As Canada prepares for the expected legalization of cannabis, a new study will examine cannabis use and provide clear guidance for creating regulations and policies.
M-J Milloy, an assistant professor of medicine with the UBC Division of AIDS and a research scientist with the British Columbia Centre for Excellence in HIV/AIDS (BC-CfE), is leading the study.
What new information do you hope to learn about Canadians’ marijuana use?
We plan to recruit about 1,500 people in Vancouver aged 15 and up to tell us about their cannabis use in order to get a better sense of the benefits and harms of cannabis.
Past research has focused on people seeking treatment for cannabis dependence and, to my knowledge, no one has done a study to gather data from the full spectrum of people who use cannabis. We’re hoping to survey people who may have problem cannabis use, people who use it medically or non-medically, and people for whom cannabis isn’t a big part of their lives. We hope to gather data that can help inform good public policy.
There are still lots of questions to sort out regarding how cannabis will be distributed and sold. How old should you be to buy it? Should it be sold in pharmacies? Is it safe to drive if you’ve been using cannabis? Unfortunately, there is a shortage of credible data. That is something courts and others have pointed to as a problem.
What do we know right now about the safety of cannabis?
We know it’s much safer than other substances like alcohol. Cannabis doesn’t carry the risk of fatal overdose that exists with some psychoactive substances, such as opioids. However, a certain proportion of users suffer from cannabis use disorders, meaning they have trouble controlling their use of the drug. In states like Colorado and Washington, where cannabis is legal, we have seen some increases in markers of problem cannabis use but we haven’t been able to confirm if there’s a true increase. Our study will try to estimate what proportion of cannabis users might be experiencing dependence and look at which types of cannabis use might be linked with a greater risk of dependence.
As a believer in harm reduction, I’m interested in generating data that could inform policies with the goal of reducing the risk of harms from cannabis use. Canada leads the world in youth use of cannabis. The Prime Minister indicated that restricting youth access to cannabis was one of the top reasons for legalizing it. There is evidence suggesting cannabis use by an individual whose brain is still developing could be detrimental, although the link between cannabis use among teenagers and the development of mental health issues is still debated.
We also know from places like Colorado that there are several benefits. For example, they have seen a decline in the rates of deaths from opioid overdoses. So we’ll be trying to find out when people are using cannabis to substitute for more harmful drugs.
What would you like marijuana or cannabis policy to look like?
Good cannabis policy will seek to mitigate the possible harms of cannabis—as small as they might be in comparison to other things like alcohol—while creating opportunities to maximize the possible benefits. For example, currently the cannabis trade is dominated by organized crime. As we’ve seen in Surrey recently, organized crime and the struggle for control of the market has resulted in a great deal of violence. Many people, myself included, support legalization in part because of the potential to take organized crime out of the equation. However, to eliminate the control of the market by organized crime, a legal cannabis system has to provide recreational users with something better than what they get from non-legal sources, in terms of factors such as price, value, convenience, and variety. Canada could be the first high-income country to legalize cannabis nationwide for both medical and non-medical use. There will be people looking to us for models of what to do and what not to do when it comes to these issues.