It’s about ‘harm-reduction’, not ‘recreational cannabis’ | Julia Farrugia

Julia Farrugia-Portelli on medical cannabis legislation in Malta

In a sense, you can’t really blame some people for being confused by the mixed messages on drugs emanating from Government these days. For decades, the Labour Party waged a ‘war on drugs’: describing such substances as ‘marijuana’ in terms of a ‘plague’ or a scourge’, to be eradicated at all costs... and the next thing we know, a Labour government first decriminalises cannabis, and now plans to attract medical marijuana companies to open in Malta. Isn’t this a complete reversal of policy?

Let’s start from the beginning. What is happening today is a continuation from the previous legislature. In that legislature, we made a distinction between cannabis and other, different drugs.  Our argument was: if someone is caught with a joint, it shouldn’t lead to a situation where that person’s criminal record is tarnished. That reform was affected in the last legislature; now, we are taking it a step further. In our electoral manifesto, we mentioned the word ‘recreational’. I didn’t agree at the time; and the reform is now based on a completely different principle: it’s a harm-reduction approach.  Drugs were, are and will remain something we believe shouldn’t be promoted or encouraged. However, we know for a concrete fact – even from our shared experience in journalism, looking at all the statistics over 20 years – that there is a high percentage of young people, even as young as 13 years of age, who already use cannabis.

We also need to distinguish between synthetic and non-synthetic drugs. In the first weeks of this legislature, this ministry worked, together with other ministries, on a new law to address the existing loopholes regarding synthetic cannabis: which can be very harmful to the user. From the outset, our position was and remains against drug trafficking and drug use. But we also understand that there are people who – just like others smoke a cigarette, or have a glass of wine on weekends – smoke a joint once a week.   There are also individuals who might use cannabis on social occasions; and some may have gone beyond that, and use cannabis far more regularly. With the legislation passed previously, these people are no longer considered ‘criminals’. But we feel there is a need to put this legislation within the context of a proper structural framework... which doesn’t exist yet... so as not to keep sweeping everything under the carpet. On a personal note, this reform is also the biggest challenge to me, as I am, and have always been, anti-drugs...

How is this reform going to work in practice, though? So far, indications have been vague. Can you clarify the parameters you’re looking at: are we only talking about marijuana for medical purposes, for instance?

At the moment there is an inter-ministerial committee, involving all the ministries concerned: health, justice, home affairs, as well as all the different services... we are drafting a model, in consultation with the stakeholders, including drug dependency agencies like Caritas, Sedqa and the Oasi foundation, among others. One important aspect is that we have separated the issues of ‘medical’ and ‘non-medical’ marijuana.

The medical marijuana aspect is already at an advanced stage: we are at the third reading of the draft bill. Non-medical use is still at consultation stage, however. There is still a lot to be done. And there are also strict parameters within which we are working. What we envisage is a structure in which an individual can be enrolled and registered [as a non-medical cannabis user], with all due data protection considerations; so if (to give an example) the police find a certain amount of cannabis on an individual, it can be established if the individual in entitled to be in possession according to the scheme... if the amount concerned is within the limit of what can be legally owned, etc.

One question that still hovers over the previous reform concerns the actual legal status of marijuana. Technically, possession is still against the law, though it is no longer a criminal offence. Will this change with the new reform? Will it be possible to legally buy cannabis in Malta?

The idea is primarily to maximise safety and to try and eliminate, as much as possible, illegal drug trafficking. One concern that cropped up in our meetings is that it is unsafe to buy from criminals. The reform envisages licensed dispensaries: though it remains to be seen whether these will take the form of the traditional pharmacy, or some other concept.  One thing we are not considering, however, is the possibility of ‘coffee-shops’. And we’re not talking about ‘edibles’, either: cannabis in cakes, muffins or spaghetti, etc. The system will not permit the sale of cannabis-based edible products. Also, in line with the safety approach, there will be zero-tolerance towards driving under the influence of cannabis. And the individual concerned will have to be referred to the dispensary by a medical doctor...

But aren’t we talking about non-medical use here? Why is a doctor’s referral needed?

As you might know, and as medical experts warn, there may be certain dormant conditions, unknown to the user, which may be triggered by cannabis use. This was a concern raised by experts, including psychiatrists, during consultation. There is research that shows if there is a family history of schizophrenia, and the individual starts using cannabis, it will increase the likelihood of the condition developing. Another concern is age: to enrol in this system, you have to be 21 or older. Below that age, the mind has not developed sufficiently to safely use cannabis.

Earlier you mentioned Malta’s drug agencies: Caritas, Sedqa, etc. These have all come out quite strongly against decriminalising cannabis for personal use. Are you encountering any resistance to the reform from these, or other quarters?

I was pleased that, during our consultation meetings – which we invest a lot of time in: they’re not 10-minute meetings, I can assure you – after an hour of discussion, we found we had points in common with the agencies you mention, including Caritas. They told us they were pleased that nowhere was the word ‘recreational’ used, and that we were adopting a harm-reduction approach. But we also spoke to users.

We held meetings with ‘Releaf’ [a cannabis legalisation lobby-group], and their feedback and response was also very positive. What I am interested in is to explore the common ground; the areas where we can all work towards an agreement. One concern that is common to all stakeholders is safety. Buying drugs illegally can expose an individual to dangers. For example, there are known cases when cannabis, bought illegally, turned out to have been adulterated with other substances – sometimes even including crushed glass – to increase the weight.

It is precisely to avoid such dangers that cannabis users (including ‘Releaf’) argue in favour of legal home cultivation. Does the reform envisage the possibility of licensed users growing their own cannabis plants: and if so, what are the parameters regarding quantity, etc?

That was another of the issues raised in those meetings.  And it was mentioned also by users who raised another point: not everyone has ‘green fingers’, or is able to grow a plant from seeds. Apparently it’s not that simple: you need certain climate conditions, etc.  But at this stage, it is not something that is considered in the reform. The new model will not include cultivation for personal use. Also, we are not looking at a scenario where anyone can just smoke cannabis in any public place, as if it were nothing. It will be restricted to private buildings.

Another issue connected with cultivation (and also possession, over a certain amount) is that Maltese law does not clear distinctions between cultivation for personal use, and cultivation for the purposes of trafficking. People have been treated as drug traffickers, not because they sold drugs, but because they fall into the legal category of ‘drug trafficker’ by accident. Does the reform look into this situation?

Yes, it is something being discussed by the inter-ministerial committee... the aim is to address all these points in a holistic way. As we go along we are improving the model all the time.

Meanwhile, another source of resistance to cannabis decriminalisation has traditionally been the Police. Former Commissioner Michael Cassar once threatened to resign over the issue on Xarabank, for instance. What sort of feedback are you getting from the police, and other law enforcement institutions and agencies?

Let me tell you a story: I was the first to resist this reform. I was not comfortable that it landed on my lap: my point of departure was that I am against drugs, and I have never taken drugs in my life. But my bone of contention was with ‘recreational’ use. Because if we are to seriously consolidate our efforts, as a country that is against drug-trafficking, and against drugs in general... I felt it sent the wrong message. But when we thrashed ideas around a table, we came to a point where we agreed – with all the stakeholders – to concentrate on a harm-reduction approach.

So I understand the premise of your question: that the forces of order are not necessarily comfortable with the way the reform was initially presented. I don’t blame anybody: that’s why we’re holding such detailed meetings. We could have got everybody under the same roof for a one-day meeting; but our intention was to allow everyone the space to ask questions, like you are doing. Regarding feedback, what I can say is that nobody left those meetings completely dissatisfied with the approach we are taking. But it’s an ongoing process: we need to continue the discussion. I am convinced that, if we work hand in hand with all the stakeholders, we will finally have a situation better than the one we have today.

Not everyone seems to share that confidence. Opposition leader Adrian Delia has just accused your government of trying to fill the country with ‘Drug Factories’... presumably a reference to the drive to attract medical marijuana producers to set up facilities locally. How do you respond to that line of criticism?

We have grown accustomed to this sort of situation. Just yesterday in parliament, I had to make a point of order when an Opposition MP claimed that we ‘never discussed medical marijuana with Caritas’. That is simply untrue. We held meetings [with Caritas] here in this very room. I feel the House was misled by that lie. But we are used to hearing similar statements: be it in former electoral campaigns... that we were ‘heading into a brick wall’, that a lot of catastrophes were going to occur... in reality, I think that the patients who hear that sort of comment – especially those patients who need medical marijuana every day – are the ones who are best positioned to judge.

The truth is that we have an electoral mandate to undertake this reform. In the last legislature, we already gave those patients a mechanism that is closer to their needs. Now, we’re going a step further. Even the family doctor will be able to write out a prescription for medical marijuana. Another thing is that this is not medicine that will be taken by everybody. It is for people whose first experience of the day, when waking up in the morning, is pain... because of their medical condition, or because of the treatment they are taking for it. So I think that we should be careful not to play with people’s emotions. Not to show disrespect towards society. This is something that should unite, not divide us. After all, the Opposition voted in favour of the existing law connected with marijuana for medical purposes...

But if I understood the argument correctly, the problem is not the sale of medical marijuana, but the production. The ‘drug factory’ claim may sound awful on paper... but isn’t it nonetheless true that we will soon have factories producing drugs which, until just yesterday, were considered ‘harmful’ and ‘dangerous’?

Then I think the Opposition must be living on another planet, to make that sort of argument. The reality is that, for decades, we have had (and still have, thank God) pharmaceutical factories that produce much ‘worse’ – using the same reasoning – drugs than cannabis.  We heard my colleague Deo Debattista, a medical doctor, explain in parliament that if you overdose on Paracetemol – I won’t mention the brand – you can die. Using that yardstick, the same danger does not exist for cannabis. So I think this is a case of trying to frighten with the Bogeyman [Babaw].

We are not talking about producing marijuana openly in fields, as happens in other places like California. It will be produced at licensed facilities working under strictly regulated and supervised conditions... as is true for other industries, by the way. Facilities that mint money: De La Rue, Crane Currency... where you have traceability, from the point of origin to the point of sale, of (in this case) a medical product. And I may I stress again that we are only talking about cannabis production for medical purposes. I think that the fact that Malta recognised the need to respond so immediately to the investment opportunities... that a considerable number of companies have expressed interest in investing, after seeing the reforms we are proposing... is something to be proud of