07/09/2015 07:58 EDT | Updated 07/09/2016 05:59 EDT

Should Canada Take a Public Health Approach to Cannabis Legalization?

young cannabis plant marijuana...

One of the most popular topics on the 2015 elections agenda is legalization and cannabis is by far the most widely used illegal drug in the Canada. The interplay between potential legalization models and our current federal medical cannabis system, the Marihuana for Medical Purposes Regulations (MMPR), is important because it will probably shape the direction legalization takes in Canada. Our federal system is unique globally and over one year later, has some important big name interests vested within.

It's certainly no secret that Licensed Producers (LPs) of medical cannabis have had this recreational market in mind. With massive facilities, sophisticated surveillance and technology, alongside experience moving through one of the most complicated and drawn out licensing processes, LPs would certainly be at the forefront of a potential recreational market, but what does this mean for a public health approach to cannabis policy?

People often compare a potential legalization model to alcohol. At one time, they say, alcohol was forbidden and constructed as a "bad drug," and now its one of the most accepted legally regulated drugs in the world. At one point in our history, alcohol was only available by prescription from a doctor (or as we like to call it in Canada, a "medical document" for marijuana). And they're right -- it should highlight how many of practices and seemingly "real" facts of social life are situated, constructed and structured. Alcohol, although legal, is linked to many deaths and social ills and the social acceptance often allows us to ignore its harms.

In our Canadian approach, all of our provinces except one monopolize the sale of alcohol (Fischer et al. 2015). Pointing to one study by Giesbrecht et al. (2006), the way alcohol is regulated in Canada provides some really important public health benefits. For one, it actually sets some limits on the availability, and secondly, it leaves the government at the head of the policy table. Following a free market model, with private entrepreneurs at the head table, means there could be other priorities at the forefront, aside from public health.

I'm not here to say private enterprises are bad and greedy, but rather that research shows private interests will push for more availability and more relaxed regulation around the production, sale and distribution of cannabis. CAMH, who recently came out with a policy position in favour of cannabis legalization, also voted for a government monopoly, where "control board entities with a social responsibility mandate provide an effective means of controlling consumption and reducing harm" (14).

However, within an active medical cannabis market with Licensed Producers in charge of production and distribution, research suggests Canada will follow places like Colorado and Washington State (Fischer et al. 2015). Studies have also looked at the role of private producers who were at the policy table and very influential in how legalization unfolded -- particularly in Colorado legalization model (Fischer et al. 2015; Pardo 2014; Room 2014).

According to a recent policy paper by Fischer et al. (2015) which questions whether the MMPR will eventually constitute 'de facto legalization' (following the footsteps of places like California), "the facts on the ground in the MMPR system will make it extremely difficult for Canadian governments in the future, even if there was a general will to do to -- to build a fully legalized supply system for cannabis that is as oriented to public health interests as the Canadian system for alcohol" (18).

With that said, I'm not convinced it would be entirely bad, or entirely good, but just reinforcing the idea that while the proposition of legalization may seem simple, it's really anything but -- especially with the multitude of stakeholders at the table. The translation of that into legal and administration reality would be really complicated so be prepared to wait. As just one example, cannabis legalization would actually go against international drug conventions -- meaning that Canada would either violate international law or seek amendments to United Nations conventions and treaties governing illegal drugs. Simple, right?

I'm curious, is opening the market to major corporations (that have financial resources and political clout) the best way to move forward?

This blog post previously appeared on Lift.


WEED: The New Science of Marijuana