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Cannabis Conference: Shaping A New Agenda

February 19, 2002
Cannabis Conference: Shaping a New Agenda; Liverpool, Devonshire House

The Conference, organised by HIT of Liverpool, was attended by approximately 200 delegates, mostly from the North West of England. These consisted of doctors, police, magistrates, probation officers, students union and youth group representatives, teachers, drug advisors and counsellors and other drug workers. There were very few cannabis campaigners present.

The Conference, which ran from 1 pm to about 4,30, consisted of two parts: the main speakers and a panel to answer questions from the audience.

The conference was introduced by Professor John Ashton, Director of Public Health, NHS Executive
North West.

John Witton, National Addiction Centre, London: Cannabis: a review of the scientific evidence.

John Witton is to release his book "Cannabis The Facts" later this year. With the help of slides showing the various claims that cannabis is dangerous to health, John systematically reduced each claim to mere speculation. He said that we would hear words such as "may cause" and "uncertain evidence" throughout his talk.

Cannabis, he stated, is entrenched in society and the harms need to be based upon a systematic review of the hard evidence. In Britain it is used by 25% of adults, 6% in the last month. Figures reflected in other countries - Australia 39% have used, 4% use weekly - USA 35% have used and 5% use regularly..

The major recent reports worth considering are those from W.H.O., the US Institute of Medicine 1999, and the National drug and Alcohol Research Centre 2001.

The main problems in assessing harm are the variation in dosage, combination with tobacco, the lack of any controlled long-term effect studies, and the intermittent and limited use over time. These all complicate the picture.

The usual claimed adverse effects, are rarely observed and mostly in novice users; these are anxiety, dysploria, panic, paranoia, psychomotive impairment, something like a psychotic reaction with high doses, and an increased risk of low weight babies for mothers who smoke. In fact, these effects are rare.

Potency:
Cannabis contains 60 cannabinoids and a claimed increase in THC content may lead to an increase in the risk of adverse effects. As yet there is no evidence of that. we must ask whether cannabis users titrate the dose if THC content is higher. In fact, there is no evidence that overall THC content has increased over 30 years. The University of Mississippi research has shown an average content of 3% in the 80'3, now only 4%. There are still plenty of questions about any impact of any increase in potency.

Psychological harm:
There may appear to be some exacerbation of the symptoms of schizophrenia and it is claimed that cannabis may precipitate it in vulnerable people, but it is uncertain whether it can cause it. The background of users needs to be considered - the evidence is contradictory.

Dependence:
The definition of the word has been changed to include a difficulty in stopping use and under that criteria there are reports of dependence. He criticised the methology.

Gateway to hard drugs:
The role of cannabis is unclear. there are pharmacological, genetic, sociological explanations too. The sequence of drug use is often identified as tobacco, alcohol, cannabis, hard drugs, but it is still unclear.

Driving skills:
There is little evidence of impairment and that is minor. Cannabis has been found in blood and urine samples of accident victims but the real role of cannabis in causing accidents is unclear. cannabis-intoxicated drivers appear more cautious than others in recent studies.

Respiratory system effects:
Cannabis is often used with tobacco but the unpleasant constituents are tars which are deposited in the lungs. This causes changes in bronchial tissues and an increase in symptoms of chronic bronchitis - but these all relate to smoke.

Cancer, the immune system and the reproductive system:
The evidence that cannabis causes cancer is very weak and there is no evidence that it causes any major impairment to the immune system or reproductive system.

Cognitive functioning, memory, amotivation:
There is no evidence of chronic brain damage or evidence of any long term impairment to memory o skills. Evidence of subtle impairment to memory is emerging in Australia. There is no evidence of amotivation - it is already there in some users.

Major at-risk people:
adolescents with poor school performance, women who smoke during pregnancy, those with pre-existing conditions such as schizophrenia or cardio-vascular problems. There is sparse research into the effects of passive smoking on children.

Professor Martin Plant, Director, Alcohol and Health Research Centre, UWE:

Cannabis, other drugs and young people.
Professor Plant stated that the debate has often been a moral one and objections have often arisen out of a bad perception of cannabis users (from the 60's - long hair and rock music)

Deaths in the UK from tobacco are 120,000 annually, alcohol accounts for a further 20,000 plus, whereas all the illicit drugs account for just a few thousand. Very rarely does cannabis feature in drug death statistics and in those case it is mostly road accidents. Yet drug offences have increased over the last 10 years and cannabis accounts for over 70% of them.

Bob Keizer, drug policy Advisor of the Ministry of Health, Welfare and Sports of the Netherlands.

In the Netherlands, the state does not interfere with individuals unless problems are caused - there is no interference with moral standards. They have diverse politics and the state and church are separated.
The main objective of Dutch policy is to prevent harm. Since 1976, there has been a distinction between cannabis and other drugs.

Drug use is not prohibited in the Netherlands, as indeed it is not under the UK Misuse of Drugs Act. Youngsters are not given a criminal record just for the possession of cannabis. Coffeeshops where small-scale supply is tolerated account for half the supply.

They have an integrated approach and invest in addict care and prevention, justice and public order, research and monitoring programs.

The principle is expediency and the goal is to decriminalise users and separate the market from hard drugs.

Coffeeshops are not legal. They are tolerated and there are strict conditions:

  • less than 5 grams per transaction per day,
  • no hard drug,
  • no advertising,
  • no nuisance,
  • no minors (under 18).

According to the EMCCD in 1999, cannabis use in the last month for 15-16 year-olds in the Netherlands was 14%; in Ireland it is 15%, in the UK 16%, in France 22%, in the US 19%.

Of the general population: Netherlands 5%; UK 9%, France 5%, USA 9%. Hard drug use: Netherlands 2.5%; UK 5.6%; Sweden (hard line policies) 3%; France 3.9%; Italy 7.2%.

Current Issues:
The problems with back door supplies to coffeeshops which cannot be regulated. Coffeeshops are still illegal and in the last 3-4 years the numbers have been reduced from 1200 to 800 due to complaints of nuisances, mostly from hard drug users.. As yet they have no solution to supply of coffeeshops.

The Netherlands has found opponents to its policies from around the world - Germany, Sweden and the USA were main opponents. Germany is now becoming more progressive and there is little criticism any more. France is also less critical. They have yet to convince Sweden or the US. There is more collaboration with European countries.

They are still fighting the hard drug trade and the organised drug trade although it is practically impossible because they are an open country with no border controls. They also seize large amounts of cannabis plants. Unlike most countries, the average age of hard drug addicts is increasing by one year each year.

Conclusions:
No increase in use,
harm reduction pays off,
no increase in number of hard drug addicts.
The key is the interplay between practice, science and politics.

Panel:
The Question and Answers panel was chaired by Rod Thomson, Joint Commissioning Manager, Sefton DAT, and consisted of:

  • Alun Buffry, Legalise Cannabis Alliance;
  • Detective Chief Inspector Colin Matthews, Merseyside Police;
  • Dr Tony Quinnell, Senior Clinical Medical Officer, Stockport CDT;
  • Hywel Sims, Chief Executive ADFAM National;
  • Brenda Fullard, Regional Coordinator Smoking Cessation, NHS Executive North West;
  • plus above three speakers and Professor John Ashton.

There appeared to be very little objection from the audience of delegates.to a change in law.

Brenda Fullard repeatedly stated that she feared a relaxation of the law on cannabis would cause an increase in use of tobacco.

The panel were otherwise in support of a relaxation of the law although, apart from the LCA who proposed full legalisation of possession, cultivation and supply, there were no real ideas of how a change could manifest.

Dr Quinnell, who was initially reluctant to publicly announce that he favoured legalisation, did precisely that in the Manchester Evening News the next day.

Questions from the audience were about increased risk of progression to hard drugs, effect of school work, possible effect on organised crime - and the one token ex-heroin addict who blamed his problems on cannabis.
DCI Matthews said that for some years Merseyside Police have been reluctant to prosecute for small scale cannabis possession.

Overall, I personally felt that the Conference went very well and was very educational to most people present, myself included, and I gained a lot by being able to present LCA views alongside those of the professionals.

Report by Alun Buffry, National Coordinator, legalise Cannabis Alliance
http://www.lca-uk.org


Tagesordnung der Konferenz in Liverpool:

Cannabis Conference: Shaping a New Agenda
Draft Programme
www.hit.org.uk
Tuesday 19 Feb 2002
---

1.00 Introduction
Professor John Ashton, Director of Public Health,
NHS Executive North West

1.10 Cannabis: a review of the scientific evidence
John Witton, National Addiction Centre, London

1.40 Cannabis, other drugs and young people
Professor Martin Plant, Addiction Research Group, Edinburgh

2.10 Dutch drug policy: experiences and future
Bob Keizer, Drug Policy Advisor of the Ministry of Health, Welfare and
Sports of the Netherlands

2.40 Break

3.00 Current issues - future options panel

Chair
Rod Thomson, Joint Commissioning Manager, Sefton DAT

CONFIRMED
+ above 'keynote' speakers
Alun Buffry, Legalise Cannabis Alliance, UK
Colin Matthews, Merseyside Police
Dr Tony Quinnell, Senior Clinical Medical Officer, Stockport CDT

OTHERS TBC

4.30 Summary

4.40 Close