Pubdate: Fri, 12 Aug 2016 Source: Journal-Pioneer, The (CN PI) Copyright: 2016 Journal-Pioneer Contact: http://www.journalpioneer.com/ Details: http://www.mapinc.org/media/2789 Author: Desmond Colohan Note: Dr. Desmond Colohan is P.E.I.'s Chief Coroner and has a keen interest in responsible public health policy. 'LOW' AND 'SLOW' WHEN IT COMES TO LEGALIZATION At the request of the Canadian Medical Association, I recently completed a survey on the legalization of marijuana for recreational use. Should marijuana be legalized for recreational use? It's hard to argue against the responsible use of a plant product which has been around for thousands of years and has been used as a social and personal lubricant since time immemorial. History teaches us that mankind has always sought respite from the stresses of daily life through chemicals, and that much of the time we have turned to psychoactive plants for relief. Marijuana was legal in Canada until 1932, when it was criminalized in the face of a mounting concern over the dangers of psychoactive drugs like heroin, cocaine and alcohol. Interestingly, it wasn't criminalized in the United States until 1937. As I have pointed out in previous articles, the regular use of cannabis is not without risk. Like other psychoactive drugs, such as alcohol and tobacco, risk increases with consumption. The more you use and the longer you continue to consume, the greater your risk of suffering accidental injury, brain damage, mental health issues, various cancers or heart disease. Putting other risk factors aside, the less you consume, the lower your risk becomes. There is no level of consumption at which increased risk falls to zero. That having been said, as with other psychoactive drugs, the relative increase in risk needs to be considered before deciding to indulge or abstain. If your risk of becoming addicted to cannabis is about 10 per cent, are you prepared to accept that risk? If you use heroin regularly, your risk of addiction is about 23 per cent, while if you use tobacco, your risk of becoming hooked is about 32 per cent. If you start using cannabis regularly when you're just 15 years old, your risk of developing schizophrenia is over 4 1/2 times higher than if you wait until you're 18. Using marijuana regularly at any age still doubles your risk, albeit from a non-user lifetime likelihood of 1% to a user likelihood of two per cent. If marijuana is legalized, who should produce it and where should it be sold? Our current legal psychoactive drugs, tobacco and alcohol, are highly regulated and restrictions are placed on where you can purchase, how much you can purchase and how old you must be to purchase. The consequences of illicit sale, purchase, over-consumption and damage resulting from consumption are spelled out in regulation and the criminal code. Marijuana should be treated no differently. There has to be federal and provincial/territorial control over the supply, distribution and sale of cannabis for recreational use. Until we get a better handle on the societal implications of legalization, I think that it should initially be grown by and sold only through licensed facilities by knowledgeable health professionals, such as pharmacists, who should be available to counsel potential consumers. I am not naive enough to believe that a black market in cannabis will cease to exist. As long as price and convenience of purchase are consumer drivers, there will always be people looking for the lowest price and the most convenient way to score their drug of choice, whether legally or illegally, but the vast majority of consumers will continue to purchase and consume legally and responsibly. We are entering uncharted waters here and should be very mindful of the experience of other jurisdictions, such as the USA, Portugal and the Netherlands. As a wise mentor once told me, "start low and go slow." - --- MAP posted-by: Jay Bergstrom