CANNABIS POLICY: MOVING BEYOND STALEMATE

Abstract

This slender and well-researched volume starts from the widely shared perception that cannabis policy has long-standing anomalous features. Its goal is to review the evidence about cannabis harms, about the efficacy of restrictive policies in controlling those harms, and about the harms associated with those policies (including both the damage associated with illicit commerce and the damage associated with law enforcement). On that basis, the authors attempt to construct a range of possible alter-native policies and a pathway towards their adoption. It would be hard to imagine a stronger team to undertake this task than that assembled by the Beckley Foundation, and the praise for their product offered by Thomas Schell-ing in the Foreword is fully justified. Cannabis is an outlier among currently illicit sub-stances in both in the breadth of its market and the modesty of the health and social damage it causes. Can-nabis policies have been widely relaxed. Use of the drug has been decriminalized to various extents, often de facto and sometimes de jure as well. In some jurisdictions there is no, or minimal, enforcement against small-scale sales. More recently, there has emerged toleration of produc-tion and sale for medical (and quasi-medical, and even pseudo-medical) use. Yet the drug remains at least nomi-nally banned for non-medical use world-wide. Nor is the ban entirely nominal. In all developed coun-tries the level of enforcement against production and sale is sufficient to make cannabis quite expensive on a unit– weight basis, albeit not very expensive on a per-hour-intoxicated basis. In the United States, the illicit market (and quasi-medical market) price is several times the esti-mated price of the drug were it legal. (Kilmer et al. esti-mate that high-potency cannabis that now retails for $300/ounce could be profitably produced and sold, even using relatively inefficient small-scale indoor growing, for about $40/ounce plus tax [1]). Cannabis supports a quite substantial illicit market: smaller in revenue terms than either cocaine or the illicit opiates, but in the low tens of billions of dollars world-wide. The cannabis markets tend to be less violent and to attract less vigorous enforcement and less drastic penal-ties than other illicit drug markets; but they continue to cause the social harms inseparable from large-scale illicit commerce, and the enforcement effort generates both costs to public budgets and harms to dealers and users. In the United States, there are more arrests for cannabis possession than for all other crimes relating to illicit drugs (although fewer than for alcohol offenses), and cannabis-related searches of individuals, vehicles and premises are common. Violating the cannabis laws is also the sole form of habitual lawbreaking for large numbers of otherwise law-abiding people. Damage to physical and mental health, although rela-tively low per dose, is magnified by the large number of users, and especially of heavy users. The numbers of cannabis users 'in need of treatment' by clinical stan-dards, and of those actually entering treatment, rank high compared to other illicit drugs, although far lower than for alcohol. Early initiation of use—an identified risk factor for various forms of damage—is a widespread concern, with the median age of initiation in some coun-tries hovering around 16 years. The potency of cannabis in terms of tetrahydrocannabinol (THC) content has been rising, along with the ratio of THC to cannabidiol; the book reviews the substantial, although not overwhelm-ing, evidence that both trends tend to make the drug more dangerous. As a set of policy outcomes all this seems not very satisfactory, and the 'stalemate' of the title reflects the authors' impatience with lack of movement toward poli-cies that might have better outcomes. A full analysis of cannabis policy would work forward from (i) formal policies embodied in statutes, regulations and the budgets and administrative rules of public agencies, to (ii) policies-in-practice (e.g. of enforcement) carried out by officials, to (iii) conditions influencing can-nabis use (such as price, availability, legal risks faced by users and attitudes), to (iv) use itself, to (v) harms associ-ated with use (vi), harms associated with illicit commerce and (vii) to harms associated with enforcement, includ-ing both budget costs and the damage resulting from punishment. On that basis it would be possible to choose, from among alternative sets of formal policies, that policy with the most attractive balance of benefits and harms. Then it would be necessary to work backwards from the identified optimal set of formal policies to the actions nec-essary to bring about their adoption. That is more or less the strategy of this book. No part of it is without difficulty. There is evidence, for example, that relaxation in formal policies towards cannabis users—notably decri-minalization of possession—tend to have little or no measurable impact on measures of use-related harm.