Cannabis law a step forward, not backwards, for Malta | Arda Özçubukçu, Ivan Ezquerra Romano

Cannabis is one of the most misunderstood drugs in the short history of drug policies despite the fact that cannabis has been used by humans for thousands of years.

During the last 60 years, cannabis has often been demonised and even designated to have no medical value at all in international treaties. Only recently, evidence for the potential medical benefits of cannabis caught up with the perceived risks. Medical cannabis is currently available in numerous countries despite the initial resistance, benefitting thousands of patients.

Malta is now trying to update its drug policies in light of the evidence on the most effective ways of protecting individuals from harm associated with cannabis use. As part of a harm reduction approach to drug use, cannabis has been legalised or decriminalised in a number of countries. Portugal and Netherlands are good examples showing the effectiveness of this approach. Other countries such as Italy, Luxembourg and Germany are also following this trend and considering legalising cannabis.

It is often assumed that the legality of drugs is related to their relative harm. In reality, history, not risk or harm, dictates the legal status of drugs. Alcohol is a good example. Experts from the UK, Germany and the European Union consistently find that alcohol is more harmful than cannabis. While the way alcohol is regulated is not ideal, the majority of people can still drink alcohol without developing addiction or other serious health problems. This is because addiction is largely caused by factors other than the drug itself – e.g. childhood trauma – and alcohol is approached from a harm reduction perspective allowing drinkers to enjoy its pleasurable effects while minimising its harms.

History has shown us that criminalising a drug can do more harm than good. For instance, re-criminalising alcohol led to more harm by increasing criminal activity, the strength of alcohol, and even its accessibility. The vulnerable, poor and marginalised groups were also affected more negatively than the rest of society. Having been criminalised for the last 60 years, cannabis shows similar patterns with criminal activity around its supply, very strong strains in circulation and its disproportionate impacts on certain groups. Decriminalising or legalising cannabis will not be a silver bullet, but it will pave the path to tackle these issues.

Concerns around cannabis and young people are valid, but only in relation to the effects of cannabis on the developing brain. Allowing the supply of cannabis through non-profit NGOs could help protect children more effectively in Malta. Currently, cannabis is easily available to young people since drug dealers sell drugs to anyone, anywhere and anytime. If the suggested model manages to replace the illicit market, it will make cannabis less accessible to young people by limiting its sales to a few non-profit NGOs that are open at specific times to adults only. In fact, when Canada and Washington legalised cannabis, teenage use declined.

Cannabis use may lead to worsened mental health irrespective of your age. It is often ignored that the relationship between worse mental health and cannabis use can go both ways. A significant proportion of people who use cannabis frequently do so to cope with existing mental health problems or to escape from the reality of their life, which is worse for some people than others. When these vulnerable people develop a problematic habit, it primarily damages their mental and physical health. These people are in need of support, they are not criminals, nor are they evil or weak individuals that are morally degraded.

Expecting people to seek support when they are criminalised, stigmatised or judged is unrealistic. Harm reduction allows to frame cannabis use as a health issue instead of a criminal one and reduces the stigma around cannabis and people who use cannabis. Harm reduction is a rehabilitative approach that allows to address the problems underlying drug use and puts people in contact with the health and social care system instead of criminal justice. At its core, harm reduction prioritises reducing the negative consequences of drug use over abstinence, accepting that some people will use drugs despite deterrent policies and for a variety of reasons.

The Maltese government’s efforts in decriminalising cannabis possession and providing an alternative to the illicit market is a great step for harm reduction. This alternative way of supply through non-profit NGOs can help curb the increasing potency of cannabis, reduce accessibility to young people and even prevent cannabis from acting as a gateway to other illicit drugs.

Consuming cannabis does not suddenly change your brain chemistry and makes you seek other ‘highs’. One of the reasons cannabis may be a gateway drug is its legal status. Cannabis is a relatively less harmful drug. However, seeing cannabis in the same legal category as other more harmful drugs skews people’s perception of harm. Interacting with dealers who sell a variety of drugs also introduces the cannabis user to other illicit drugs. Having used an illicit drug, in this case cannabis, ultimately normalises the use of any illicit drug.

Replacing the illicit cannabis market is a tough task and it will be difficult to get it right at first. Home-growing and supply through non-profit NGOs is a sensible and cautious approach to see how it all plays out without risking the emergence of a badly regulated industry such as Big Tobacco.

Malta is not setting off a risky journey blindfolded. Harm reduction is informed by evidence and evidence shows that it works. There has not been a moral decline, a public health crisis or a surge in drug use in countries with decriminalised or legalised markets. Instead, drug-related harm has been reduced.

The decriminalisation efforts of the Maltese Government as part of a harm reduction approach should be welcomed. The Government still has work to do to ensure that complementary policies are in place, especially the ones around education and the provision of support. Harm reduction is a step forward, not backwards, and the political will is there to implement it successfully.

Arda Özçubukçu is Co-founder and Director of NeuroSight and Communications Associate at Clerkenwell Health; Ivan is a cognitive neuroscience PhD student at University College London and Co-founder and Director of Drugs and Me.