Complex. Challenging. Broad societal impact. Words that come to mind when thinking about the legalization and regulation of cannabis in Canada. I recently had the opportunity to hear the Honourable Anne McLellan, chair of the Government of Canada’s Task Force on Cannabis Legalization and Regulation, also use these words when she spoke at the University of Waterloo School of Public Health and Health Systems. She spoke about the work of the Task Force and where we are headed. Having scanned the 106-page Task Force’s report on the recommended framework for legalization and regulation, it was a welcome opportunity to learn more about how the recommendations came together (80 diverse position statements taken into consideration) and how quickly so (five months), in a more dynamic way. While Ms. McLellan recapped the general public health approach and principles upon which the legislation introduced by the federal government is based, i.e., take a cautionary approach and protect the public’s health and safety, she imparted some interesting and important side notes, a few I’d like to share here.
- It’s cannabis, NOT marijuana, from here on, folks! —As we go forward, we need to stop using the term marijuana in our messaging and replace it with the correct botanical name, cannabis. Marijuana is slang and more typically thought of as the dried flowers of the cannabis plant used for smoking or ingesting. Cannabis can be consumed in many different forms in multiple ways, so we need to re-educate ourselves, colleagues and those we serve.
- There is soooo much we don’t know about this plant!—We know something about THC and CBD, and still more to learn about them, but what do we know about the 104 other active ingredients in cannabis? Not much. Are they harmful or helpful? We need to know. There will be a huge focus on primary research in the botanical sciences and merging that knowledge into the biomedical space. Interested in studying plants? There should be plenty of work available in that field as we move forward.
- Why recommending the minimum legal age be 18 years makes sense—It’s true the developing brain is vulnerable to harms associated with cannabis use until 25 years of age. Contrary to recommendations made by medial associations and others to set it higher, the task force made this recommendation for a number of valid reasons. First, it makes practical sense for Provinces and Territories to choose to harmonize it with their legal drinking age, three of which have set that age at 18. Second, although it seems counter intuitive to not set a higher age when the focus is to protect youth, setting the minimum age too high would encourage an illicit market targeting youth and thus, leaving them more vulnerable to the harms associated with unregulated substance content and criminal interaction. Third, most Canadians who report use of cannabis in the past year are 15-24 years of age. Usage falls off dramatically after age 25 to about 10%. If the legal age were 25, it would criminalize the bulk of users and wouldn’t have much of a harm reduction impact, now would it? The Task Force believes that with quality public education, most people by age 18 can make an informed decision.
- It’s a one-sided gender target market, so far—Males by far out-number females in terms of recreational cannabis consumption, approximately to the tune of 3:1. However, once legalized in Colorado, consumption did see a rise among females. It will be interesting to see if that holds true in Canada as well.
- Education is key: from creating clarity around legalization to promoting health and safety—Ms. McLellan noted that many members of the advocacy for recreational cannabis community only seem to hear the word “legalization”, while the word “regulation” is ignored. Just because it will become legal, doesn’t mean it’s a free for all for cannabis to be consumed by anyone, anywhere, anytime. People must be educated to understand the rules and be held accountable to them for the sake of public health and safety. And while we must move away from a psychology of prohibition to legal use, proper public education is required to address both the benefits and harms to mitigate both fear among those opposed to legalization and the misguided belief there are no harms associated with cannabis among the fervent advocates. To keep children and teens safer, longer, it is paramount that parents and other adults involved with youth, and youth themselves receive effective education about the potential harms to the developing brain ahead of legalization and on-going.
In a nutshell, there is much to learn about cannabis, its effects, and how to best legislate production, distribution, and use to promote public health and safety. Every aspect of society will be impacted in some way by legalization and regulation of recreational cannabis from perceived norms to business development to educational opportunities to health care to law enforcement to—you name it! Thus, the Task Force has recommended legislation that is cautious and flexible to respond to evolving knowledge and experience. As health educators and promoters, we must get ahead of legalization and teach the risks of developmental harms to youth and those associated with problematic patterns of use at any age. We must target and engage parents, health care providers, educators, community workers, and youth themselves to develop and evaluate effective tools about facts, norms, and making healthy, safe choices around cannabis, regardless of what the laws will look like.