Over 1,400 researchers, activists, students, patients, harm reductionists, drug users, organizations, policy makers and politicians gathered last weekend in Washington D.C for the International Drug Policy Reform Conference hosted by the Drug Policy Alliance (DPA).
From November 18 – 21st, people from all over the world discussed, debated and engaged in topics from psychedelic research, to the prescription pill panic, to cannabis regulation, reflecting a diverse movement with various interests. Ethan Nadelmann, Executive Director of the DPA, framed wider drug policy reform as a movement about freedom and liberty – and positioned cannabis regulation as central to that movement.
Each breakout session had various panels focused on cannabis and regulation around the world, covering topics such as challenges to marijuana legalization, diversity and equity in the marijuana industry, drug prevention in the age of marijuana legalization, and cannabis regulation from around the world.
With panelists such as Florencia Lemos, co-founder of the CLUC Cannabis Club in Uruguay, Vicki Hansen, a PhD Candidate from the University of the West Indies, and Steve Rolles, senior policy analyst from Transform Drug Policy in the UK - just to name a few - there were certainly a variety of voices at the table.
Attendance also included NORML Colorado, the Marijuana Policy Project, Denver Relief Consulting, Privateer Holdings, the Cannabis Patients Alliance, the Canadian Drug Policy Coalition, Canadian Students for Sensible Drug Policy, and Doctors for Cannabis Regulation, all representing a wide variety of cannabis-related groups. It was insightful to hear from some of the people who are actually living in Uruguay’s legally regulated world, or are active voices in the changing landscape of Jamaica as it passes decriminalization reforms for religious and medical uses of cannabis.
One interesting panel titled, “Beyond Prohibition: 21st Century Drug Policy” featured a panel of drug policy experts moderated by cannabis law and policy expert Amanda Reiman, who is known for her work in cannabis substitution and medical marijuana dispensaries in the U.S. It included faces such as Dr. Craig Reinarman and Dr. Robin Room. Dr. Room, whose policy research focuses on alcohol and tobacco regulation and who used to be the VP of Research at the Addiction Research Foundation of Ontario. Room brought Canadian alcohol regulation and provincial control into the discussion, and has published recent policy commentary that questions whether Canadian legalization policy “would actually pursue the necessary law reforms, or pragmatically rely on the MMPR ‘solution’ already put in place” (Fischer et al., 2015: 17).
Another interesting debate occurred when a youth from Students for Sensible Drug Policy in Ohio questioned Ian James, who was at the head of the recently failed Ohio ballot initiative to legalize cannabis, known as Issue 3. The catch? Initial commercial cultivation would be limited to 10 already identified companies. The push back to this initiative was reflected when the student questioned James about unity in the movement for legalization, and why he continued to push for his own initiative rather than teaming up with local initiatives like Legalize Ohio (you can watch it here, and note he doesn’t really answer the question). Although perhaps a distant comparison, this division can certainly be seen in the Canadian context, and pushes us to question whether these various voices in our own national movement would be stronger advocating together.
On a panel titled, “Medical Cannabis in 2015: From the Lab to the Clinic”, it was interesting to hear drug policy expert Ethan Russo speak to the four pillars of a “true medication”: efficacy, safety, standardization and accessibility. He also noted the weaknesses in many current cannabis clinical trials: too short of a duration, small sample sizes, the use of unstandardized cannabis preparations (which render results unreplicable), and the placebo effect – where the mere act of being in a trial results in a certain degree of subjective improvement in patients.
Russo highlighted the need for a practical delivery system, and the minimization of risk and intoxication. Although he noted that epidemiological studies show that smoking cannabis does not cause cancer, he also affirmed that smoking still has risks. In speaking to the minimization of intoxication as necessary for FDA approval, he noted, “I won’t say it's a bad thing, but the FDA certainly thinks the euphoric effect is a bad thing”. Russo also spoke about pharmaceutical options such as Sativex (he has also worked for GW Pharmaceuticals) as important to easing some of the current controversies around cannabis as a medicine.
In light of Dr. Michelle Sexton’s presentation, which spoke to the importance of patient experience, the patient-plant relationship and questioned if we truly listened to patients in our work, I wondered how the two presentations could speak to one another as we move from experience to evidence based medicine.
On the one hand, Russo highlighted the importance of standardized medicine such as Sativex for getting cannabis based medicines approved and in the hands of patients. On the other side, knowing that some patients do not have success with pharmaceutical alternatives, and Sexton’s discussion of patient’s relationship with the plant, I wondered how we could reconcile the two.
Sexton highlighted a more personal patient relationship to the plant, where things such as smell are important to patients. Another important point which really stuck with me was her data demographics which surveyed about 2,500 medical cannabis patients. In the U.S, much like in Canada, identified patients are mostly white, highlighting that particular groups of people may not be accessing medical cannabis, or able to access it, precisely because of the war on drugs in which non-white communities have been heavily impacted by cannabis prohibition since its inception.
Dr. Sue Sisley also had some interesting insight into medical cannabis research in the United States. You may remember a professor being fired from the University of Arizona (even after NIDA approved her cannabis and PTSD research) because the work “disturbed some important figures”. Although picked up by another university, and other organizations such as MAPS, Sisley also received the largest of nine grants from the state of Colorado.
Regardless, it was clear that many barriers still exist, both practically and in the realm of stigma. Noting that many efficacy studies are often privately funded, she really highlighted how the DEA-NIDA monopoly on cannabis really impedes work, where the DEA mandated a NIDA monopoly on the only available federal legal supply of cannabis for research. She showed a photo of this NIDA-supply of cannabis – and it reminded me of the type of quality Canadians would have seen under Prairie Plant Systems and the MMAR.Sisley showed the audience a photo of the quality of cannabis received through NIDA - riddled with sticks, stems and seeds. This is an impediment to research, where this cannabis is regarded as less potent than the marijuana therefore not medically interesting easily available on the street or through other avenues. This also means it is not reflective of what patients are actually using.
Dr. Zack Walsh from the University of British Columbia represented the Canadian landscape well, and spoke about the PTSD study done in conjunction with UBC and Tilray. He spoke to some of the challenges with the PTSD study so far, even noting a mandatory 750-pound safe that needed to be installed at the university and subsequently bolted to the ground. It was interesting to hear Walsh speak to the research side of things within a Canadian context, making a similar point as Sisley to the poor quality of federally available cannabis, where Prairie Plant Systems was Canada’s only legal supply, and compared it to NIDA cannabis. Here Walsh highlighted the importance of Licensed Producers in Canada taking on research roles and funding this work, because for the first time research will be done on the quality of cannabis that patients are actually using.
If there was one take home point from the Reform Conference I could pass along to Lift readers, it would be the importance of always keeping the impact of the drug war on less visible and minority communities central. Although these effects may be invisible to many Canadian patients, it’s easy to forget about those who are not protected by a legal document, or even afforded the opportunity to access our medical program. In this way, regulation will never be the new prohibition. Assuming that regulation, even conservative regulation, is “worse” than prohibition, does not truly consider the effect of the drug war on minority communities.
I haven’t seen anyone question the racial demographics of the overwhelmingly white community that accesses the MMPR or the MMAR. We need to question why that is, and think about the structural barriers and lack of social capital afforded to various communities in Canada.
The underlying theme to many of these panels urged us to think about legalization as more than just medical, economical or a freedom movement, but also one about racial justice. One panel, “Ensuring Inclusion, Repairing Damage: Diversity, Equity and the Marijuana Industry” featured Shaleen Title from the Minority Cannabis Business Association, and Deborah Peterson-Small from Break the Chains in California, and grappled with how and if communities deeply impacted by the drug war will be able to benefit from legalization.
Although Canada has a different racial landscape, we can still learn from the experiences of indigenous and black Canadians, and question what type of model truly addresses the harms that years of prohibition have done to Canadians. We need to think about who these unjust laws have impacted for so long, and who fills the insides of our prison system. Both these communities are significantly overrepresented in federal and provincial correctional institutions, but this has typically received less attention in both the academic and public policy worlds in Canada than in the United States. What’s really surprising is a criminal justice system that doesn’t collect data on race:
"Canada’s reluctance to acknowledge and document race is most evident in the operation of its criminal justice system and in its criminal justice policies. Unlike in the United States and the United Kingdom, where race-based criminal justice statistics are readily available to the public and researchers alike, the Canadian criminal justice system does not systematically collect or publish statistics on the race of individuals processed through the system" (Owusu-Bempah & Wortley, 2013: 295)
Further, since legalization isn’t a quick fix for discrimination in other realms like family and employment, how will we ensure that people do not continue to be punished for cannabis use under a legalized regime? While we seem to be swept up at the moment with what model regulation in Canada will follow, these considerations need to be pushed to the forefront of our legalization discussions.
Check out this short video on the International Reform Conference here: https://www.youtube.com/watch?v=uvv9WYQAlJQ
Both images via twitter.com/jennav5