Policy on cannabis and other recreational drugs

My position on the manufacture and supply of cannabis and other unregulated ‘street drugs’ is now pretty simple. If we are going to allow them to be lawfully used, then regulation and not decriminalisation is the only course of action I’m willing to support.

Decriminalisation of cannabis is, in my opinion, a charter for legalising organised crime, including forced prostitution, organised paedophilia, human trafficking, etc.

Regulation would be the only realistic option, as the manufacture and distribution could be ensured to be made up of lawful activity only and could have the benefit of driving the organised criminals out of the market.

Cannabis, whether the cannabis lobby like it or not, is a potentially dangerous drug. Long-term misuse can result in psychosis – in my view this is because misuse can result in the brain no longer being able to self-regulate dopamine and serotonin levels. But this is why it should be legalised and regulated. I would do it as follows:

  • Apply the same taxation procedures as for cigarettes;
  • Have similar rules on consumption levels as for alcohol; and
  • Have the same point-of-sale advice and restrictions on purchase quantities as paracetamol.

A low dose of cannabis could be safe for recreational use, where as too high a dose could lead to long-term problems, like chronic mental health issues. Same as with alcohol, and in the case of cigarettes the long -term effects can be fatal, often unlike cannabis.

Even so, my fourth way question is – why legalise a millennia old drug like cannabis, which has these well documented risks from long-term use and abuse, when there is potential profit to be made by the pharmaceuticals designing and patenting new and safe recreational drugs? This could drive up innovation in the economy, and mean that the checks and balances in place for medical drugs could be in place for recreational drugs. Pharmaceuticals are unlike to want to develop medicines based on cannabis as they are unlikely to be patentable, meaning they won’t get their money back. So unless the government start letting health mutuals get cheaper licences for proven uses, so old out of patent drugs will be failed to be used for new affordable purposes.

So my policy on recreational drugs is that their design, manufacture and distribution should regulated and they should only be available for sale if they pass what I call the ‘safe sex pill test’. That is, if the risks to the person using them are easily as understandable as the contraceptive pill, and pose no more harm to them than that potentially can do at a safe dose, then it should be available in licenced premises  for recreational use. If the risks of misuse are so high, as with cannabis, then that is more reason to legalise and regulate it and not less!

 

Banning Cannabis

Jonathan believes it does not follow to be against banning one rectifiable lifestyle choice and then to support another with lasting consequences

Marty Langford of Pyle associates me with the “anti-cannabis brigade” saying I lack the “experience” of what I am talking about, which he claims to have had for the last 50 years (Letters, May 28).

He claims to be against prohibition of cannabis, yet only last year he was advocating banning plastic bags saying it was time we caught up with Ireland (Letters, Aug 28, 2010).

If he is so keen on Ireland’s policies, then he should note they have prohibited the manufacture, production, preparation, sale, supply, distribution and possession of cannabis for any purpose, except under licence from the Minister for Health since Misuse of Drugs Acts of 1977 and 1984.

Is he saying that the cost to Mother Nature of a few degradable plastic bags being in her trees outweighs the costs to economy and the NHS from the reduced cognition in many users of cannabis admitted to mental health units and absent from work each month? It is easy to clean up a few plastic bags in the eco-system. However, it is much harder to restore someone to full mental health after consumption of cannabis has altered their mind. Far from questioning my knowledge on the subject, I think he should question his priorities.

Going for Gold – Should athletes give up Magners?

David provided me with evidence that street cannabis, marijuana, was safer than caffeine in the diagram in my previous post and therefore should be made legal.

My basis on using caffeine as a bench mark was that it created less dependency than alcohol, was in between alcohol and street cannabis, and more importantly caffeine is regarded as a substance not prohibed by the International Olympic Committee.

So to be fair, I thought I’d look at all the criteria used by the Olympic authorities and compare them against Caffeine, Alcohol, and Cannabinoids. I have taken the criteria from the BBC and performed a brief literature search on the equivalent scientific terms associated with them.

Stimulants – Drugs that boost bodily functions, including heart rate and brain activity.

Caffeine: Caffeine has been shown by Silvio Buscerni to have no effect on the QT-Interval. It has been shown by D.M. Warburton that caffeine has the effect of improving cognitive functioning, in terms of attention, problem solving and delayed recall. Therefore, whilst caffeine may not have a positive or negative effect on heart rate it does have a positive effect on brain activity.

Alcohol: Alcohol has been shown by Karl-Jürgen Bär to increase the QT-interval after withdrawal, which has the oppostive effect to boosting heart rate. Alden Gross has found that sustained alcohol use has the effect of impairing cognition in later life.

Therefore alcohol can be seen to have a negative effect on heart rate when withdrawn from. It also has an eventual negative effect on cognition, so may not be suitable for long-term use by athletes.

Cannabinoids: Cannabis had been shown by Kimina Hanormand to have a negative effect on cognition when compared with non-use. According to GW Guy cannabis has a minimum effect on boosting QT-interval shortly after consumption, so has a minor performance reducing effect.

Therefore cannabis does not have the performace reducing effects of alcohol in terms of increasing QT-interval, it does have short-term performance reducing effects in terms of cognition, whereas this is only true of alcohol in the long-term.

Narcotics (Painkillers)

Caffeine: According to TA Astotino caffeine has no effect on reducing perception of pain, so should therefore not be seen as a performance enhancing drug in this context.

Alcohol: According to SA Shah alcohol has a positive effect on reducing pain up-to a period of 9 months.

Cannabinoid: As previously stated, David Blake has shown that the cannabis-based medicine, Sativex has a positive effect as a pain-killer in people with rheumatoid arthritis.

Joy Goebel has found that the use of alcohol and other substances like cannabis for self-management of pain has little beneficial effects in veterans.

Diuretics

It is acknowledged by the IOC that alcohol and caffeine are diuretics. Also, I have found no studies assessing the diuretic properties of cannabinoids. So therefore I have not considered this in great detail.

Summary of Findings

Alcohol has the effect of reducing performance, as the withdrawal effects boost the QT-interval. Cannabis on the other hand has minimum impact on QT-interval, and caffeine none. Caffeine has the effect of increasing performance in brain activity, whereas cannabis reduces it in the short-term to long-term and alcohol in the long-term. Caffeine has little effect as a painkiller (narcotic) whereas alcohol and cannabis do. There seems to be little relevance in the use of drugs as diuretics other than their effectiveness at masking the use of banned substances.

Conclusions

Whilst cannabis has a greater immediate negative effect on brain activity than alcohol, the long-term outcomes are the same. Caffeine on the other hand has positive effects in brain activity. Also, withdrawal from alcohol has a greater negative effect on heart performance than cannabis. Therefore, if the IOB wishes to ban cannabis because of reduction in performance then it should also ban alcohol. If it is willing to ban other drugs which improve performance then it should also ban caffeine.

Alcohol has been shown to have painkilling advantages, just as cannabis has. Caffeine has no such properties, but it can boost concentration to overcome the attention focus on pain. Therefore if the IOB wants to ban cannabis then it should also ban alcohol.

I therefore conclude that in the long-term alcohol has the same harmful effects as short-term use of cannabis in terms of cognition. Also, alcohol has the same harmful effects on heart-rate on withdrawl as other QT-prolongers such as anti-psychotics, potentially leading to stroke and therefore reduced cognition.
While as an employer the immediate benefit of having a workforce who are able to self-medicate and still perform effectively using alcohol and caffeine instead of cannabis which has more immediate cognition-reducing effects, as a society we need to consider the externalities of alcohol on cognition in later life, and potentially after withdrawl. That is the costs to the NHS of dealing with elderly patients or stoke victims may be the same for those who consumed excessive alcohol leading to associated disorders as those who consumed cannabis.

Risks on cannabis – Response to Comments

I had a lot of comments to my ‘risks of cannabis’ article. I will provide my responses here.

People who raised the alcohol vs. cannabis argument

There are a lot of studies showing how moderate alcohol use can prevent terminal illness like cancer. Only misuse of alcohol has externalities for the NHS, whereas when I visited East Glamorgan Hospital’s Mental Health ward in Llantwit Fardre when I was the councillor for Llantwit Fardre I saw the extent to which cannabis use cost the NHS.

If you look at the above diagram you can see that a higher dose of alcohol is required to be damaging than marijuana, or street cannabis as I call it. So on this basis I would say that to consider cannabis to be safe it would have be in the form of a cannabinoid which falls somewhere around the Caffeine mark. Caffeine is considered safe by the International Olympic Committee to be suitable for athletes, so I think this should be the benchmark. As can be seen from the diagram, street cannabis has a lower dependence rate than alcohol, but is more lethal compared alcohol, where one would need to consume more to have the same effect. So unless there is a cannabinoid with a higher active dose threshold, then it would, as I said, be preposterous to legalise it for off-prescription use.

People who raised the ‘safety’ of street cannabis

Consider the Prisoner Dilemma. A black market drug dealer has in their possession ‘safe’ cannabis of a street value of £1000. They also have an imitation of the same quantity with a street value of £10 which contains toxic substances. Which do you think they would be most likely to sell? If it was proved to be safe, without the regulation of cannabis to the extent of alcohol then people can be sold a pup, and they won’t know whether it will make them barking or not.

People who raised the ‘health benefits’ of cannabis argument

I accept that studies have shown cannabis derived medicines have greater efficacy over placebo in treating pain and anxiety. However, as someone who has taken medication for both pain and anxiety after a car accident, I know that even the most ‘proven’ medicines have side effects. I want to see clinical trials comparing the efficacy of cannabis derived medications with current treatments. If the cannabis medications are proven to have greater efficacy than placebo then they should be recommended by NICE and then only issued if approved by the person’s GP. If my GP thought it would be better at curing my anxiety than my current mediation without any serious side-effects then maybe I’d be willing to take it as a medicine. However, I am not even willing to take diazepam at present because long term use can mean its efficacy can be reduced and it can actually make the situation worse not better – I would like more longitudinal studies in the efficacy of controlled cannabinoids.

Compromise

I would be willing to budge on wish to ban substances like cannabis and nicotine and have minimum tax on them if those wishing to use them off-prescription for recreational use had to do the following:
1. Take out private/people health insurance to cover any treatment needed, which their employer can claim from to fund replacement staff while they are being treated, and the NHS can to recover costs of lifestyle choices.

2. Be restricted in their vocations if a risk assessment shows up potential problems, such as that they could injure others through not operating machinery correctly for example.

If all this happened I would be happy for a ‘safe’ cannabinoid to be sold to an even greater extent than in the Netherlands where it is still illegal but not prosecutable for personal use. I think it should also happen for people who abuse alcohol. It could be part of one’s household insurance policy, so someone who calls in sick to work with a hang-over for instance would either have to not be paid for the day or claim off their household policy. Any long term absences costing the government or business money would have to be paid by the user’s insurance

If this was not accepted, or if it was accepted and someone was not able to provide a receipt on request of where they bought the cannabinoid from, or they were drunk/stoned and disorderly, then the following would apply.

1. If found with street cannabis or drunk/stoned and disorderly, they should be given the option of taking a fixed penalty notice of £75 or going on a drug rehabilitation programme.
2. If they chose three fixed penalties they would get an ASBO. On the fourth time if they refused to go a drug rehabilitation programme they could go to a correction unit for two years.

Those dealing in street cannabis outside of the safety net would, if I had my way, face prosecution under international criminal law after an investigation by Europol.

Risks of cannabis

Last Saturday some members of the public took to the streets of Cardiff calling for the legalisation of cannabis.

Street cannabis has serious side-effects from psychosis to mortality. In fact, 63% of paedophiles have used cannabis or other narcotics according to Dr Reuben Lang of the Institute of Psychology and Law.

Dr Louis Fabre of the American Medical Association has found that the synthetic cannabinoid drug, Nabilone, has greater efficacy in treating anxiety than placebo and does not have the serious side effects of the street drug.

Dr David Blake of the Royal National Hospital for Rheumatic Diseases has found that the cannabis-based medicine, Sativex, has greater efficacy than placebo of reducing pain in patients with rheumatoid arthritis.

Despite these controlled benefits of cannabis, to say that legalising cannabis off-prescription therefore makes sense is preposterous.

Equally, criminalising users of street cannabis, who may have been pressured into using it, is also wrong – they are victims and should be given help not punishment.

In my view the only “self-medicating” drugs that should be available to buy off-prescription should be those with which moderate use would have no negative impact on one’s quality of life or life expectancy.

Street drugs like cannabis and behind the counter drugs like cigarettes have such a negative impact so should be banned.

If I was an MP I would ban cannabis and cigarettes in the UK and imports from the rest of the EU, using the public health criterion of the rule of reason under (Article 34) of the EU Treaty.