The illicit cannabis trade has created a market which is focused primarily on profit, not on the health and wellbeing of its consumers, with no regulation to keep this in check. Not just in the UK, but around the globe, governments have attempted to address this problem through police enforcement and punitive measures. While the focus of this report is not to assess or review these approaches, it must be recognised that change is taking place when it comes to drug policy. Alternative systems are being implemented which provide solutions to the problems highlighted in this report.
The illicit market is unmanageable and, regardless of the attempts to clamp down on it, it continues to flourish.
The difference between a criminal, unregulated market and a legal, regulated one is not in the incentive to create profit, but the way in which government can implement effective controls over the sale of its products. The illicit market is unmanageable and, regardless of the attempts to clamp down on it, it continues to flourish. A regulated market can be changed and controlled by government – and, in the UK, we have a track record of doing so with alcohol and tobacco.
The cannabis market does not have to be in the grip of criminal gangs. It can be regulated, controlled and managed appropriately. The UK can provide a model where those who wish to use cannabis are given the information and support to do so safely. Money can be diverted away from crime and into the economy, where it can be used to support those who develop problematic use.
Finding a Balance
As we have explored, young people are at an increased risk of harm from consuming cannabis. Any proposals therefore need to have the interests of young people at their heart and work to best restrict access. At the same time, it is vital to move the market out of the hands of organised crime.
Finding a solution with these two goals in mind creates some tension. A system seeking to prevent access to young people requires many safeguards and controls, such as age limits, pricing strategies to discourage consumption, limits on promotion and advertisement. On the other hand, a model focused on displacing the illicit cannabis market requires the creation of a legal market that can effectively eradicate it. Excessive restrictions could therefore easily lead to the formulation of another illicit market.
The key is finding a balance where young people are adequately safeguarded with sensible restrictions on access and promotion, within a regulated market that can compete with the illicit trade.
In a regulated market, health advice and information could be provided at the point of sale, allowing consumers to make informed choices.
There should also be a balance when it comes to the choice of cannabis given to consumers. This report has raised concerns regarding strains high in THC and low in CBD, but many consumers may still wish to consume strains of such a nature, regardless of any risk. In a regulated market, health advice and information could be provided at the point of sale, allowing consumers to make informed choices. Should there be a demand for high THC cannabis, it may be that within a regulated model such strains are sold alongside adequate health warnings. This would ensure that the illicit market does not re-establish itself and that consumers act within a safer, monitored market that does not fund criminal enterprise.
There are many options available to tax cannabis and the most suitable method of doing so is likely to depend on the circumstances of the country in which regulation is being considered. One option would be that of a Pigouvian tax system, designed to cover the harms caused by the selling of cannabis through tax. To implement a Pigouvian tax system, the overall social cost of consuming cannabis would be calculated and then the product taxed to ensure that enough money is provided to mitigate against its harms. This method of taxation could be used to ensure cannabis with high levels of THC and low levels of CBD are taxed higher than more balanced strains. This would work in the same way as alcohol taxation does in the UK, where drinks containing a higher ethanol content are more heavily taxed.
This kind of system would not only provide a means to fund treatment services, but also encourage manufacturers of cannabis to produce balanced strains. This in turn would encourage consumers to also try more balanced strains rather than sticking solely to high potency cannabis. It would also allow cannabis with higher levels of THC to continue to be produced, although it is likely that such a product would not exist in vast quantities due to the increased cost to the consumer through taxation.
Protecting young people from the adverse effects of street cannabis is a priority and setting a minimum age for purchase is therefore a crucial issue.
A Minimum Age of Purchase
The evidence presented in this report shows how young people should be safeguarded against easy access to cannabis (particularly street cannabis) due to the associated health risks and current ease of access that exists. Protecting young people from the adverse effects of street cannabis is a priority and setting a minimum age for purchase is therefore a crucial issue.
It is important to acknowledge that age restrictions alone are unlikely to prevent young people from using cannabis and would need to be complemented with preventative measures such as improved access to drug education and restrictions on advertising in order to be effective.
Making a decision about age restrictions would require a careful balance of considerations. Setting the minimum age too high might result in the criminal market for cannabis continuing to thrive, but setting it too low could mean that young people are permitted to consume cannabis before their neurological development has stabilised. However, marking out cannabis consumption as an activity that is only for adults, able to make informed, responsible decisions, would be a very positive step to reduce harm.
The UK could follow the same guidance and ensure that preventative measures are in place to mitigate the harm to this group.
In Canada, where a regulated cannabis market is being established, the minimum age of purchase has been set at 18, although the task force advising the Government on regulation has recognised the importance of robust measures regarding both advertisement and education.
“To mitigate harms between the ages of 18 and 25, a period of continued brain development, governments should do all that they can to discourage and delay cannabis use. Robust preventive measures, including advertising restrictions and public education… are seen as key to discouraging use by this age group.” 1
The UK could follow the same guidance and ensure that preventative measures are in place to mitigate the harm to this group. The minimum age requirement could also be flexible, based upon the emergence of new evidence and understanding in the area of cannabis and its impact on young people’s brains.
Prevention and Education
It is essential that preventative work is undertaken alongside a regulated market to educate and inform young people of the detrimental effects of cannabis use, particularly on brain development, mental health, social integration and educational achievement. The Government’s latest drug strategy recognises the importance of effective preventative work and calls for more evidence-based work to be undertaken in education.2 The key issue in meeting this call for action is one of funding and resource. However, with a regulated cannabis market in place, tax collected by the Government could easily support evidence-based education programmes, to build resilience among young people and help to prevent problematic use.
Regulation also increases the opportunity for treatment services to engage with consumers of cannabis. Our ‘Black Sheep’ report highlighted how most problematic cannabis users are not engaged with treatment services and that the challenges of doing so in an illicit market are complex.3 If cannabis were to be sold in a regulated market, treatment services could develop relationships with shops selling the drug to establish referral pathways and promote non-problematic patterns of use in the community. Treatment services could facilitate drop-ins, provide promotional material and engage with the community far more easily than they do at present.
Having additional funding through a Pigouvian tax system could also allow specific services to be established, aimed at engaging problematic cannabis users. At the moment, the majority of cannabis users are not accessing treatment, which suggests that more innovation is required from treatment services to effectively support this cohort.
Strict Control on Promotion and Packaging
It is important to recognise that promotional work and advertising could have a detrimental effect on the efforts of youth drug education and prevention. Irresponsible advertising and promotion could present a mixed message to young people and lead to an increased desire to use, as well as more problematic use in both young people and adults.
To guard against this, advertisement restrictions similar to those outlined in the Tobacco Advertising and Promotion Act 2002 would ensure that promotion is only available at the point of sale, in places where under-18s are not permitted entry.
There is a debate amongst regulators and the public health community around the extent to which branding should be permitted. A branded product certainly create healthy competition and a high quality of product, but could become irresponsible in its attraction of young people if not sufficiently restricted. The answer appears to lie in responsible and regulated branding, allowing the formulation of brands, but not to the point where branding is irresponsible.
Many of the young people we spoke to for this report said that they only consume strains with high levels of THC and low CBD because it is all that they can get.
While the demand to smoke cannabis by young people in the UK will no doubt still exist, regulation opens up the opportunity for more effective policy to reduce the number of young people consuming cannabis. With an effective, regulated market in place there will be little need for an illicit cannabis market, and the availability and ease of access for young people could therefore significantly diminish. With such a reduced illicit market in place, enforcement agencies would find the task of policing it far easier, saving time, resources and money. This in turn would reduce the ease by which young people could access street cannabis.
As the illicit market reduces in favour of a regulated one, the type of cannabis that young people might be able to procure would change in nature. Street cannabis is grown to meet the needs of the illicit market and therefore contains exceptionally high THC and little CBD. As a regulated market with a variety of strains becomes available, those who do procure the drug illegally via the regulated market are far more likely to access less harmful strains of cannabis. Many of the young people we spoke to for this report said that they only consume strains with high levels of THC and low CBD because it is all that they can get.
By removing the illicit market, even those who do manage to illegally access cannabis not only have a choice on the strain (as many young people do procuring alcohol illegally), but they would be in most cases consuming cannabis that has far fewer risks associated with it.
Reform Provides Solutions
Policy reform can address the issues highlighted in this report. We do not have to continue to allow the illicit market to make billions of pounds in profit for criminal gangs and fill the market with harmful strains of cannabis that are impacting negatively on the mental health of consumers. We can take control by eliminating the illicit market, prioritising public health and by giving consumers greater choice in the procurement of cannabis. By providing choice, regulation would cut down on the use of more problematic strains which evidence shows are more likely to lead to addiction.
As the procurement of cannabis is currently a lottery and no evidence exists that enforcement can work, the only sensible solution is to follow other countries around the world and create a safer, regulated legal market.
The Cost of Doing Nothing
There is a need for a new debate and dialogue around cannabis in this country. While the evidence on the impact of THC on consumers’ mental health continues to emerge and be discussed, those who appear to be most at risk have ubiquitous access to highly potent cannabis. Rather than waiting for the debate to continue indefinitely and years of further academic research to come to light, we should take steps now to protect consumers’ mental health and address the issues raised in this report as a priority.
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