The problem with cannabis is that it doesn’t have a label | Andrew Bonello

There is a stereotype of the typical cannabis user as a (mostly young) ‘non-productive member of the community’. But as the country discusses decriminalization, more and more public figures are crawling out of the woodwork to offer a very different view.  On the basis of your own experience with Releaf: what is the real profile of the typical cannabis user?

It’s not possible to give a single answer, because the reality is that people from all walks of life use cannabis: including professionals, non-professionals, businessmen, airline pilots, and people who occupy all sorts of responsible positions in society. And yes, coach potatoes, too….

I won’t mention names, but one of the first people who approached us, when we set up the NGO, was a priest. He told us he was a cannabis user, and went into all this spiel about how it ‘comes from God’, etc. So the profile of a typical cannabis user could be… literally anybody.

At Releaf, for instance, we form part of a pan-European network of NGOS and charities like ours: all campaigning for a more reasonable approach to cannabis regulation. But it’s not just activists, or the sort of people you might expect. There are doctors, lawyers, scientists… and what unites them is a common concern that our present drug-policies are failing; as well as a desire to make sure that policy is changed at European level.

Meanwhile, in Malta there are certainly signs that a discussion is under way. The Prime Minister has just announced a White Paper on a possible new drug reform. From what you’ve seen so far, does it conform to your expectations?

In general, the gist of what the Prime Minister is proposing – that he is considering allowing cultivation of a couple of plants; and that people should stop getting arrested for simple possession – was all broadly in line with what we suggested in our meeting with him on February 9.

During that meeting, we homed in on two specific issues, that I am pleased to see were both highlighted in Robert Abela’s proposals.

One is the right to grow: because for us, that is one of the most fundamental aspects of the whole reform. It hits a lot of nails on the head: you can control your own product, so there is no danger of the cannabis being adulterated with other substances; you don’t have to go out and deal with the criminal market to score; and so on.

There is also the issue of fundamental human rights; such as the right to privacy, and what an individual is free, or not free, to do in the privacy of his own home; as well as the right to personal development.

But one other right - which many people seem not to understand - is the right to health. The perception of cannabis, for instance, is that it is a one-compound drug; that its only active ingredient is THC, and the only point in taking it is ‘to get high’. But the reality is much more complex than that. Cannabis contains hundreds of compounds – cannabinoids, terpenoids, etc. – and the way drug affects an individual depends on the balance of these compounds.

And people take it for all sorts of different reasons, too: including therapeutic ones. This is why the lack of access to information on what is in the plant – as you would get, by law, with any clinically-approved medicinal product – is basically risky.

As things stand today, all you get is just a transparent baggy with a bud in it. But you won’t know what’s in that bud, or how it will affect you…

There is, however, an irony in what you’re saying. Opponents to decriminalization use the same reasoning – the complexity of the drug – to argue that cannabis is harmful. At the same time, however, we have legalized medical cannabis, in recognition that the same plant also has beneficial health properties. Do you see a contradiction in that?

It’s either ‘harmful’, or it has ‘health benefits’. We have to make up our minds. But if you ask me, the most dangerous aspect of cannabis, under the current legal model, is that… it doesn’t have a label.

If you compare with medical cannabis, for instance: people buying those products do not run the same risk as the small percentage of recreational cannabis users who might develop problems. That is because, for one thing, they are dealing with a doctor: who prescribes the drug after a sit-down talk, in which the user is told what’s in it, and how it should be consumed. This automatically makes it much safer, than buying it off the street.

This is the main difference between legal and illegal cannabis: recreational users don’t have the option to choose between different, medically approved strains. And ironically, the fact that cannabis remains illegal also increases the possible harmful effects.  Apart from endangering the health of people who consume cannabis, the present system is also contributing to fuel market monopoly of the criminal underworld.

And the illicit market’s only objective is profit: unlike any legitimate trader, drug-dealers require no checks and quality assurance of their product. This, in fact, is why we’ve been seeing an increase in high THC-concentration products, and no availability of more CBD balanced strains.

That ‘small percentage’ you mentioned earlier, however, does exist: as do scientifically-recognised links between cannabis, and conditions such as schizophrenia. Isn’t it also a case that decriminalization activists tend to downplay these concerns?

If anything, I feel the issue has been over-inflated. People who do suffer from health problems – and I don’t deny they exist - usually have a predisposed condition which is brought out by cannabis use. But it can also be triggered by other things: including alcohol, and even tobacco.

So I think it’s a flawed argument, to suggest that the entire plant should be illegal, because it may have negative effects on a small number of users. And the statistics are there: 8.9 per cent of users are susceptible to those kinds of effect. Conversely, over 90% of users develop no health problems at all.

On the other hand, however: the danger, small that it is, is only exacerbated by a situation in which the product itself is illegal: where users are given no information whatsoever – still less, medical advice – on which to take an informed decision.

Having said this, it’s not as though we’re ‘recommending’ the use of cannabis, either: especially among the young. Among adults, it’s should be a question of personal choice; and, as with all other things, the more informed the decision, the better.

With young people, however, it’s a different story. Consumption of cannabis at a young age - or other mind-altering substances such as tobacco and alcohol - does present numerous risks. There is general consensus that young people should be discouraged from experimenting with drugs. We agree with that, too: which is why we’re also in favour of a 21-year age limit.

But the 2019 ESPAD survey also confirms that a number of young people are consuming cannabis in Malta, whether it is legal or not; and our concern is that the laws and policies we have in place do not seem to take this category into account.

To be fair, there is also evidence that preventive programs in schools are working. The rate of young habitual users has remained stable, and even gone down slightly.  But apart from a preventive programme, young people also need additional psychosocial tools and inter-personal developmental training. This is why we are also calling for strong preventive educational tools, including a harm reduction approach; but also to ensure that these youths are kept away from the criminal justice system; and, if needed, redirected towards education and training instead.  

And yet, the major players involved in drug rehabilitation – including Caritas, Sedqa, etc. – have all come out against decriminalization: claiming that it would increase the availability (and therefore consumption); and that cannabis is a ‘gateway drug’, leading to other forms of substance abuse. How do you respond to those arguments?

Personally, I was a bit disappointed by the joint statement issued by Caritas, Sedqa, etc. Not because I expected the position to be any different; but because it seems that very little, if any, research went into it at all.

There is absolutely no scientific evidence to back the ‘gateway’ theory, for example; in fact, it was debunked way back in 1999, when there was discussion about it in the USA.

My response, however, would be: would you expect a person who is a wine connoisseur - who enjoys drinking wine, and takes a scientific interest in oenology - to end up on heroin, as a result of his wine consumption?

Not likely, no; but you don’t buy wine from the same source as heroin…

That’s the problem, right there. If there is any truth to the ‘gateway theory’, it would be that, when you go to buy cannabis – and, at present, there is no alternative but to buy from the criminal market – the dealer might offer you other drugs instead.

If, on the other hand, cannabis was controlled and regulated, in the same way as the Dutch did in the 1970s – by removing the monopoly from the hands of criminals, and placing it where it could be properly regulated – it would provide a safety-net for consumers of cannabis.

This is, in fact, he part that baffles me most. If one wants to seriously and logically discuss the potential risks linked with cannabis and mental health, then we have to at least ensure that we are listening to what science says. We have to recognize that these health effects – and not just health; but also the different ways in which different strains tend to affect people – are dependent on the levels of THC and CBD being consumed.

Yet no mention at all is made of the important role of identifying the THC and CBD levels of a particular strain; or whether the lack of information, on these and other aspects, may also be contributing to the resulting health problems.

There is, however, another aspect to the health issue, when it comes to cannabis in particular; we also have to ensure that our existing policies do not end up being more harmful – to the individual, and to society – than the drug itself.

I don’t doubt their intentions; but the agencies involved in rehab do not seem to recognize that certain aspects of our system are directly contributing to this problem. After decades of heavy police enforcement and sustained criminalisation, recreational users have now been stigmatized.

Even after the reforms of 2015, law enforcement agencies still retain excessive powers to invade the privacy of the home; arrest, interrogate and lock up in preventive custody, for up to 48 hours, any person found in possession of even small amounts.

Admittedly, they can no longer actually charge suspect over simple possession. But arrests and interrogation still happen… and this continues to create an aura of stigma and discrimination – not to mention the psychological effects on the (mostly young) suspects - against people whose only crime is to cultivate, consume and share cannabis.

All this can seriously affect one’s mental health, too. Yet there doesn’t seem to by any concern about this aspect at all…

These are all arguments that now come also from criminologists, lawyers, politicians, and even – on occasion – by the judiciary itself. Clearly, there has been a significant shift in public perceptions of cannabis. Do you think this is because of increased awareness among the wider public; or is it a reflection of the failure of Malta’s (and the world’s) drug policies to date?

I would say it’s a bit of both. Coming back to another anti-decriminalisation argument: the main perception seems to be that, if we legalise or decriminalize something, it would become available everywhere.

This, however, overlooks the fact that cannabis is already ‘available everywhere’ – anyone can get hold of it; it’s always going to be just a phone-call, or a street corner, away. And we already have the US Prohibition-era experience, to know that it also has other effects, too: such as fuelling the rise of organized crime networks.

So yes, I do believe that people are attitudes are slowly changing, because they’re reading up more on the subject; and one of the things people realise, as they do their research, is that the existing approach to drugs has clearly failed.

The 1971 Convention on Narcotics, for instance, is going to turn 50 years old this year; so there’s a hashtag going around, ‘50 years of failure’. And it’s hard to see it as anything but a failure, to be honest. They tried to stamp out something; yet 50 years later, it is more widespread than ever before.

That is also why the profile of NGOs such as ours consists of so much more than activists. It is now visible to everyone – including policy-makers – that there is, in fact, a very urgent need of reform.