Sir, – Four years ago we wrote to this newspaper to highlight our concerns regarding cannabis use in Ireland, which we described as an ignored crisis. Sadly, the health problems arising from cannabis use remain ignored.
There are an estimated 22,000 people with cannabis dependency in Ireland.
The latest hospital admission data for 2020 indicates that there was a record number of people admitted to our medical and psychiatric hospitals with a cannabis-related diagnosis, more than 1,000 admissions in the year.
Cannabis remains the most common substance generating demand for addiction treatment by people under 25 years old – a bigger issue than alcohol.
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In spite of the evidence of substantial and increasing harms, the public perception of the harms of cannabis has continued to decline. This, in turn, drives up use.
We called for a comprehensive public health campaign to ensure citizens are aware of the potential hazards associated with cannabis use.
While there is unrelenting pro-cannabis messaging on social and traditional media, there has been little attempt by Government or the HSE to counter this with factual information.
The roll-out of the SPHE senior cycle programme on substance use for secondary school students has been very slow.
As doctors, we are growing tired of seeing young lives, and the lives of their families, being derailed by the use of this drug. Cannabis problems are evident in every community – rural and urban – from the most affluent to the most deprived.
There are some loud voices suggesting that cannabis legalisation might be the answer.
We now have a decade of data from the US and almost five years from Canada to show that legalisation not only fails to improve the situation, but it actually increases public health problems arising from cannabis use.
In locations where cannabis use is legal, the escalation in health harms is most evident among young adults, aged 18-24 years. A staggering 10-12 per cent of young adults in those locations now use cannabis daily. The black market continues to thrive there also.
Road traffic incidents involving cannabis-impaired drivers are increasing. Emergency department attendances due to mental and physical effects of cannabis are also increasing.
The adverse effects on young children from heavy parental cannabis use is a major concern.
Cannabis use is associated with increased risk for psychosis, depression, anxiety and suicidal behaviours and worsens outcomes in those with mental disorders.
We are certainly not alone in concluding that the current scientific evidence indicates that cannabis legalisation is a mistake from a public health perspective. This is also the assessment by the American Medical Association and State Medical Societies in the US.
While we view legalisation itself as unhelpful, there are some legislative options worth considering.
Government policy now includes a planned health diversion scheme for people found by Garda to be in possession of drugs. This is arguably a form of decriminalisation and should be supported.
Incarceration should be removed from the list of sentencing options in cases of simple drug possession.
Although cannabis-based products have an extremely limited use in medicine, legislation and policy has already been altered to allow sufficient controlled access to same.
The legalisation in Canada has seen the emergence of cannabis corporations, and this new industry has attracted extensive investment from big tobacco and big alcohol corporations.
Lobbyists from the cannabis industry now march around the world meeting governments and policymakers, seeking to expand their market. This is now happening in Ireland and their activities further skew an already unbalanced public discourse.
Cannabis invites a huge amount of avoidable misery into a large number of homes across Ireland. While we witness this as doctors, the plight of these individuals and families seems otherwise ignored.
The upcoming Citizens Assembly provides an opportunity to move on from the endless conversation about legislation and gives renewed priority to the more important issues of prevention and treatment. –
Yours, etc,
Yours, etc,
DR RAY WALLEY
DR HUGH GALLAGHER,
PROF BOBBY SMYTH,
PROF MATTHEW SADLIER,
DR BRENDAN O’SHEA,
PROF COLIN P DOHERTY,
PROF DAVID COTTER,
PROF WALTER CULLEN,
DR SUMI DUNNE,
DR JOHN HILLARY,
DR JAMES KIRRANE,
DR PAUL GAFFNEY,
DR WILLIAM BEHAN,
DR KIERAN CUNNINGHAM,
PROF FRANK MURRAY,
DR IDE DELARGY,
PROF DAVID COGHLAN,
DR JOE GALLAGHER,
DR MICHAEL QUIRKE,
PROF TIM LYNCH,
DR MARY COSGROVE.