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Posts tagged medical cannabis
Moving Away from the Punitive Paradigm: An analysis of the 2023 OHCHR report on drug policy

By The International Drug Policy Consortium (IDPC)

In September 2023, the UN High Commissioner for Human Rights released a landmark report on human rights in drug policy. Prepared at the request of the Human Rights Council as a contribution to the mid-term review of the 2019 Ministerial Declaration on drugs, this report constitutes the most ambitious and comprehensive UN document to date on the alignment of drug policies with human rights. The report consolidates existing human rights standards, develops new recommendations, and proposes a blueprint for transformative change, from a global punitive paradigm to drug policies based on health and human rights.

This IDPC advocacy note focuses on three key issues. First, the new standards and recommendations developed in the OHCHR report, which update our understanding of the human rights dimension of drug policies. Secondly, the consolidation of prior human rights standards developed by other UN bodies. Lastly, we lay down our recommendations for an effective implementation of the vision proposed by the report.

London: IDPC, 2023. 7p.

Drugs: UK Parliament Home Affairs Committee Third Report of Session 2022–23

By UK Parliament, House of Commons, Home Affairs Committee

Drugs can have a significant and negative impact on people who use drugs, their loved ones and society. Trends in drugs may vary over time but this consequence is constant. Concerningly, drug misuse deaths across the UK continue to increase with opiates playing a significant role in this, and ‘street’ benzodiazepines and polydrug use also playing an increasing role. There were 250 drug misuse deaths per million population in Scotland in 2022—significantly higher than in England, Wales and Northern Ireland. In her Independent Review of Drugs, Professor Dame Carol Black estimated the total cost of drugs to society to be more than £19 billion per year—more than twice the value of the illicit drugs market (an estimated £9.4 billion).

In recent years, the response by the international community and devolved nations to drugs has increasingly focused on responding to drugs through a public health lens. UK policy should ensure that an approach originally and primarily based on criminal justice principles continues to adapt to achieve a proper balance of public health interventions that may reduce illicit drug use in the longer term rather than aiming simply to disrupt demand. We believe that this approach would be best supported by making drug policy the joint responsibility of the Home Office and the Department of Health and Social Care, with a minister sitting across both departments.

The main piece of legislation controlling drugs in the UK—the Misuse of Drugs Act 1971—is more than 50 years old. It is in need of review. Further, a full review by the Advisory Council is required on whether the most commonly controlled drugs in the UK are correctly classified and scheduled (under the Misuse of Drugs Regulations 2001), based on the evidence of their harms.

The Government’s latest drugs strategy, ‘From Harm to Hope: A 10-Year drugs plan to cut crime and save lives’ (the 10-Year Drugs Strategy) signals a shift towards recognising the need for a holistic response to drugs that not only aims to tackle the illicit drug market but also supports people who use drugs, their loved ones and society. However, the Government’s response could go further by adopting a broader range of public health-based harm reduction methods in tandem with its support of law enforcement efforts to tackle the illicit drugs market.

We support the use of diamorphine assisted treatment supported by psychosocial support as a second-line treatment for people with a chronic heroin dependency. We visited a centre in Middlesbrough and saw the dramatic and positive effect this treatment had on the lives of a small group of people who had used drugs and, albeit on a small scale, to local crime reduction. Disappointingly, such treatment programmes are few and controversial, and the Middlesbrough programme lost its funding. The Government should provide centralised funding for such programmes.

Safe consumption facilities, where people who use drugs may do so in safe, secure surroundings, may also reduce harm and deaths, but the status of such facilities is uncertain because of the restrictive regime in place under the 1971 Act. We recommend that the Government support a pilot facility in Glasgow and create a legislative pathway to enable more.

A national drug checking service in England could enable people to anonymously test samples of drugs, again preventing harm and potentially death. We recommend the Government establish a drug checking service, taking into account the experience of Wales. We also recommend the expansion of on-site drug checking services at temporary events such as music festivals and in the night-time economy through the creation of a dedicated licensing scheme. The power to issue such licences could include the devolution of power to grant licences to local authorities.

These public health and harm reduction interventions must be balanced with the role of police in applying the law. The police can also have a role in aiding prevention of drug use and treatment of harms. Scotland’s pioneering programme of having all police officers carry naloxone (a nasal spray or injection that can be administered immediately to reverse the effects of an opioid overdose) should be rolled out elsewhere in the UK as a straightforward means of saving lives. The police can also play an important role in diverting young people who have committed low-level drug-related offences away from the criminal justice system. We support greater standardisation of police-led diversion across England and Wales, to avoid a ‘postcode lottery’ in the treatment of such offenders.

London: House of Commons, 2023. 98p.

Cannabis Use Frequency and Cannabis-Related Consequences in High-Risk Young Adults Across Cannabis Legalization

By Amanda Doggett, ; Kyla Belisario,; André J. McDonald,; et al

Importance A key concern about recreational cannabis legalization is increases in use and adverse consequences, particularly among young adults (aged 18-29 years) who have the highest prevalence of cannabis use, and especially in higher-risk, more vulnerable young adults. However, few longitudinal studies have examined patterns of cannabis consumption in high-risk young adults over the course of legalization.

Objective To examine changes in cannabis use frequency and cannabis-related consequences over recreational cannabis legalization in Canada in a longitudinal sample of high-risk young adults.

Design, Setting, and Participants Longitudinal observational cohort study following young adults in Ontario, Canada, aged 19.5 to 23.0 years who reported regular heavy episodic drinking (65% past-month cannabis use) at enrollment. Participants were surveyed every 4 months for 3 years between February 2017 and February 2020 (3 prelegalization waves, 4 postlegalization waves). Data were analyzed from March to May 2023.

Exposures Recreational cannabis legalization in Canada and 4 potential moderators of change: sex, income, education, and prelegalization cannabis use frequency.

Main Outcomes and Measures Cannabis use frequency and cannabis-related adverse consequences.

Results In a cohort of 619 high-risk young adults (baseline mean [SD] age, 21.0 [1.2] years; 346 female participants [55.9%]), omnibus model testing revealed significant overall decreases in both cannabis use frequency (F = 2.276, 3000.96; P = .03) and cannabis-related consequences (F = 10.436, 3002.21; P < .001) over time, but these changes were substantially moderated by prelegalization frequency (frequency: F = 7.5224, 3021.88; P < .001; consequences: F = 7.2424, 2986.98; P < .001). Follow-up tests showed individuals who used cannabis more frequently prelegalization significantly decreased their use and cannabis-related consequences postlegalization. In contrast, individuals who did not use cannabis prelegalization exhibited a small magnitude increase in frequency over time but nonsignificant changes in cannabis-related consequences. Sex, income, and education did not moderate changes over time.

Conclusions and Relevance In this cohort study of high-risk young adults, individuals using cannabis frequently prelegalization showed significant reductions in use and consequences over time, reflecting an aging out pattern. Small increases in use among participants with no prelegalization use were observed over time, but without parallel changes in cannabis-related consequences. The results did not reveal substantive adverse near-term outcomes across the legalization period, although a within-participants design cannot rule out the possibility of alternative trajectories in the absence of legalization.

JAMA Netw 5 September 2023Open; 6(9); 2023

World Drug Report 2023: Contemporary Issues on Drugs. Booklet 2

By United Nations Office on Drugs and Crime (UNODC)

The booklet opens with a look at the challenges posed to law enforcement by synthetic drugs, both in terms of their increasing potency, adaptability and ease of manufacture and their shorter supply chains, reduced risk and lower production costs compared with drugs of natural origin. Other law enforcement challenges are considered in the context of the increasing use of social media for buying and selling drugs online.
Booklet 2 also examines approaches to regulating the medical cannabis market in different countries and assesses recent developments surrounding the therapeutic, spiritual and non-medical use of substances known as “psychedelics”. The remainder of the booklet focuses on issues related to drugs in specific contexts, including the Amazon Basin, where the convergence of drug crime and crimes that affect the environment poses a threat to natural and human ecosystems. The risk factors for and vulnerability to substance use disorders among forcibly displaced populations are also discussed in the booklet, and the interim outcomes of innovations and modifications of services for people who use drugs during the COVID-19 pandemic are summarized.

New York: United Nations,  2023. 205p.