Cannabis, medicine and the law

 

Sir, – A letter signed by 20 doctors attempts to address a wide range of controversial issues, among them adolescent cannabis use, medicinal cannabis and legalisation and/or decriminalisation of cannabis for so-called recreational use (Letters, May 20th).

It is estimated that 90 per cent of people who use cannabis do not seem to develop any major problems with it (other than the fact that the drug they usually use it with (ie tobacco) is likely to cause them far greater harm and significantly contribute to their cause of death. As health advocates we take the issue of tobacco, alcohol and all drug related harm seriously.

The central point of the Amy 20th letter appears to be that there is a lack of awareness particularly among young people of the potential harm of cannabis use. No evidence is presented to support this statement. In fact, a motion was passed last year at the Irish Medical Organisation AGM to urge the Government to review both the positive and negative effects of cannabis, and we understand that a report is about to be published and the Government is planning to introduce new legislation.

The May 20th letter calls for a media campaign to highlight the dangers of cannabis. Research internationally, over many decades, has shown that many youth education programmes are ineffective and may actually cause more harm than good. Education is vital but we need to learn how to talk to young people about the effects of drugs and explore why they take drugs rather than continuing to preach the message of “Just Say No”.

We appreciate that this is a contentious issue with opinions polarised regarding the best solution. The Government made a statement recently that it had no plans to legalise cannabis, although countries such as Canada, parts of the US, Uruguay and Mexico have legalised cannabis as politicians, health and drug policy experts in those countries have decided that fighting a war on cannabis causes more harm than good. The outcomes so far in these countries do not show that cannabis use has increased significantly or that it is causing greater harm and the evaluations to date have been positive, both from a health perspective and financially.

It will ultimately be up to the Irish Government to decide whether or not to take this approach in the future but we believe it should explore all options to provide the public with a drug policy programme that is based on good empirical evidence and one that attempts to reduce drug-related harm. The harms currently caused by cannabis are occurring in a paradigm of criminalisation and prohibition. We need to take a different path and change drug policy for the better.

We believe the issue of medicinal cannabis should be dealt with separately to recreational cannabis use. The May 20th letter signed by these doctors made a number of claims that are not supported by international evidence. The reference to medicinal cannabis being a “Trojan horse” to full legalisation implies that these doctors are sceptical about medicinal cannabis. There are many people who are benefitting from taking medicinal cannabis but sadly the vast majority are breaking the law in the process. This is inhumane and wrong.

The claim that cannabis is a “gateway” to harder drugs is again not supported by international research evidence. Addiction to, for example, heroin is complex, and citing cannabis as a significant risk factor in its development misunderstands the intricate relationship between biological, psychological and social factors involved.

The letter mentions decriminalisation but media comments by some of the signatories of this letter show that they believe cannabis possession should continue to be criminalised. We strongly oppose this position. Given the vast majority of people who use cannabis do not develop significant problems surely it makes no sense to criminalise those that do. Cannabis is the most commonly used illicit drug in Ireland and its use has increased significantly over the past few decades. Legal measures to curtail use have clearly not worked.

We urge the Government to decriminalise all drug possession for personal use and adopt a health-led, rather than criminal justice, approach to this problem. – Yours, etc,

Dr GARRETT McGOVERN,

International Doctors

for Healthy Drug Policies,

GP Specialising in Addiction Treatment, Dublin;

Dr CATHAL

O SÚILLOBHÁIN,

International Doctors

for Healthy Drug Policies,

GP Specialising in

Addiction Treatment,

Dublin;

Dr JOHN GILBERT,

GP Specialising in Addiction Treatment, Dublin;

Dr JOHN HORAN,

GP Specialising in Addiction

Treatment, Cork;

Dr ANJUM MADANI,

GP Specialising in Addiction

Treatment, Dublin;

Dr PETER CAHILl,

GP Specialising in

Addiction Treatment,

Dublin;

Dr JAMES LEITCH,

GP Specialising in

Addiction Treatment,

Wicklow;

Dr PAT IRWIN,

GP Specialising in Addiction

Treatment, Dublin;

Dr AONGUS Ó CASAIDE,

GP Specialising in Addiction

Treatment, Dublin;

Dr CLIODHNA

O’CALLAGHAN,

GP, Limerick;

Dr CHRIS FORD,

International Doctors

for Healthy Drug Policies,

London;

Dr STEPHEN WILLOTT,

International Doctors

for Healthy Drug Policies,

Nottingham;

Dr NICHOLAS SWIFT,

International Doctors

for Healthy Drug Policies,

Wales;

Dr ALEX WODAK,

Emeritus Professor,

Alcohol and Drug

Services, Australia;

Dr KEITH SCOTT,

International Doctors

for Healthy Drug Policies,

Cape Town,

South Africa;

Dr OSCAR D’AGNONE,

International Doctors

for Healthy Drug Policies,

London;

Dr DAVID CALDICOTT,

Consultant in Emergency

Medicine,

Australia;

Dr VIC SALAS,

International Doctors

for Healthy Drug Policies

and Independent Consultant,

Cambodia.