Public Health Policy Implications for the Legalization of Cannabis in Canada

JONOWIN TERRANCE

On October 17th, 2018, marijuana was legalized in Canada. Despite its popularity amongst citizens, discussions surrounding marijuana and its public health policies are lacking. This article seeks to discuss current rules and policies for marijuana users, as well as common issues associated with the new laws. There are important global health-related conversations to be had in the wake of this legalization.

Legalizing cannabis provoked debate primarily because of its detrimental impact on health. Many who oppose the legalization worry about the harmful effects of its continued use. For example, histological studies have demonstrated premalignant changes, such as the presence of benign tumors, in the bronchioles of marijuana smokers. The legalization of cannabis equally prompts discussions on how to ensure that rights of the non-smoking public, and those underage, are not impacted by the rights of those who are now legally able to consume cannabis. The inclusion of a comprehensive framework for driving under the influence of cannabis, and the development of new standards governing how and where cannabis is sold are just two examples of robust policy work regarding safe cannabis use. New bylaws that prohibit smoking in certain smoke-free areas, as well as advertising and sponsorship associated with the sale of cannabis must also fall under the same heavy regulation that governs alcohol and tobacco.

Healthcare workers including physicians have suggested the development of evidence-based promotional campaigns targeted at youth and their parents in order to increase awareness of the harms of smoking and to deter cannabis use at a young age. The problem with the legalization of cannabis in Canada is that this is largely uncharted territory. There is currently no universally accepted definition of a public health approach to cannabis. Controlling the properties of and access to the substance is essential in monitoring psychoactive substances. We have already discussed the implications of increased access for people, but a public health approach to cannabis must also incorporate controls over the quality, and the properties of the substance. This means rules and regulations will inevitably have to come into place to ensure that the substances people are consuming meet rigorously tested safety standards.

One potential practice could be the one currently adopted and used by Uruguay, where the government has established an arm’s length commission – in which all parties involved are acting in their own self-interest and that there is no collusion between buyer and seller – that purchases cannabis from growers and then sells it to distributors. This would allow the government to ensure standardized quality and safety (much like the Food and Drug Administration does with pharmaceuticals in the United States). One could compare this process to the regime of the Liquor Control Board of Ontario (LCBO) or the British Columbia Liquor Stores (BCL) that takes on the role of both purchaser and distributor, and the establishment of a separate regulatory agency that oversees the distribution to independent retailers of cannabis. Given its potential for abuse, additions to Canada’s laws surrounding marijuana use and sales are warranted.