The Greens want to legalise and regulate cannabis for Australians over the age of 18, claiming that taking it out of the hands of criminals will make our society safer. The policy announcement has set off alarm bells for many, especially those concerned about young people getting easy access to yet another dangerous drug. Maybe you’re also asking ‘Who needs that grief?’ But possibly more notable than the objections is the seismic shift in the drug debate. Australia21 Director Deborah Riceunpacks the arguments.

Are you worried about legalising cannabis only because using it has been a crime for almost a century? Of course not — everyone knows laws change to reflect changing social attitudes. In Australia being gay is no longer illegal; no fault divorce is no longer illegal; wearing a bikini is no longer illegal. What worries most people about legalising cannabis is the potential health and social damage it may do, especially to young people. Cannabis (aka marijuana, dope, weed or pot) is a dangerous toxic substance, a poison: that’s why it’s illegal, right?

Well, yes. And no.

It can be argued that cannabis use was only made illegal in Australia because of pressure from a racist government in the United States of America, which was running a scare campaign about Mexican immigration in the early 1900s. False claims about the dangers of ‘marijuana’ were used to demonise Mexicans and other people of colour, without most Americans realising it was the same as the cannabis plant, or hemp, that they had been using perfectly legally as a medicine and relaxant for centuries.

It’s true that cannabis use can be linked to increased rates of psychosis in some particularly vulnerable people. But there’s also a swathe of authoritative research demonstrating that cannabis is actually less dangerous than some currently legal drugs, including alcohol.

In 2011, the highly reputable British Association for Psychopharmacology examined the relative physical, psychological and social harms of these two most frequently used intoxicant drugs in the UK. Among other impacts, the study took into account the rates of schizophrenia and psychosis from cannabis consumption and liver cirrhosis hospital admissions and deaths from drinking alcohol. The comparison confirmed previous research showing that alcohol was more than twice as harmful as cannabis to users, and five times as harmful as cannabis to others around them.

In Australia, alcohol is linked to 5,000 deaths and more than 150,000 hospitalisations each year. In 2017, Australian Medical Association President Michael Gannon slammed the federal government for its ten-year National Drug Strategy listing methamphetamine as its top priority, although ice use “pales into insignificance with the problems caused by legal drugs like alcohol.” Cannabis doesn’t even come close.

It has to be recognised, however, that there’s strong medical evidence that both cannabis and alcohol can have negative impacts on developing brains — the younger that people start using them, and the greater the frequency, the greater the risks of harm.

Dr Alex Wodak, who ran the Alcohol and Drug Service at St Vincent’s Hospital in Sydney for 30 years, supports the Greens’ policy because it’s based on the principle that any drug or substance (including alcohol, tobacco and pharmaceuticals) has the potential to be of harm to the individual or to the community.

Dr Wodak, who’s President Australian Drug Law Reform Foundation and a Director of Australia21, recommends strict penalties for people caught selling cannabis to anyone under 18, just as there are for alcohol.

He says regulation would also enable governments to mandate plain packaging, like we have for cigarettes. The packages could provide health warnings, information about seeking help, and consumer product information including the content of psychoactive ingredients and their concentration.

“Government-commissioned guidelines for less risky alcohol consumption have existed for decades. Regulating cannabis would enable government to start commissioning guidelines for less risky cannabis consumption,” says Dr Wodak.

But even if you accept the evidence that cannabis is less harmful than alcohol and health warnings can help keep the risks in check, the question remains: Why make any narcotic more easily available? Doesn’t that just compound the drug problem and put our children in greater danger? Surely two wrongs don’t make a right.

Wouldn’t legalising cannabis increase the use and the associated harms?

The Greens’ argument that making cannabis legal would actually reduce the harms from its use sounds totally counter-intuitive, so it’s not surprising that the gut reaction of a lot of people has been to reject the policy.

For example, Jo Baxter from Drug Free Australia told Channel Ten’s The Project that a policy of taxing cannabis would never offset the burden on our health system if it was legalised.

“It would send the message that it’s permissible and safe to use, and it would increase use, particularly among young risk-takers.”

Not so, according to the Australian Medical Association.

“Importantly, we know that countries that have adopted non-punitive responses to drug use have not experienced major increases in the prevalence of drug use, and have reduced the stigma associated with drug use and seeking treatment from doctors,” says AMA Vice President Tony Bartone.

Dr Wodak agrees with that assessment.

“Supporters of cannabis prohibition frequently assert with great confidence that punitive approaches reduce consumption while a lenient approach increases use. Yet credible evidence to support this contention is unimpressive.

“A study comparing residents of more liberal Amsterdam and more punitive San Francisco using the same methodology found less illicit drug use (including cannabis) in Amsterdam,” says Dr Wodak.

The Greens want advertising of cannabis banned from the outset, saying use of the substance shouldn’t be condoned or encouraged. But they argue the idea of prohibiting it altogether to protect people ignores an important reality: many Australians are buying black market cannabis already.

The 2010 National Drug Strategy Household Survey found that cannabis is the most commonly used illicit drug in the nation. According to the federal government’s own figures from 2016, millions of Australians choose to use cannabis each year despite it being illegal; Dr Bartone says 35 per cent of the population has tried it. And research shows the drug is easy to obtain in Australia. So advocating abstinence as a widespread policy has proven very ineffective.

Wouldn’t punishing cannabis users stop them from getting harmed?

Far from preventing damage, many health professionals and social services providers warn that criminal convictions often cause or worsen a whole range of harms for individual drug users and Australia as a whole.

The highest proportion of illicit drug arrests in Australia are for cannabis possession — and 90 percent of those arrested are consumers, not manufacturers or traffickers. The sad irony is that arrest and prosecution often leads to the loss of employment, housing and family and community support. This can spiral into further crime, while also increasing homelessness, domestic violence, child protection interventions, mental health issues and suicide rates.

To top it off, there’s no evidence that offenders who’ve been jailed reduce their drug consumption — quite the opposite, in fact. It’s well known that spending time in jail, particularly if prisoners are young, puts them in greater physical and mental danger, exposes them to harder drugs and turns many into life-long criminals instead of rehabilitating them.

So Australia’s current laws cause collateral damage to the drug users’ families and their communities — and all Australian taxpayers end up footing the bill for the negative flow-on effects.

That’s why the Australian Medical Association supports reforming drug laws.

Although it’s cautious about the model the Greens are proposing, the AMA agrees that harm reduction strategies should take into account both the potential damage from using substances such as cannabis, and the potential damage and negative impacts of the different approaches for controlling the use and supply of the substances.

“We support their harm minimisation intent, believe that criminal penalties for personal use are unhelpful,” AMA President Dr Michael Gannon tweeted after the Greens’ announcement.

Vice President Tony Bartone went further:

“Prohibition of cannabis use with criminal penalties has the potential to produce harms and risks. Furthermore, the effectiveness of criminal prohibition of cannabis use in reducing the health-related harms associated with cannabis use is questionable.”

“The way Australia manages drug use is clearly not working. Increased investment in policing and incarceration is not having the desired impact. There are other more appropriate measures available,” Dr Bartone told the ABC.

Aren’t the support services for problem drug users inadequate?

Another critic of the Greens’ policy, former WA police commissioner Karl O’Callaghan, told the ABC he was worried that removing criminal sanctions for cannabis use could trigger or exacerbate mental health problems for people like his son, who had battled with drug addiction.

“They are very significant and trying to get adequate help, even today, without decriminalisation is very, very difficult. I would be concerned that parents would be left with nowhere to turn if the services are not in place as a result of this proposed policy.”

Prevention and treatment programs are far more likely to help someone overcome substance addiction than sending them to jail, but Mr O’Callaghan is right: there’s a chronic lack of services. Drug rehabilitation and education are (dare we say it) criminally underfunded, a fact highlighted by a recent federal parliamentary report.

This is exactly why health and social service organisations and policy leaders from across Australia held a summit in March 2018 and signed a joint statement calling on Australia’s federal, state and territory governments to treat drug use primarily as a health and social issue and to remove criminal sanctions for personal use and possession.

Also, in 2017 a prominent group of serving and former senior police, prison officers, lawyers and Alcohol and Other Drug experts put their names to Australia21’s groundbreaking report Can Australia respond to drugs more effectively and safely?, calling for decriminalisation of personal use and possession, hand-in-hand with the provision of more health and social services to reduce drug-related problems.

According to former Australian Federal Police Commissioner Mick Palmer, who’s now a Director Emeritus of Australia21, one of the flaws of the current law and order approach is that it discriminates against those who are most vulnerable.

“People most likely to come to notice of police are Indigenous people, homeless people, people who suffer mental health and other health related problems, including people like Vietnam vets.”

The experience with alcohol shows that some people are likely to struggle with dependence and other adverse reactions like overdoses, whether the substances they take are legal or not. But in the case of illicit drug use, Mr Palmer says getting help is a whole lot harder.

“Impairments are occurring now under a totally unregulated black market regime and when people suffer adverse reactions, they are less likely to immediately seek help and tell the truth, due to the unlawfulness of their conduct.”

As Dr Bartone pointed out, removing the stigma and threat of prosecution for cannabis use would make it easier for people to seek medical treatment as soon as they need it.

The Greens argue that regulating the market would provide welcome revenue through the taxation system, which could be spent on appropriate mental health services. Australia21’s own research has identified further potential cost savings from reducing the prison population and supporting police and the judicial system to focus law enforcement more usefully.

Isn’t cannabis a ‘gateway drug’ for more dangerous substances?

Health Minister Greg Hunt was a vocal critic of the Greens’ cannabis policy, claiming that legalising it would create physical and mental health problems.

“Marijuana is a gateway drug. The risk of graduating to ice or to heroin from extended marijuana use is real and documented,” Mr Hunt told reporters in Melbourne.

But Mr Hunt is wrong. The Gateway theory was used for decades without evidence and has long been discredited. There’s actually stronger correlation between early alcohol/tobacco use and later heroin use.

“A 2014 study showed that in US states where medicinal cannabis was lawful, the rate of opioid overdose deaths was 25% lower — and that it was lowest in the states that had legalised it earlier,” says Dr Wodak.

Papers published since have supported that research.

Mick Palmer is disappointed with the Health Minister’s response.

“Mr Hunt is an intelligent man who should  be able to do better. I don’t believe anyone proposing change is ignoring any adverse impacts – physical or otherwise. The reduction of harm is at the very heart of what drug reform is all about.

“Some 2-3 million Australians are already using cannabis – and many are holding down very responsible positions. They currently purchase cannabis from criminal black markets, without knowledge of its toxicity or purity and the profits line criminal’s pockets. No one is suggesting there is a perfect solution here, but Australians have the right to expect our political leaders to be prepared to consider and discuss any proposal that has any potential to improve the status quo.”

Mr Palmer is also critical of Labor leader Bill Shorten, who called the Greens’ policy ‘political click-bait’ and dismissed drug use as a state and territory responsibility.

“I was extremely disappointed that Mr Shorten should simply play politics with this issue. Not to recognise the value of considering the Greens policy is, I believe, a reflection of the sadness of contemporary politics.

“The health of many ordinary decent Australians who – for whatever reasons – take cannabis recreationally, or who become addicted, should be of concern to everyone and particularly our politicians. We need Commonwealth leadership,” says Mr Palmer.

Doesn’t international evidence show increased car accidents and hospital admissions?

In an interview on The Project, panellist Waleed Aly challenged Greens leader Dr Richard Di Natale about figures from Colorado in the United States, showing a jump in traffic fatalities since recreational cannabis was legalised there in 2012. But the original analysis by the Denver Post was questionable. The Colorado Department of Transportation and public safety officials dismissed it because there wasn’t enough data to positively prove that the deaths were linked to the cannabis or its legalisation.

The US National Institute on Drug Abuse and the American Automobile Association both caution that THC, the principal psychoactive constituent of cannabis, can remain detectable in body fluids for days or even weeks after intoxication, so testing positive doesn’t necessarily mean drivers are impaired or at fault for fatalities — it may merely show an unsurprising rise in the legal use of cannabis. On the other hand, they point out that many drivers who test positive for cannabis also have alcohol and other drugs in their system, which may contribute more significantly to crashes. A 2017 report to Congress by the National Highway Traffic Safety Administration based on US-wide experiences concluded there was poor correlation between impairment and THC levels in the blood or oral fluids.

Mr Aly also quoted figures indicating a rise in hospital Emergency Room visits for cannabis-intoxicated children in Colorado, but the interpretation of those figures has been disputed too. To begin with, ‘children’ referred to anyone up to 21 years old. Cannabis use wasn’t necessarily the underlying cause of the emergency or even related to it, but was noted if there was any possibility that it may have been relevant to the patient’s treatment — as were other possible causes. The figures were not backed by any lab testing.

Another issue raised by Mr Aly was a spike in poisonings from edible cannabis. Colorado definitely erred in initially not requiring sufficient warning about risks of cannabis overdose from edibles — oral absorption of cannabis is quite slow, so some people who thought it wasn’t having much effect ate more than they should have, not realising it was still to kick in. Colorado quickly revised its protocols. There are now prominent warnings on the packaging, which staff selling the edibles are required to read to customers.