regimes. We conclude with our views on medical use of marijuana. In a later chapter, we discuss which public policy regime would be most appropriate given the status of medical use of marijuana

We observed that:

Ø There are clear, though non-definitive indications of the therapeutic benefits of marijuana in the following conditions: analgesic for chronic pain, antispasm for multiple sclerosis, anticonvulsive for epilepsy, antiemetic for chemotherapy and appetite stimulant for cachexi;

Ø There are less clear indications regarding the effect of marijuana on glaucoma and other medical conditions;

Ø Marijuana has not been established as a drug through rigorous, controlled studies;

Ø The quality and effectiveness of marijuana, primarily smoked marijuana, have not been determined in clinical studies;

Ø There have been some studies of synthetic compounds, but the knowledge base is still too small to determine effectiveness and safety;

Ø Generally, the effects of smoked marijuana are more specific and occur faster than the effects of synthetic compounds;

Ø The absence of certain cannabinoids in synthetic compounds can lead to harmful side effects, such as panic attacks and cannabinoid psychoses;

Ø Smoked marijuana is potentially harmful to the respiratory system;

Ø People who smoke marijuana for therapeutic purposes self-regulate their use depending on their physical condition and do not really seek the psychoactive effect;

Ø People who smoke marijuana for therapeutic purposes prefer to have a choice as to methods of use;

Ø Measures should be taken to support and encourage the development of alternative practices, such as the establishment of compassion clubs;

Ø The practices of these organizations are in line with the therapeutic indications arising from clinical studies and meet the strict rules on quality and safety;

Ø The studies that have already been approved by Health Canada must be conducted as quickly as possible;

Ø The qualities of the marijuana used in those studies must meet the standards of current practice in compassion clubs, not NIDA standards;

Ø The studies should focus on applications and the specific doses for various medical conditions; and

Ø Health Canada should, at the earliest possible opportunity, undertake a clinical study in cooperation with Canadian compassion clubs.

It is always difficult to gauge the public’s opinions, attitudes and concerns. The traditional method of surveying a representative sample of the population was too expensive for our resources. Surveys also have limits that we discuss in more detail. However, we did commission a qualitative study using focus groups, the results of which are presented in this chapter. We also report the results of other surveys that we researched and considered. As well, many Canadians wrote to us or sent us e-mails, and others came out to our public hearings to participate. Obviously we cannot draw solid conclusions from this. The people who wrote to us were probably those to whom the issue is very important, regardless of which way they may lean. Some are cited in our Report but we must reiterate that no conclusion should be drawn from these opinions in terms of representativeness. No account of Canadians’ opinions on and attitudes toward drugs in general would be complete without an examination of the role of the media in shaping those opinions and attitudes. In recent years, as a result of this Committee’s work and other initiatives, various Canadian newspapers and magazines have run stories or have written editorials on the issue. These are the focus of the first part of the chapter. The next part presents the results of surveys and polls, including the survey we commissioned and surveys conducted in different provinces. The last part covers our understanding of what Canadians told us.

We observed the following:

Ø Public opinion on marijuana is more liberal than it was 10 years ago;

Ø There is a tendency to think that marijuana use is more widespread and that marijuana is more available than it used to be;

Ø There is a tendency to think that marijuana is not a dangerous drug;

Ø The concern about organized crime is significant;

Ø Support for medical use of marijuana is strong;

Ø There is a tendency to favour decriminalization or, to a lesser degree, legalization;

Ø People criticize enforcement of the legislation in regards to simple possession of marijuana; and

Ø There is a concern for youth and children.

part iii -- policies and practices in canada

Chapter 11 - A National Drug Strategy?

Based on the importance of the subject, it would probably surprise many Canadians to learn that only from 1987 to 1993 did Canada have a fully funded national drug strategy. It is true that Canada has had legislation dealing with the use of psychoactive substances since the passage of the Opium Act in 1908. This Act was followed by several pieces of criminal legislation over the years that increased federal enforcement powers over psychoactive substances and expanded the list of illicit substances. These pieces of legislation have historically focused on the supply of psychoactive substances, adopting a prohibitionist approach to use. It is widely acknowledged now, however, that a more balanced approach is required if one is to deal effectively with those who abuse psychoactive substances.

This chapter recounts the development and implementation of the 1987 National Drug Strategy, which had as an objective the promotion of a balanced approach to the problem of psychoactive substance abuse. This is followed by a discussion of what became of the national strategy and what goals have been achieved.

We observed the following:

Ø Canada urgently needs a comprehensive and coordinated national drug strategy for which the federal government provides sound leadership;

Ø Any future national drug strategy should incorporate all psychoactive substances, including alcohol and tobacco;

Ø To be successful, a national drug strategy must involve true partnerships with all levels of government and with non-governmental organizations;

Ø Over the years, the intermittency of funding has diminished the ability to coordinate and implement the strategy; adequate resources and a long-term commitment to funding are needed if the strategy is to be successful;

Ø Clear objectives for the strategy must be set out, and comprehensive evaluations of these objectives and the results are required;

Ø At the developmental stage, there is a need to identify clear and shared criteria for “success”;

Ø The core funding for the Canadian Centre on Substance Abuse (CCSA) has been insufficient for it to carry out its mandate; proper funding for the CCSA is essential;

Ø There is a need for an independent organization – the CCSA – to conduct national surveys at least every second year; there is also a need to achieve some level of consistency, comparability and similar time frames for provincially-based school surveys;

Ø Coordination at the federal level should be given to a body that is not an integral part of one of the partner departments; and

Ø Canada’s Drug Strategy’s should adopt a balanced approach – 90% of federal expenditures are currently allocated to the supply reduction.

Chapter 12 - The National Legislative Context

Drugs have been prohibited for fewer than a hundred years; cannabis for slightly more than 75 years. It is tempting to think that the decisions made over the years to use criminal law to fight the production and use of certain drugs are in keeping with social progress and the advancement of scientific knowledge about drugs. But is this really the case? The history of legislation governing illegal drugs in Canada, like the analysis in Chapter 19 of the structure of international conventions, suggests that it is highly doubtful. To what extent is such reasoning really rational? Is the rationale of the system of controls acceptable in the eyes of civil society, users as well as abstainers? What criteria motivated legislator decisions? Indeed, were there criteria? What motivated parliamentarians from Canada and elsewhere to prohibit certain substances, to control access to certain others, and to permit still others to be sold over the counter?

Knowing where we have been helps in understanding where we are going. That is the goal of this chapter, retracing the evolution of Canadian drug laws from 1908 to the present day. We have identified three legislative periods. The first, and longest, spans 1908 to 1960, the period of hysteria. We were told that drugs were made criminal because they are dangerous. Analysis of debates in Parliament and in media accounts clearly shows how far this is from truth. When cannabis was introduced in the legislation on narcotics in 1923, there was no debate, no justification, in fact many members did not even know what cannabis was.

The second period, much shorter, runs from 1961 to 1975, the search for lost reason. Following the explosion in drug use in the early 1960s and demands for reform from various sectors of society, governments appointed a commission of inquiry in Canada, the Le Dain Commission. Last comes the contemporary period at the beginning of the 1980s. Reform is not on the policy agenda any more and anti-drug policies have forged ahead.

In summary, we observed that:

Ø Early drug legislation was largely based on a moral panic, racist sentiment and a notorious absence of debate;

Ø Drug legislation often contained particularly severe provisions, such as reverse onus and cruel and unusual sentences; and

Ø The work of the Le Dain Commission laid the foundation for a more rational approach to illegal drug policy by attempting to rely on research data. The Le Dain Commission's work had no legislative outcome until 1996 in certain provisions of the Controlled Drugs and Substances Act, particularly with regard to cannabis.

Chapter 13 - Regulating Therapeutic Use of Cannabis

Cannabis has an extremely long history of therapeutic use, going back several thousands of years. It was often used for the same medical conditions it is used for today. With the development of the pharmaceutical industry in the last century, the medical community has gradually discontinued its use. Various factors may explain this. Developments in the pharmaceutical industry provided the medical community with more stable and better tested medication. The practice of medicine itself has changed and so has our conception of health. Then, at the turn of the 20th century, the plants from which opium, cocaine and cannabis are derived were banned by the international community, except for medical and scientific purposes. In the case of cannabis, no rigorous study had been done until recently.

Further to the social rediscovery of cannabis and the identification of its molecular composition and chemical elements in the 1960s, renewed interest in the therapeutic applications of cannabis grew in the early 1970s. More people began using the plant for its therapeutic benefits and many demanded a relaxation of the prohibitionist rules governing cannabis.

Partly because its safety and effectiveness have yet to be reviewed in clinical trials, cannabis has not been approved for sale in Canada as a medical product. Despite this lack of approval, many use cannabis for its therapeutic purposes without legal authorization. In addition, because of the many claims regarding its therapeutic benefit, a growing number of people have called for a less restrictive approach and are demanding access to cannabis for people who could benefit from its use.

This chapter reviews the events that prompted the recent enactment of the Marihuana Medical Access Regulations. One of the objectives of the regulations is to provide a compassionate framework of access to marijuana for seriously ill Canadians while research regarding its therapeutic application continues. Also discussed is the implementation of these regulations, which came into force on 30 July 2001.

We have observed the following:

Ø The MMAR are not providing a compassionate framework for access to marijuana for therapeutic purposes and are unduly restricting the availability of marijuana to patients who may receive health benefits from its use;

Ø The refusal of the medical community to act as gatekeepers and the lack of access to legal sources of cannabis appear to make the current regulatory scheme an “illusory” legislative exemption and raises serious Charter implications;

Ø In almost one year, only 255 people have been authorized to possess marijuana for therapeutic purposes under the MMAR and only 498 applications have been received – this low participation rate is of concern;

Ø Changes are urgently needed with regard to who is eligible to use cannabis for therapeutic purposes and how such people gain access to cannabis;

Ø Research on the safety and efficacy of cannabis has not commenced in Canada because researchers are unable to obtain the product needed to conduct their trials;

Ø No attempt has been made in Health Canada’s current research plan to acknowledge the considerable expertise currently residing in the compassion clubs;

Ø The development of a Canadian source of research-grade marijuana has been a failure.

Chapter 14 - Police Practices

Views on police priorities regarding enforcement of laws on illicit drugs are, at the very least, inconsistent, if not contradictory. Some believe that too much police time, effort and resources are spent in investigating illicit drug offences and, more specifically, possession offences, even more specifically, cannabis possession offences. Others, including the police themselves, claim that police priorities are already focused on traffickers and producers, and that possession charges are laid as a result of police presence to deal with other criminal activity. Thus, they maintain that the vast majority of cannabis possession charges are incidental to other police responsibilities.

This chapter reviews the key organizations that are responsible for enforcing Canada’s current illicit drugs legislation, the Controlled Drugs and Substances Act (CDSA). It includes a discussion of the powers they have been granted, and the investigative techniques used, in relation to illicit drug investigations. Finally, key police-related statistics are explored. This information should help clarify some of the misconceptions related to enforcement of laws on illicit drugs.

The Committee found that:

Ø The annual cost of drug enforcement in Canada is estimated to be between $700 million and $1 billion;

Ø Reduced law enforcement activities resulting from amendments to the drug legislation on cannabis could produce substantial savings or a significant reallocation of funds by police forces to other priorities;

Ø Due to the consensual nature of drug offences, police have been granted substantial enforcement powers and have adopted highly intrusive investigative techniques; these powers are not unlimited, however, and are subject to review by Canadian courts;

Ø Over 90,000 drug-related incidents are reported annually by police; more than three-quarters of these incidents relate to cannabis and over 50% of all drug-related incidents involve possession of cannabis;

Ø From 1991 to 2001, the percentage change in rate per 100,000 people for cannabis-related offences is +91.5 – thus, the rate of reported cannabis-related offences has almost doubled in the past decade;

Ø The number of reported incidents related to the cultivation of cannabis increased dramatically in the past decade;

Ø Reported incident rates vary widely from province to province;

Ø Cannabis was involved in 70% of the approximately 50,000 drug-related charges in 1999. In 43% of cases (21,381), the charge was for possession of cannabis.;

Ø The rate of charges laid for drug offences vary significantly from province to province;

Ø The uneven application of the law is of great concern and may lead to discriminatory enforcement, alienation of certain groups within society, and creation of an atmosphere of disrespect for the law; in general, it raises the issue of fairness and justice; and

Ø Statistics on seizure seem to confirm an increase in cannabis cultivation in Canada and also a shift in police priorities regarding this offence.

Chapter 15 - The Criminal Justice System

The previous chapter examined how people first come into contact with the criminal justice system through the enforcement of criminal legislation. Several questions remain, however. What happens once a person has been charged with a drug offence? Who is responsible for prosecuting drug cases? What type of punishment do people receive? Who ends up with a criminal record? Have there been any challenges to the constitutional validity of drug legislation? These issues and others related to the criminal justice system are reviewed in this chapter

We have observed the following:

Ø The cost of prosecuting drug offences in 2000-2001 was $57 million with approximately $5 million or roughly 10% of the total budget relating to prosecuting cannabis possession offences;

Ø In 1999, it was estimated that Canadian criminal courts heard 34,000 drug cases, which involved more than 400,000 court appearances;

Ø The Drug Treatment Court initiatives seem very encouraging, although comprehensive evaluations are needed to ensure such programs are effective;

Ø Disposition and sentencing data with respect to drug-related offences are incomplete and there is an urgent need to correct this situation;

Ø Correctional Service Canada spends an estimated $169 million annually to address illicit drugs through incarceration, substance abuse programs, treatment programs and security measures; expenditures on substance abuse programs are unreasonably low, given the number of inmates who have substance-abuse dependence problems;

Ø A criminal conviction can negatively affect a person’s financial situation, career opportunities and restrict travel. In addition, it can be an important factor in future dealings with the criminal justice system; and

Ø Provincial courts of appeal have so far maintained the constitutionality of cannabis prohibition. They have found that because there is some evidence of harm caused by marijuana use that is neither trivial nor insignificant, Parliament has a rational basis to act as it has done, and the marijuana prohibition is therefore consistent with the principles of fundamental justice in section 7 of the Charter. These decisions have been appealed, and the Supreme Court of Canada will soon decide whether cannabis prohibition is constitutionally sound.

Chapter 16 - Prevention

Viewed in theory, at least, as a public health issue, a policy on illegal drugs should call for a strong prevention strategy. Nothing, however, is more fluid, vague, or even controversial, than prevention. When it comes to illegal drugs, the legal and political context makes the issue of prevention even harder to clarify and actions even harder to define. The national legal context surrounding illegal drugs and the interpretation of international drug policies are such that because they are defined a priori as harmful substances, illegal drugs must not be used. Another way of putting it is that any use is abuse. If use is abuse, if individuals or organizations involved in prevention are unable to make distinctions that are essential in setting objectives and devising preventive measures, what hope is there of establishing successful prevention programs? There are, as this chapter will show, many prevention programs that are not aimed solely or even particularly at the prevention of use, but rather the prevention of at-risk behaviour. Harm reduction, for example, is not only a general strategy for dealing with psychoactive substances, but is also a preventive approach that seeks to lower the risks associated with drugs and drug control without requiring abstinence. However, harm reduction is the subject of much controversy and criticism because it is based on the premise that use of drugs is a social reality. Addressing the issue of prevention means considering at the same time government policies on illegal drugs. Any discussion of prevention entails discussion of the limits of government intervention and of how one conceives of human action. How far should government interventions go in identifying groups at risk without further stigmatizing groups already at risk? To what extent are humans rational beings who act in their best interest provided they are given the right information?

This chapter on prevention begins with a statement that will come as no surprise to health or justice experts: when it comes to prevention, there is lots of talk, but the resources allocated are small and the initiatives weak. The second section asks the question: what prevention? We look at current knowledge of the factors underlying prevention initiatives and the effectiveness of some preventive measures, with special emphasis on one of the most important weapons in the war on drugs, the DARE program. The third section looks at the harm reduction approach to prevention. As in the other chapters, our conclusions are in the form of observations that may serve to guide future actions.

The Committee found that:

Ø Prevention is not designed to control but rather to empower individuals to make informed decisions and acquire tools to avoid at-risk behaviour;

Ø A national drug strategy should include a strong prevention component;

Ø Prevention strategies must be able to take into account contemporary knowledge about drugs;

Ø Prevention messages must be credible, verifiable and neutral;

Ø Prevention strategies must be comprehensive, cover many different factors and involve the community;

Ø Prevention strategies in schools should not be led by police services or delivered by police officers;

Ø The RCMP should reconsider its choice of the DARE program that many evaluation studies have shown to be ineffective;

Ø Prevention strategies must include comprehensive evaluation of a number of key elements;

Ø A national drug strategy should include mechanisms for widely disseminating the results of research and evaluations;

Ø Evaluations must avoid reductionism, involve stakeholders in prevention, be part of the program, and include longitudinal impact assessment;

Ø Harm reduction strategies related to cannabis should be developed in coordination with educators and the social services sector; and

Ø Harm reduction strategies related to cannabis should include information on the risks associated with heavy chronic use, tools for detecting at-risk and heavy users and measures to discourage people from driving under the influence of marijuana.

Chapter 17 - Treatment practices

With the exception of the treatment given to offenders imprisoned in federal institutions and Aboriginals, the care available to individuals who are substance-dependent is essentially the responsibility of the provinces and territories. This chapter is therefore brief since we received only a few submissions and heard few witnesses on this question.

In Chapter 7 we determined that physical dependency on cannabis was rare and insignificant. Some symptoms of addiction and tolerance can be identified in habitual users but most of them have no problem in quitting and do not generally require a period of withdrawal. As far as forms of psychological dependency are concerned, the studies are still incomplete but the international data tend to suggest that between 5% and 10% of regular users (using at least in the past month) are at risk of becoming dependent on cannabis. We estimated that approximately 3% or 600,000 adult Canadians have consumed cannabis in the past month and that approximately 0.5% or 100,000 use it on a daily basis. This indicates that somewhere between 30,000 and 40,000 people might be at-risk and 5,000 to 10,000 might make excessive use. For those aged 16 and 17, the numbers were between 50,000 and 70,000 at-risk and 8,000 to 17,000 potentially excessive users. The data also indicated that the peak period for intensive use is between the ages of 17 and 25 years. These broad parameters indicate where to look to prevent dependency and offer treatment services for those in need.

What form does cannabis dependency take? Most authors agree that psychological dependency on cannabis is relatively minor. In fact, it cannot be compared in any way with tobacco or alcohol dependency and is even less common than dependency on certain psychotropic medications.

We have observed that:

Ø The expression ‘drug addiction’ should no longer be used and we should talk instead of substance abuse and dependency;

Ø Between 5% and 10% of regular cannabis users are at risk of developing a dependency;

Ø Physical dependency on cannabis is virtually non-existent;

Ø Psychological dependency is moderate and is certainly lower than for nicotine or alcohol;

Ø Most regular users of cannabis are able to diverge from a trajectory of dependency without requiring treatment;

Ø There are many forms of treatment but nothing is known about the effectiveness of the different forms of treatment for cannabis dependency specifically;

Ø As a rule, treatment is more effective and less costly than incarceration;

Ø Studies of the treatment programs should be conducted, including treatments programs for people with cannabis dependency; and

Ø Studies should be conducted on the interaction of the cannabinoid and the opioid systems.

Chapter 18 - Observations on practices

Previous chapters have described public action by dividing it into the major sectors of involvement. Before closing the third part of this report, we make some general observations that cut across the individual areas we have examined. The first concerns difficulties in harmonizing the various levels and sectors of involvement; the second, the difficulty in co-ordinating their various approaches; and the third, the costs of drugs and public policy.

A study published by CCSA in 1996 but based on 1992 data had identified the following costs of substance abuse:

· The costs associated with all illegal drugs were $1.4 billion, compared with $7.5 billion in the case of alcohol and $9.6 billion in the case of tobacco.

· Expressed as a percentage of the gross domestic product, the total costs for all substances was 2.67%. Of this, 0.2% was for illegal drugs, 1.09% for alcohol and 1.39% for tobacco.

· The principal costs of illegal drugs are externalities, that is, loss of productivity - $823 million, health care - $88 million, and losses in the workplace - $5.5 million, for a total of about 67% of all costs related to illegal drugs.

· The cost of public policies, or opportunity costs, represent about 33%.

· The cost of enforcing the law represents about 29.2% of all costs, or about 88% of all policy costs. The balance goes to prevention, research and administration.

Previous studies conducted in British Columbia in 1991, in Ontario in 1988 and in Quebec in 1988, using different methodologies, established costs of $388 million, $1.2 billion and $2 billion respectively, for a total cost of $3.5 billion in these three provinces alone. These figures demonstrate the extent to which such estimates can vary, according to the methodology selected and the availability of data.

Nevertheless, with the CCSA study taken as the standard, two comments must be made. First, loss of productivity – the major cost – is measured in mortality - $547 million and morbidity - $275 million. Except in the case of traffic fatalities, cannabis is not a cause of death and involves none of this type of social cost. Morbidity corresponds to losses attributed to problems caused by drug use as measured by the difference between the average annual income of users and of the population in general. Here, two further observations about cannabis should be noted. A large proportion of cannabis users are young people who are not yet part of the workforce and cannabis use involves none of the addiction and attendant problems that follow from heroin or cocaine use. Therefore, the costs that can be attributed to cannabis in this regard are likely minimal. If one accepts the methodology of the authors, cannabis in itself entails few externalities, which are the main measures of the social cost of illegal drugs.

However, it should also be noted that the study did not calculate the costs of substance-related crime. Alcohol is well known for its frequent association with crimes of violence (at least 30% of all cases), as well as with impaired driving, which results in major social and economic losses. Crime related to illegal drugs is of several types: organized crime, crimes against property committed in order to pay for drugs, true mainly in the case of heroin and cocaine, and crimes of violence committed under the influence of drugs. With the exception of organized crime and driving under the influence, cannabis involves few of the factors that generate criminal behaviour.

Secondly, according to the CCSA’s study, the main cost of illegal drugs, after loss of productivity, is the cost of law enforcement, which the study estimates at approximately $400 million. In Chapters 14 and 15, we note that police and court costs are certainly much higher than this figure, and probably total between $1 and $1.5 billion. The proportion of these costs attributable to cannabis is impossible to determine for certain. But, insofar as 77% of all drug-related offences involve cannabis, and of these 50% simple possession, and given that about 60% of incidents result in a charge, of which some 10% to 15% of cases the accused receives a prison sentence, it is clear that a considerable proportion of the drug-related activity addressed by the penal justice system is concerned with cannabis. While admitting this to be a very rough estimate, we suggest that about 30% of the activity of the justice system is tied up with cannabis. On the basis of our estimates and the lowest cost of law enforcement, or $1 billion, it costs about $300 million annually to enforce the cannabis laws.

In effect, the main social costs of cannabis are a result of public policy choices, primarily its continued criminalization, while the consequences of its use represent a small fraction of the social costs attributable to the use of illegal drugs.

Overall, we observed the following:

Ø The lack of any real national platform for discussion and debate on illegal drugs prevents the development of clear objectives and measurement indicators;

Ø The absence of a national platform makes exchange of information and best practices impossible;

Ø Practices and approaches vary considerably between and within provinces and territories;

Ø The conflicting approaches of the various players in the field are a source of confusion;

Ø The resources and powers of enforcement are greatly out of balance compared with those of the health and education fields and the civil society;

Ø The costs of all illegal drugs had risen to close to $1.4 billion in 1992;

Ø Of the total costs of illegal drugs in 1992, externalities (social costs) represented 67% and public policy costs 33%;

Ø The social costs of illegal drugs and the public policy costs are underestimated ;

Ø The cost of enforcing the drug laws is more likely to be closer to $1 billion to $1.5 billion per annum;

Ø The principal public policy cost relative to cannabis is that of law enforcement and the justice system; which may be estimated to represent a total of $300 to $500 million per annum;

Ø The costs of externalities attributable to cannabis are probably minimal - no deaths, few hospitalizations, and little loss of productivity;

Ø The costs of public policy on cannabis are disproportionately high given the drug’s social and health consequences; and

Ø The Canadian Centre on Substance Abuse is seriously under-funded; its annual budget amounts to barely 0.1% of the social costs of illegal drugs alone (alcohol not included). Its budget should be increased to at least 1%; that is, approximately $15 million per annum.

This chapter could begin and end with the same words: The international drug control conventions are, at least with respect to cannabis, an utterly irrational restraint that has nothing to do with scientific or public health considerations.

Three points bear making concerning the substance of the current conventions.

The first has to do with the absence of definitions. The terms drugs, narcotics and psychotropics are not defined in any way except as lists of products included in schedules. It follows that any natural or synthetic substance on the list of narcotics is, for the purposes of international law, a narcotic, and that a psychotropic is defined in international law by its inclusion in the list of psychotropics. The only thing that the 1961 Convention tells us about the substances to which it applies is that they can be abused. The 1971 Psychotropics Convention, which reversed the roles in that the synthetic drug producing countries wanted narrower criteria, indicates that the substances concerned may cause dependence or central nervous system stimulation or depression and may give rise to such abuse as to “constitute a public health problem or a social problem that warrants international control.”

The second point, following from the first, relates to the arbitrary nature of the classifications. While cannabis is included, along with heroin and cocaine, in Schedules I and IV of the 1961 Convention, which carry the most stringent controls, it is not even mentioned by name in the 1971 Convention, though THC is listed as a Schedule I psychotropic along with mescaline, LSD and so on. The only apparent criterion is medical and scientific use, which explains why barbiturates are in Schedule III of the 1971 Convention and therefore subject to less stringent controls than natural hallucinogens. These classifications are not just arbitrary, but inconsistent with the substances’ pharmacological classifications and their danger to society.

Third, if there was so much concern about public health based on how dangerous “drugs” are, one has to wonder why tobacco and alcohol are not on the list of controlled substances.

We conclude from these observations that the international regime for the control of psychoactive substances, beyond any moral or even racist roots it may initially have had, is first and foremost a system that reflects the geopolitics of North-South relations in the 20th century. Indeed, the strictest controls were placed on organic substances – the coca bush, the poppy and the cannabis plant – which are often part of the ancestral traditions of the countries where these plants originate, whereas the North's cultural products, tobacco and alcohol, were ignored and the synthetic substances produced by the North’s pharmaceutical industry were subject to regulation rather than prohibition. It is in this context that the demand made by Mexico on behalf of a group of Latin American countries during the negotiations leading up to the 1988 Convention, that their use be banned, must be understood. It was a demand that restored the balance to a degree, as the countries of the South had been forced to bear the full brunt of the controls and their effects on their own people since the inception of drug prohibition. The result may be unfortunate, since it reinforces a prohibitionist regime that history has been shown to be a failure, but it may have been the only way, given the mood of the major Western powers, to demonstrate the irrationality of the entire system in the longer term. In any case, it is a short step from there to question the legitimacy of instruments that help to maintain the North-South disparity yet fail miserably to reduce drug supply and demand.

We make the following observations:

Ø The series of international agreements concluded since 1912 have failed to achieve their ostensible aim of reducing the supply of drugs;

Ø The international conventions constitute a two-tier system that regulates the synthetic substances produced by the North and prohibits the organic substances produced by the South, while ignoring the real danger the substances represent for public health;

Ø When cannabis was included in the international conventions in 1925, there was no knowledge of its effects;

Ø The international classifications of drugs are arbitrary and do not reflect the level of danger they represent to health or to society;

Ø Canada should inform the international community of the conclusions of our report and officially request the declassification of cannabis and its derivatives.

Chapter 20 - Public Policies in Other Countries

The vast majority of Canadians have heard about the "war on drugs" which the USA is conducting and about its prohibitionist approach, but many would be surprised to see the major variations between states, indeed between cities, within that country. Even fewer know that Sweden enforces a prohibitionist policy at least as strict as that of the US, but through other means. Many of us have, in one way or another, heard about the "liberal" approach introduced in the Netherlands in 1976. Fewer people know of the Spanish, Italian, Luxembourg or Swiss approaches, which are even more liberal in certain respects. More recently, Canadians learned of the decision by the UK's Minister of the Interior to reclassify cannabis as a Class C drugs, but it is not clear that we know precisely what that means. In view of the preconceptions that many may have in relation to France with regard to wine, many may be surprised to learn that its policy on cannabis appears more "conservative" than that of neighbouring Belgium, for example. As may be seen, after the overall framework of the puzzle has been established by the international community, the ways the pieces are put together vary widely among states, and at times among the regions of a single state.

That is why, in order to learn about the experience and approaches of other countries, the Committee commissioned a number of research reports on the situations in other countries and heard representatives of some of those countries in person. We of course had to make some choices, such as limiting ourselves to the western countries of the northern hemisphere. This is a weak point in our Report, we agree, but our resources were limited. In addition, as we wanted to compare public policies with data on use trends and judicial practices, we were forced to choose countries with an information base. In our hearings with representatives of those countries, we were mainly limited by time and cost.

In this chapter, we describe the situations in five European countries — France, the Netherlands, the United Kingdom, Sweden and Switzerland — and in Australia and the United States.

Public policy is not just a matter of enabling legislation, in this case criminal legislation. Nonetheless, when it comes to illegal drugs, criminal legislation occupies a symbolic and determinative place. It is as if this legislation is the backbone of our public policy. Public discussions of cannabis do not deal so much with such matters as public health, user health, prevention of at-risk or excessive use, but with such questions as the pros and cons of decriminalization, establishing a civil offence or maintaining a criminal offence, or possible legalization and the extent thereof.

In respect of illegal drugs, where the key issues are, first and foremost, matters of public health and culture (including education and research), and where criminal law should be used only as a last resort, public policy must be based primarily on clear principles and objectives. For this to come about, public policy must be equipped with a set of tools designed to deal with the various issues that drugs represent to societies. Legislation is only one such tool. The social and economic costs of illegal drugs affect many aspects of society through lower productivity and business loss, hours of hospitalization and medical treatment of all kinds, police time and prison time, and broken or lost lives. Even if no one can pinpoint the exact figures, a portion of these costs arise, not from the substances themselves, but from the fact that they are criminalized. In fact, more than for any other illegal drug, its criminalization is the principal source of social and economic costs. However, in spite of the fact that the principal social costs of drugs affect business, health and family, the emphasis on the legal debate tips the scales of public action in favour of law enforcement agencies. No one can deny that their work is necessary to ensure public order and peace and fight organized crime. At the same time, over 90% of resources are spent on enforcing the law, the most visible actions with respect to drugs in the public sphere are police operations and court decisions and, at least with respect to cannabis, the law lags behind individual attitudes and opinions, thus creating a huge gap between needs and practice.

Most national strategies display a similar imbalance. The national strategies that appear to have the greatest chance of success, however, are those that strive to correct the imbalance. These strategies have introduced knowledge and observation tools, identified indicators of success with respect to their objectives, and established a veritable nerve centre for implementing and monitoring public policy. The law, criminal law especially, is put in its proper place as one method among many of reaching the defined objectives, not an aim in itself.

This chapter is divided into three sections. The first examines the effectiveness of legal measures for fighting drugs, and shows that legal systems have little effect on consumption or supply. The second section describes the various components of a public policy. The third considers the direction of criminal policy, and defines the main terms used: decriminalization, depenalization, diversion, legalization, and regulation.

In our view, it is clear that if the aim of public policy is to diminish consumption and supply of drugs, specifically cannabis, all signs indicate complete failure. One might think the situation would be worse if not for current anti-drug action. This may be so. Conversely, one might also think that the negative impact of anti-drug programs that are currently centre stage are greater than the positive effect, specifically non-compliance with laws that are inconsistent with majority attitudes and behaviour. One of the reasons for this failure is the excessive emphasis placed on criminal law in a context where prohibition of use and a drug-free society appear to remain the omnipresent and determining direction of current public policies.

We think that a public policy on psychoactive substances must be both integrated and adaptable, target at-risk uses and behaviours and abuses based on a public health approach that neither trivializes nor marginalizes users. Implementation of such a policy must be multifaceted.

Some say that decriminalization is a step in the right direction, one that gives society time to become accustomed to cannabis, to convince opponents that chaos will not result, to adopt effective preventive measures. We believe however that this approach is in fact the worst case scenario, depriving the State of a necessary regulatory tool for dealing with the entire production, distribution, and consumption network, and delivering hypocritical messages at the same time.

In our opinion, the data we have collected on cannabis and its derivatives provide sufficient grounds for our general conclusion that the regulation of the production, distribution and consumption of cannabis, inasmuch as it is part of an integrated and adaptable public policy, is best able to respond to the principles of autonomy, governance that fosters human responsibility and limitation of penal law to situations where there is demonstrable harm to others. A regulatory system for cannabis should permit, specifically:

· more effective targeting of illegal traffic and a reduction in the role played by organized crime;

· prevention programs better adapted to the real world and better able to prevent and detect at-risk behaviour;

· enhanced monitoring of products, quality and properties;

· better user information and education; and

· respect for individual and collective freedoms, and legislation more in tune with the behaviour of Canadians.

In our opinion, Canadian society is ready for a responsible policy of cannabis regulation that complies with these basic principles.

Conclusions and recommendations

The Senate Special Committee on Illegal Drugs’ mandate was to examine Canada’s public policy approach in relation to cannabis and assess its effectiveness and impact in light of the knowledge of the social and health-related effects of cannabis and the international context. Over the past two years, the Committee has heard from Canadian and foreign experts and reviewed an enormous amount of scientific research. The Committee has endeavoured to take the pulse of Canadian public opinion and attitudes and to consider the guiding principles that are likely to shape public policy on illegal drugs, particularly cannabis. Our report has attempted to provide an update on the state of knowledge and the key issues, and sets out a number of conclusions in each chapter.

This final section sets out the main conclusions drawn from all this information and presents the resulting recommendations derived from the thesis we have developed namely: in a free and democratic society, which recognizes fundamentally but not exclusively the rule of law as the source of normative rules and in which government must promote autonomy as far as possible and therefore make only sparing use of the instruments of constraint, public policy on psychoactive substances must be structured around guiding principles respecting the life, health, security and rights and freedoms of individuals, who, naturally and legitimately, seek their own well-being and development and can recognize the presence, difference and equality of others.

Thirty years ago, the Le Dain Commission released its report on cannabis. This Commission had far greater resources than we did. However, we had the benefit of Le Dain’s work, a much more highly developed knowledge base since then and of thirty years' historical perspective.

The Commission concluded that the criminalization of cannabis had no scientific basis. Thirty years later, we confirm this conclusion and add that continued criminalization of cannabis remains unjustified based on scientific data on the danger it poses.

The Commission heard and considered the same arguments on the dangers of using cannabis: apathy, loss of interest and concentration, learning difficulties. A majority of the Commissioners concluded that these concerns, while unsubstantiated, warranted a restrictive policy. Thirty years later, we assert that the studies done in the meantime have not confirmed the existence of the so-called amotivational syndrome and add that most studies rule out this syndrome as a consequence of the use of cannabis.

The Commission concluded that not enough was known about the long-term and excessive use of cannabis. We assert that these types of use exist and may present some health risks; excessive use, however, is limited to a minority of users. Public policy, we would add, must provide ways to prevent and screen for at-risk behaviour, something our policies have yet to do.

The Commission concluded that the effects of long-term use of cannabis on brain function, while largely exaggerated, could affect adolescent development. We concur, but point out that the long-term effects of cannabis use appear reversible in most cases. We note also that adolescents who are excessive users or become long-term users are a tiny minority of all users of cannabis. Once again, we would add that a public policy must prevent use at an early age and at-risk behaviour.

The Commission was concerned that the use of cannabis would lead to the use of other drugs. Thirty years' experience in the Netherlands disproves this clearly, as do the liberal policies of Spain, Italy and Portugal. And here in Canada, despite the growing increase in cannabis users, we have not had a proportionate increase in users of hard drugs.

The Commission was also concerned that legalization would mean increased use, among the young in particular. We have not legalized cannabis, and we have one of the highest rates in the world. Countries adopting a more liberal policy have, for the most part, rates of usage lower than ours, which stabilized after a short period of growth.

Thirty years later, we note that:

Ø Billions of dollars have been sunk into enforcement without any greater effect. There are more consumers, more regular users and more regular adolescent users;

Ø Billions of dollars have been poured into enforcement in an effort to reduce supply, without any greater effect. Cannabis is more available than ever, it is cultivated on a large scale, even exported, swelling coffers and making organized crime more powerful; and

Ø There have been tens of thousands of arrests and convictions for the possession of cannabis and thousands of people have been incarcerated. However, use trends remain totally unaffected and the gap the Commission noted between the law and public compliance continues to widen.

It is time to recognize what is patently obvious: our policies have been ineffective, because they are poor policies.

Ineffectiveness of the current approach

No clearly defined federal or national strategy exists. Some provinces have developed strategies while others have not. There has been a lot of talk but little significant action. In the absence of clear indicators accepted by all stakeholders to assess Canadian public policy, it is difficult to determine whether action that has been taken is effective.

Given that policy is geared to reducing demand (i.e. drug-use rates) and supply (by reducing the availability of drugs and pushing up drug prices), both these indicators may be used. A look at trends in cannabis use, both among adults and young people, forces us to admit that current policies are ineffective. In Chapter 6, we saw that trends in drug-use are on the increase. If our estimates do indeed reflect reality, no fewer that 2 million Canadians aged between 18 and 65 have used cannabis at least once over the past 12 months, while at least 750,000 young people between the ages of 14 and 17 use cannabis at least once per month, one third of them on a daily basis. This proportion appears, at least in the four most highly-populated provinces, to be increasing. Statistics suggest that both use and at-risk use is increasing.

Of course, we must clearly establish whether the ultimate objective is a drug-free society, at least one free of cannabis, or whether the goal is to reduce at-risk behaviour and abuse. This is an area of great confusion, since C