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https://infirmiere-canadienne.com/blogs/ic-contenu/2017/03/02/legalisation-et-reglementation-du-cannabis-elabora

The federal task force’s recommendations support a balanced approach

Mar 02, 2017, By: Rose Simpson

A federal task force has provided the Canadian government with a detailed roadmap on how to transform cannabis from a prohibited substance into a legal product for both medical and recreational use and sale.

The final report of the nine-member task force, chaired by lawyer and former Liberal cabinet minister Anne McLellan, was released to the public on Dec. 13, just five months after the task force was created. The report includes 80 recommendations and provides advice on the design of a new legislative framework for legal access to cannabis, consistent with the government’s commitment to legalize, regulate and restrict access to cannabis.

The government has signalled its intention to introduce legislation this spring.

The task force travelled across Canada and met with provincial, territorial and municipal governments; Indigenous governments and organizations; and experts, patients, advocates, employers and industry. They consulted with officials from Colorado, Washington and Uruguay, jurisdictions that have legalized cannabis for non-medical use. Online public consultation generated nearly 30,000 submissions.

“Legalization will impact virtually all aspects of people’s lives one way or another,” says McLellan, who held the health, justice and public safety and emergency preparedness portfolios during four terms as a member of Parliament. “Apart from the visible changes that people will see, there will need to be a psychological transformation. We’re moving from a regime, the basis of which was a criminal prohibition, to a regulatory regime in which cannabis is a legal product. It will take time for people to understand all the implications of this transformation.”

Recommendations

The wide-ranging report addresses many of the concerns CNA raised in its submission to the task force. Included in the recommendations in the report are

• that the production of cannabis and its derivatives be regulated at the federal level, drawing on the good production practices used in the cannabis for medical purposes system
• that marketing and promotion be restricted
• that revenue from cannabis be used to fund administration, education, research and enforcement
• that an evidence-informed public education campaign be implemented, targeted at the general public but emphasizing youth, parents and vulnerable populations
• that limits be placed on the density and location of retail storefronts, including appropriate distances from schools, community centres and parks
• that a separate medical access framework be maintained to support patients.

“Overall, from a harm reduction and injury prevention perspective, the task force report was very comprehensive,” says CNA president Barb Shellian. “We were happy to see that there was an emphasis on a planned approach and a focus on protecting vulnerable populations.”

NDP health critic Don Davies says he was generally impressed with the scope of the report. “It’s a multidisciplinary approach. There’s a justice element, there’s a health angle and there’s a public safety consideration,” he says. “I was especially pleased to see an emphasis on the health implications.”

Davies says he is in favour of the use of plain packaging and of limiting the quantities that Canadians can possess, including allowing no more than four cannabis plants per household.

“Overall, I think it is a very well thought out report and does a good job in balancing competing interests. It certainly will give the government a lot to work with.”

Medical use of cannabis

CNA supports the strategy of having two separate frameworks. Further, Shellian says she was pleased to see the call for more research into the medical applications of cannabis.

“We need to really continue the research into the indications for the medical use of cannabis because it can be life-saving and life-altering for people,” she says. “For the patient, it provides relief from pain, relief from seizures. That’s very different from the perspective of those who use it recreationally.”

McLellan says there was strong support for maintaining a medical access framework. “I was surprised by the passion with which patients made the case that they were using out of necessity, not out of choice,” she says. “Patients feel very strongly that they are using because it helps alleviate chronic pain and other conditions and helps them function in society.

“Patients expressed some concerns about access to cannabis products. Some patients feel that a certain strain is particularly effective in treating their condition. I think it’s fair to say that there have been shortages of particular strains. This is something on the medicinal side that the federal government will need to monitor over the next few years.”

Harm reduction

The task force proposed measures it said would maintain and improve the health of Canadians by minimizing the harms associated with use of cannabis.

The public health approach considered the risks of developmental harms to youth, of frequent use and co-use of cannabis with alcohol and tobacco, of interactions with the illicit market and to vulnerable populations.

The task force examined a range of protective measures, including a minimum age of use, promotion and advertising restrictions, and packaging and labelling requirements for cannabis products.

The recommendation that the minimum age at which a person could legally purchase and use cannabis be set at 18 has raised concerns in some quarters.

“There are problems with psychological disorders that develop, such as schizophrenia and other mental disorders, that are permanent,” says Conservative health critic Colin Carrie. “Marijuana is illegal because it is dangerous, and if it’s abused it can cause significant medical problems, particularly with our youth.”

In its submission, CNA suggested that the task force carefully evaluate the age-limit issue by balancing the known harms of marijuana on the developing brain (of those under 25) with the knowledge that Canada has the highest rates of youth marijuana use in the world.

McLellan says the task force aimed to balance a number of competing public policy goals. “Eighteen- to 25-year-olds are the single largest user group in Canada,” she says. “If you put the age at 21 or 25 for legal use, all those people between 18 and 21 or 25 would buy the product from the illegal market. And they would be buying product that was unregulated, could be tainted, with no safety standards.”

In the end, it will be up to the provinces and territories to decide whether the age should be 18 or higher. Most jurisdictions will likely tie it to the age at which residents can legally purchase alcohol, McLellan says.

Carrie notes that legalization poses a significant safety issue because there is as yet no effective field sobriety test for cannabis in place. “There is no way to test a person who is intoxicated and driving, so there will be more people driving under the influence.”

McLellan agrees that drug-impaired driving could pose a problem. “We do not have good baseline information about how big a problem it is now,” she says. “We should be starting to collect those stats to get a better handle on the actual drug-impaired driving that is happening right now on our roads. Fortunately, this is also an area where science is catching up quickly.”

Public education

The task force recommended that governments move quickly to invest significant resources to better educate all segments of the Canadian population, including health-care professionals. “That also includes changing curricula in nursing schools, medical schools and pharmacy schools,” McLellan says.

Shellian says she would like to see the government go slower in terms of introducing the legislation to give stakeholders time to develop an effective public education program. It needs to be “thoughtfully targeted, not just to say that we’ve done it but that we’ve done it in a robust, thoughtful way,” she says. “Things like operating a vehicle, things like using a harm reduction approach. We’ve seen evidence that good public relations and marketing campaigns can be effective. Perhaps if the effort is put into this, the time frame can be met.”

She is particularly concerned about youth. “We need a bigger strategy for risk-related activities,” she says. “We need to talk to youth about responsibility, about not crossing the…line. It’s different when you have a public education campaign for youth than it is when you’re talking to 40-year-olds.”

Rose Simpson is a freelance journalist in Ottawa.