As the cannabis industry grows, so does the need to better understand how to help dependent users.
This is the first part of a two-part blog on cannabis use, the industry and treatment to help promote Global Drug Survey 2018.
In the last few years, the USA has shown that legalising cannabis does not lead to the world collapsing. In fact, other than an amazing new tax revenue for local governments and green businesses employing thousands, you don’t often hear anything negative about the possible consequences of making weed legal.
Putting an end to pointless criminal conviction and imprisonment, allowing diversion of precious police resources to things more worthwhile are such overwhelming positive aspects of enlightened drug reform that it seems almost a shame to ask a few uncomfortable questions. But at Global Drug Survey, that’s what we do. We ask people who use drugs to share their experience with us so we can help people use drugs more safely, regardless of the legal status of the drug. And the sad truth is that unfortunately ‘for-profit industries’ don’t often put public health ahead of profit. History tells us that when you put a bunch of private companies in charge of selling a product that can create dependence―yes, that’s cannabis along with tobacco and alcohol―those industries will try to create and maintain a group of heavy users, because that is where most of the profit is.
As a general rule, higher potency products tend to do people more harm because it’s easier to consume larger amounts of the active ingredient. Spirits over beer, high potency weed and concentrates over lower strength preparations. And this leads usually to an increased risk of harms associated with acute intoxication, as well as the more rapid development of tolerance which can increase overall consumption and risk of dependence. Given that concentrates and edibles represent the fastest growing part of the cannabis market in the U.S., this issue deserves serious attention.
Over the last five years, GDS has looked at how people use cannabis, how different preparations make people feel, how people want to see it regulated and how it’s used as medicine. We’ve explored harm reduction strategies, cannabis concentrates and vaping, and what types of help people who want to use less would like. This year on the back of a consistent finding from over 250,000 cannabis users around the world that one in three would like to use less and almost half have tried to stop, we thought we’d ask about people’s experiences of trying to quit.
Although cannabis dependence does not carry anywhere the near the risks of harm associated with alcohol and tobacco and withdrawal is far less problematic than for most drugs, 10-15 percent of current cannabis users are dependent (the rate is higher for those starting in their early and mid-teens).
Given the potential of increased access to cannabis to increase use, it’s at least possible that there will be an increase in the number of people who develop problems. I think so far, many governments have missed a trick relying on a top-down approach to regulation and asking experts in health and policy (with a little lobbying from the industry no doubt). Now of course they have a role but what about consumers? Surely the people who are going to keep the industry profitable should have a stay?
In GDS2017 we asked people how they wanted to see cannabis regulated. Some key findings included the fact that 47 percent supported minimum pricing/gram based on the percent of THC in the product with higher potency preparations being more expensive (28 percent were unsure), and 45 percent supported lower prices for preparations balanced by higher CBD levels (39 percent were unsure). In the U.S. and Canada, 45 percent wanted shopfronts with no advertising at all. All this shows that users may be a great resource for sensible advice on cannabis regulation.
What about government guidelines on cannabis use?
It struck me as very odd that legalisation in the U.S. did not come hand in hand with mandated health warnings and guidelines on safer use and how to reduce harm and self-regulate use, as exists in many countries for alcohol. In GDS2017 over 75 percent supported the idea that government should produce such guidelines. I agree. By suggesting guidelines for illicit drugs I am not suggesting that drugs are safe. Quite the contrary in fact. Drugs can be very dangerous.
I spend my working day with people whose lives have been ruined by drugs. From acute toxicity and the risks of intoxication-related behaviours to longer-term physical complications and dependence, I know drugs can kill people. And I am not suggesting guidelines will be a panacea to society’s drug problems.
But as social care budgets are slashed and governments are starting to embrace population-based strategies, such as behavioural economics, to moderate unhealthy behaviors, having some common-sense guidelines that highlight how taking less drugs less often is associated with a reduced risk of harm might be a useful benchmark for people to reflect upon.
This is why GDS developed the world’s first Safer Using Limit guidelines for cannabis. The Safer Use Limits is aimed at raising people’s awareness of their risk levels. We developed the guidelines by asking 40,000 cannabis users to rate how the “risk” of harm from different drugs (including alcohol) is related to different patterns of use.
“Risk” here refers to the probability, range and severity of harm. The higher the score, the more likely it is for a person to experience harms and problems, with higher scores indicating an increased severity of said harms. We also asked our respondents to think about the likelihood of a person experiencing harm over the next one to two years. By harm, we mean anything that causes a person problems, such as mental or physical health, relationships and behaviors, finances or the ability to work, study, or just do the things in life they want to do. Check out www.saferuse.limits.co to see how you rate.
This year GDS wants to explore how people who use cannabis develop problematic use and how they quit. In the next part of this blog I’ll talk about cannabis withdrawal and what we hope to find out. In the meantime, if you want to help us understand how the world uses cannabis in 2017 please take 15-30 minutes to take part in the world’s biggest drug survey.