Public health considerations a key part of pot legalization

Daily Brew

As Canada works towards marijuana legalization, it can learn from the public health policies of other jurisdictions that allow recreational pot, advocates say.

More than two-thirds of Canadians support the Liberal government’s stated plan to legalize marijuana, according to a Globe and Mail and Nanos Research poll released Monday.

But even with strong public support for the shift, it’s important to strike a balance between legalization and health protection — and it’s worth taking the time needed to get things right from the start, Ian Culbert of the Canadian Public Health Association tells Yahoo Canada News.

“We certainly support the legalization of marijuana, but only if it’s accompanied by a really strong regulatory framework that has a number of different controls around every aspect of cannabis production from seed to sale,” says Culbert, executive director of the independent not-for-profit representing public health. 

Before legalized pot is made widely available, Culbert says, it’s important to address the ways that legalization will affect public health — for example, by determining appropriate minimum ages for purchase, or lower limits for intoxication while driving.

And looking at the experiences of jurisdictions that have already legalized marijuana could provide some examples of best practices — and cautionary tales. 

Some of those concerns were highlighted last week by the news that Colorado ER visits by marijuana-using tourists doubled from 2013 to 2014, the year recreational cannabis use became legal in that state, researchers found. Researchers said it’s thought that the increases were related to the higher tetrahydrocannabinol concentrations — the active ingredient in marijuana — found in the legal products.

Pitfalls to avoid

Colorado’s experience highlights some of the potential pitfalls Canada could plan for as it moves towards marijuana legalization, Culbert says. In particular, it shows that rushing to create a regulatory framework is not ideal.

“In Colorado they were forced to do it in one year’s time, and everyone agrees that was too fast,” Culbert says.

Alaska and Oregon also had less than two years between the passage of ballot measures on legalization in late 2014 and the introduction of their laws allowing pot growth and possession in 2015. However, both states won’t introduce a regulated and taxed marijuana market until this year at the earliest.

But experience of Colorado and other states also provides some examples of positive ways to move forward, researcher Jenna Valleriani tells Yahoo Canada News.

“I think that there’s a lot that we could learn from Colorado,” says Valleriani, a PhD candidate at the University of Toronto and a board member for Canadian Students for Sensible Drug Policy. “We can also learn from their struggles.”

And while it’s valuable to learn from other jurisdictions it’s also important not to throw out the model Canada already has, Valleriani says — that is, its decade-old framework for legal medical marijuana. Part of doing that is ensuring that room remains for the medical system once Canada has legalized recreational pot, she says.

“While legalization is really exciting and there’s a lot of talk around it, I think we also need to be sure that we don’t sweep medical users under the rug,” Valleriani says.

Valleriani advocates for both the continuation of a medical model and the option of home growing — a ban on which a Federal Court struck down last week — and half the respondents to the Globe/Nanos poll agree with her. Home growing is allowed in Alaska and Colorado, though there are limits on the number of plants allowed in each home. But Washington state does not permit home growing. 

But Culbert says that home growing should be unnecessary under legalization and that a new framework should remove a separate distinction for medical marijuana.

“We really feel that it will be important to have only one regulatory framework once legalization comes to be, and the retail framework is the way to go,” Culbert says.

Health issues to address

Whatever the regulatory framework for legal marijuana looks like, it will have to deal with a variety of public health issues related to pot use. Key among those is a decision on a legal age for the purchase of marijuana, something that Culbert says must consider the potential harms of pot for younger users.

“We’re hoping that by creating the legal and regulatory framework we’ll be more effective at keeping marijuana out of the hands of minors,” Culbert says. CPHA would like to see that age at 21 nationwide.

A myriad of other factors must be considered, Culbert says, including appropriate guidelines for so-called drugged driving, packaging and advertising for legal pot products, and dosages for various forms of cannabis. 

Decisions must also be made about where marijuana will be sold: through separate dispensaries like those that already operate illegally across the country, through liquor stores or through another means like pharmacies. 

Colorado already had a network of legal dispensaries due to the state’s earlier legalization of medical marijuana, for example — and this proved valuable once those sites could sell recreational marijuana as well. But Washington didn’t, which meant demand for the product was difficult to meet in the early days of legalization.

Taking time to get these decisions right — and educating the public on how to avoid the potential harms of use — is key to transitioning to legal marijuana safely and effectively, he says.

“Education is going to be a huge part of what needs to be done, long before the actual legalization takes place,” Culbert says. “We have to switch from the prohibition model of ‘Just say no’ to the harm-reduction model of ‘Know when to say when.’”