Wayne Hall takes a look at the US approach to medical and personal use of cannabis, and what it might mean for the rest of the world.
Policies towards the use of cannabis in the United States have changed radically in the past 20 years. For much of the past 40 years the US has had some of the highest rates of cannabis use and some of the most punitive policies towards it in the developed world.
Personal cannabis use was decriminalised in half the US states during the 1970s, but there was a return to punitive policies under Reagan.
Since 1996 around half – 23 – of the states, have legalised cannabis use in some form, for “medical purposes”. Legalisation often occurs by citizen-initiated referenda – a proposal that attracts the required number of signatures is put to the popular vote and, if passed by a majority, must be enacted by the state legislature.
Liberal medical marijuana laws arguably paved the way for the later legalisation of recreational cannabis use. Advocates defined medical use very broadly, allowing large numbers of users to obtain an indemnity against arrest under state law. Some states also allowed commercial “dispensaries” to supply cannabis to “patients” who had a doctor’s recommendation. This created a de facto legal cannabis market in states like California where 10 per cent of males aged 18-24 years reported “medical use”.
Increased public support for cannabis legalisation between 2009 and 2013 enabled the passage of referenda to legalise cannabis in Colorado and Washington State in 2012 and Alaska and Oregon in 2014. Similar proposals are likely to be voted on in 2016, including 10 competing initiatives in California.
So far Colorado, Oregon and Washington State have decided to regulate a legal cannabis market in much the same way as alcohol, limiting use to adults over the age of 21 (the legal drinking age), licensing producers, processors and retailers, and imposing a state tax. Critics are concerned this will lead to the commercialisation of the retail cannabis market with TV advertisements, special deals for frequent buyers etc. So far cannabis commercialisation has been constrained because the drug is still prohibited under US Federal law.
Should the citizens of these US states be worried about legalising cannabis? Those who see it as a wonder herb no doubt see legalisation as a good thing. It allows adults to use the drug without fear of arrest, it provides these states with a new source of tax revenue, and reduces the costs of enforcing the criminal law against cannabis users.
A less sanguine view would be that legalisation could also increase the amount of heavy use and cannabis-related harm. Cannabis is a drug with similar effects to alcohol. It is used for similar reasons by the same demographic – young males – and around 10 per cent of users engage in daily use, often for years, and sometimes decades.
Heavy cannabis use probably has fewer adverse effects than heavy alcohol use (although this is not a ringing endorsement, given the damage that heavy alcohol use causes). The clearest adverse effects are: an increased risk of motor vehicle accidents, if users drive while stoned; and in daily users, a dependence syndrome much like that of alcohol, where users find it difficult to control their use and are unable to stop, despite acknowledging that it is harming them.Troubled young people seem to be especially likely to become daily users and in this group, daily use is associated with poor mental health, early school leaving, other illicit drug use, unemployment and welfare dependence as adults, and cognitive impairment, if they continue to use daily from their teens and through their 20s and 30s.
It is still early days for cannabis legalisation in Colorado and Washington, but we have some clues as to what may happen from studies of the effects of medical marijuana laws (MMLs) that have operated for much longer. So far studies have not found increased cannabis use by young people in states with MMLs. There is growing evidence, however, that states with MMLs have higher rates of daily cannabis use among adult users. This is unsurprising because MMLs have made cannabis cheaper and more readily available, and increasing access to and reducing the price of alcohol also increases its consumption. MMLs have not so far had a clear impact on motor vehicle accidents but there is emerging evidence that they may have increased the number of people reporting cannabis use problems in surveys, and more users are presenting to addiction treatment services.
A major challenge for US state governments that have legalised cannabis is that it remains a criminal offence to produce, use and sell cannabis under Federal law. Under the Constitution, Federal laws pre-empt state laws when the two conflict, as the US Supreme Court ruled in 2001. In 2013 the Obama administration announced that it would give a low priority to enforcing Federal law in states that legalised retail sales of cannabis, provided these states regulated cannabis in ways that did not endanger public health or public order. The Department of Justice reserved the right to enforce Federal law if these priorities were not respected. It could take action in the US Supreme Court to over-ride the state laws or it could prosecute producers, sellers and state officials for breaking Federal laws; or it could simply confiscate the profits of legal cannabis sellers as the proceeds of criminal activity under Federal law.
It is uncertain how this policy may change after the election of a new President in 2016. Republicans are less supportive of cannabis legalisation than Democrats, but they also prefer to leave these issues to the states. A Federal response will also depend upon how many US states legalise recreational cannabis use in citizen-initiatives that coincide with the 2016 Presidential election.
Advocates of cannabis legalisation have their greatest hopes centred on California with its large-scale medical marijuana industry and a population of 38 million people. If California were to legalise, the Federal government would come under considerable pressure to change Federal laws e.g. by removing cannabis from the Federal Controlled Substances Act (CSA). California rejected a ballot initiative in 2010, but there are at least 10 ballot cannabis initiatives to be voted on in 2016.
The legalisation of recreational cannabis use in these US states is in breach of the 1961 Single Convention on Narcotic Drugs. This has major international significance because the US State Department has been the major architect and defender of the international drug control treaty system. The failure of the US government to comply with the drug control treaties will be seen as giving a license to other states to do the same.
Uruguay legalised cannabis in 2013 (in the face of a majority of opposing public opinion). Mexico and other Latin American countries have been discussing similar changes. Europe has more liberal cannabis policies than the USA.
What about Australasia? There is no mechanism for citizen-initiated referenda in Australia and New Zealand and even there were, the majority of public opinion opposes cannabis legalisation. The de facto or de jure decriminalisation of personal use has also arguably reduced some of the adverse social costs of cannabis prohibition, possibly reducing the pressure for more radical reform. This makes it more likely that our politicians will wait and see what happens in the USA before they contemplate more radical changes in their cannabis policies.
Wayne Hall is one of the speakers at the Applied Research in Crime and Justice Conference 2016 on 18-19 February in Brisbane. The event is organised by the Griffith Criminology Institute. For more details: http://www.policyforum.net/events/the-applied-research-in-crime-and-justice-conference-2016/