Cannabis: Decriminalization, Enforcement or Health Promotion



I Introduction



The consumption of any harmful substance has never co-existed harmoniously with health, whether it be the recreational use, occasional or abusive, of either legal drugs (such as alcohol and tobacco) or illicit drugs.



For both young and older users, the regular consumption of harmful substances such as cannabis, marijuana and others increases the risk of substance abuse, with the many repercussions that is known to have on individuals, families and communities, which have been abundantly proven and documented by numerous studies. The long-term effects of substance abuse are heightened in the case of young drug users because of their physical, mental and psychological vulnerability and the fact that they are compromising their future, and thereby society's.

II The Canadian Situation



For years now, every level of government in Canada has spent vast sums of money to combat substance abuse, with little success. All kinds of well-substantiated studies show that the rate of consumption of illicit substances and cannabis is steadily increasing in Canada. Data from surveys on cannabis use among young people and adults are worrying.



For instance, "A Statistics Canada study indicates that the percentage of people who admit to consuming cannabis has virtually doubled in 13 years. In 1989, 6.5% of Canadians said they had smoked cannabis at least once in the past year. In 2002, the proportion had increased to 12%. Almost half of those who had used cannabis had done so less than once a month. Approximately 10% said once a week, and another 10% said every day. The highest number of consumers are youth aged 15-24" (http://www.radio-canada.ca/url.asp?/radio/maisonneuve/22072004/37951.shtml)



The search for the causes of rising drug use in Canada reveals one striking fact: increased social acceptance of certain substances, in this case, marijuana. The reason for this general permissiveness is elusive: "In recent years, we have noticed greater social acceptance. Surveys indicated recently that 47% of Canadians would support the legalization of marijuana, or so a survey by the Globe and Mail newspaper in late 2001 revealed. And more than 50% of Quebecers would be prepared to decriminalize the consumption of cannabis for personal use (Nadeau, 1995). According to the Canadian Press, a Léger Marketing survey showed that 53% of Quebecers would approve of the federal government's legalization of the sale and consumption of marijuana." (http://www.geocities.com/mauricehotte1999/cannabis).



Concerned about the quality of life of our country's entire population, we sometimes overreact to the magnitude of the overt consequences of substance abuse, which often prevents us from seeing the real reasons that drive people to use drugs and seeking appropriate solutions. In our desire to eliminate the effects of substance abuse, we spend our time battling the symptoms, and thus respond by advocating drug treatment centres and enforcement measures. Of course it is important to detoxify substance abusers so they can become citizens who are better equipped to contribute to the development of their community, but tackling the real causes such as problematic socio-economic environments, social values based on individualism and the pleasures of drug use would be much more effective. Preventive measures based on health promotion principles can be much more effective in the battle against substance abuse. The statistical data in this respect are compelling: "These substance abusers often come from problematic socio-economic environments where poverty and crime are pervasive, or share similar characteristics: low self-esteem coupled with psychological and social distress. This minority uses drugs to fill a significant emotional void" (http://www.geocities.com/mauricehotte1999/cannabis).



Youth and adults in this category of drug users referred to as substance abusers need help, not enforcement. Enforcement may result in a temporary decrease in the rate of consumption of a given product, but it will not produce the anticipated results; i.e., encouraging youth and adults who decide to stop using drugs. If we had allocated most of the billions of dollars spent in North America on enforcement over the past few years on prevention and health promotion instead, we would probably have had better results. Prevention may prove more effective in the battle against a social evil such as substance abuse, "And yet scientific literature makes it clear that prevention is necessary to decrease prevalence. The governments are fully aware that they must invest in prevention, and yet they continue to discriminate in favour of funding for treatment centres and the enforcement sector...Enforcement has very little impact on the decision whether or not to smoke pot. In fact, more than 90% of those arrested for possession of cannabis continue, despite the enforcement to which they were subjected, to use cannabis the following year (CCLAT, 1998)" (http://www.geocities.com/mauricehotte1999/cannabis).



Decriminalization does offer some solutions. Because they can speak without fear of reprisal, drug users can enable public institutions and prevention and promotion agencies to get a better understanding of their needs and perhaps to develop more appropriate programs. In addition, a number of well-documented studies have shown that light consumption of cannabis has therapeutic benefits, i.e., it provides some relief for chronically ill patients who are in constant pain. Decriminalization, however, may create another problem: smuggling. According to Line Beauchesne, a professor in the University of Ottawa's Department of Criminology, "Although decriminalization offers the advantage of reducing police control and allows the drug users some degree of social integration, it is a very limited solution from a health promotion perspective. It does not result in quality control or any improvement in the distribution channels for the products, which would help reduce intoxication. Moreover, it does not legalize recreational use. Decriminalization does not consider users as people who would be capable of regulating their consumption if they were properly informed about the products, if the substance was low strength and its quality was guaranteed.



"The many government commissions and scientific studies that have assessed the effectiveness of the prohibition of certain drugs in the prevention of drug use are unanimous: the current legislation has been outright ineffectual as a health promotion strategy. Moreover, it has exacerbated the situation it was meant to prevent by creating a huge, out-of-control black market and by depriving thousands of people of certain kinds of medical treatment." (Beauchesne, 1994)



Maurice Hotte, a social worker who specializes in substance abuse, has this to say about decriminalization: "In my practice, I have noted repeatedly that the lack of cannabis, for example, could prompt some users, especially young people, to try much more harmful products, such as powerful hallucinogens like LSD, or other dangerous substances, such as volatile products like aerosols, gasoline, etc." (http://www.geocities.com/mauricehotte1999/cannabis).



~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *



III Conclusion



Given that enforcement has proven limitations in the battle against substance abuse, and decriminalization has only limited advantages (fostering social inclusion, allowing the therapeutic use of cannabis) which are offset by the potential problem of smuggling, we must concentrate our efforts on what Maurice Hotte calls "a holistic strategy of prevention and health promotion." In other words, appropriate and effective prevention and stepped-up socio-economic measures to improve the living conditions of at-risk groups. Practically speaking, that implies the following:

* Taking concrete steps to help those in need, thereby decreasing the suffering that places them at risk and

* Increasing funding for prevention programs.



Substance abuse prevention requires both standardized practices by substance abuse workers and an emphasis on the following:

* Skilled workers

* Trust between substance abuse workers and the target population (MSSS, 1991). Patient participation in the development and implementation of prevention programs is essential (Blanchet, 1993)

* Respect for and acceptance of patients

* Education



In short, without discarding decriminalization altogether because of its role in social integration, prevention and health promotion strategies remain a sound investment in the battle against substance abuse. In order to ensure environments conducive to our societal development, these strategies must make the public aware of the impact of its acceptance of cannabis. Then the battle against substance abuse will be able to claim a significant victory.

Beauchesne, L., Gigure, E. "Le sport et la drogue." Montréal : Le Méridien, 1994.



Hotte, M. "Entre la décriminalisation et la légalisation du cannabis:

La vraie mesure ?" http://www.geocities.com/mauricehotte1999/cannabis. Accessed July 15, 2005.



Maisonneuve. "Le cannabis de plus en plus populaire" (Le 22 juillet 2004). http://www.radio-canada.ca/url.asp?/radio/maisonneuve/22072004/37951.shtml. Accessed July 15, 2005.