Legalising Cannabis: Looking Beyond the Simplistic Case for Reform

Legalising Cannabis: Looking Beyond the Simplistic Case for Reform

The debate about legalising cannabis in Australia deserves careful consideration. It is easy to reduce the argument to a simple question: should people who use cannabis be treated as criminals? But it is not the only question.

Any significant change to drug laws has consequences beyond the immediate people who are prosecuted, or the criminal networks that currently supply prohibited drugs. It can also affect people who do not use drugs – families, children, future generations, public health, mental health services, road safety and the wider community. Criminal activity finds a path to other substances besides cannabis, and to other activities. Nothing new.

For me, this issue is particularly concerning because I have witnessed the consequences of severe cannabis use and associated psychotic behaviour at close range. I have seen the impact not merely on the person using the drug, but on the people around them. Families can experience fear, confusion, anxiety, fractured relationships and profound emotional distress. In some circumstances, the effects can continue for years. A person who does not connect to reality has complicated mental health side-effects, including inability to receive or give love in the common sense. For such, legalising cannabis does not address these profound issues or the associated use of other drugs  by a cannabis user such as methamphetamines.

These experiences have made me cautious about arguments that present cannabis legalisation primarily as a way of “removing criminals” from the equation. And, if we say keep it illegal, i.e. “catch the deserved criminals”, it does not stop criminal activity, as mentioned.

There is a legitimate argument that criminalising drug users can create significant problems of its own. People who use cannabis can become involved with the criminal justice system, and prohibition can create opportunities for organised crime. Those considerations should not simply be dismissed.

But neither should the potential consequences of making cannabis more accessible. This is what concerns me, having seen devastation. Not only seen, but experienced. Legal change may look at an idea in relative isolation, or a  simpler equation rather than all the compounding real impacts on real people.

Addiction also has a moral implication regarding families and friends who are given no option but to live in that environment. Legislation addresses the activity, in some fashion, not the moral responsibilities and losses. Those cannot usually be legislated due to the human condition, unless there is physical violence. Increasingly however we see the results of long-term consequences on mental health to others, or social consequences such as driving a vehicle while “out of it”.

There is now substantial medical evidence linking cannabis use with an increased risk of psychosis and schizophrenia, particularly among frequent users, types of user characteristics, age groups and strength of the cannabis. The risk is not identical for every person, and cannabis use does not mean that someone will inevitably develop a psychotic disorder. Nevertheless, the association is sufficiently established that it should form part of any serious public policy discussion. Even so, many have given personal accounts of the unpleasantness or derivative problems of cannabis use in the workforce and social settings.

This raises an important question.

If a change in the law makes cannabis more socially acceptable (whether forced or welcomed) or accessible, what will be the effect on people who currently do not use it? Will some people who would otherwise never have tried cannabis begin using it? Will some of those people develop problematic use? Will vulnerable individuals experience psychosis or other serious mental-health consequences? Will the number of people requiring treatment increase? And what will the consequences be for their families?

These questions deserve evidence rather than assumptions. We cannot of course deny choice and personal free will, but where are the boundaries as it applies to others from such choices? And when those choices have become deeply planted, who has the right to think it is a simple thing to change a person and stop their use. A negative response is to say the person deserves whatever bad outcome they get. Turn the tables and experience pain and suffering oneself, and one understands this is a deeply sad situation not to be flippantly discarded.  While an addict removes others from themselves who were once friends, separation in and of itself is a dramatic experience that needs better understanding rather than just a reactive “how dare you” response. This approach does not mend relationships, but does give better insight despite how sad.

The whole issue becomes particularly significant when we think beyond the individual.

A person experiencing severe substance dependence or psychosis does not exist in isolation. They may have parents, partners, children, siblings, friends and colleagues. Their behaviour can affect the emotional and physical security of everyone around them. A child growing up in a household dominated by addiction or severe mental illness may (or will) experience circumstances that affect their own development and future relationships. If the child is humiliated in front of friends, emotionally trapped by the parent, with elevated and permanent anxiety, these are consequences the child may not understand. Legalising the substance, ignoring the possibility of creating this environment among innocent people, thus impacting their future, concerns me.

Those consequences are difficult to measure because they do not necessarily appear in statistics as a single cannabis-related event.

A person may lose employment.

A marriage may break down.

Children may grow up frightened or confused.

Friendships may disappear.

A family may spend years trying to manage behaviour they cannot understand.

Someone may repeatedly deny events that others clearly experienced.

Someone experiencing psychosis may genuinely believe things that are not true and act upon those beliefs.

These are not abstract consequences to the people living through them. I have seen enough of this to understand why someone who has experienced it might be deeply concerned about expanding access to cannabis.

At the same time, personal experience has limits. What I have witnessed cannot by itself establish what will happen to the Australian population if cannabis is legalised. That is precisely why I believe the question deserves considerably more research and public discussion before policy is changed. For example, is it feasible for addiction to be recognised as exactly that, and provide legalised medical access.

We should be asking not only whether legalisation reduces cannabis-related criminal offences, but also whether it changes the number of people using cannabis, the age at which people begin using it, the frequency and potency of use, cannabis dependence, psychosis, mental-health presentations, drug-driving, family harm and demand on health services.

We should also ask whether different forms of regulation would produce different outcomes.

Perhaps the choice does not have to be simply between prohibition and unrestricted legalisation.

There may be approaches that reduce the harms associated with criminalisation while maintaining strong restrictions around access, advertising, potency, age, driving and supply. There may also be specialised medical and treatment approaches for people who are already severely dependent, where the priority is getting people away from criminal supply and into appropriate health and addiction services.

That possibility deserves investigation even though an addict, I assume in some cases, would not like being “exposed” and assisted.

I am not arguing that every person who uses cannabis will become psychotic, addicted or socially destructive. That would be an unfair and medically indefensible claim. Nor am I suggesting that prohibition has no harms.

My concern is with the simplicity of the argument.

“Legalise cannabis and remove the criminals” sounds straightforward. But drug policy is not straightforward. The problem is when an action has become one-sided without balance, not inquiring about the consequences.

The people affected are not only those selling cannabis, nor only those purchasing it. They include people who may begin using it after the law changes, people who may be particularly vulnerable to its effects, and the families and communities that may carry some of the consequences. Strict enforcements are appropriate to certain aspects of our society, but so is the “level” of law.  We do not accept a parking ticket for $200 when parking tickets are around $100, however a business may charge $200 – in a sense criminal and getting away with it. If we were charged $1,000 for an accidental parking mistake, we would all agree that is completely unacceptable. The issue becomes one of proper and informed enforcement as opposed to, for example, an idea or motivation that is simplistic in either for or against direction.

There is also a deeper question about what we mean when we say that something should be legal.

Legal does not mean harmless.

Alcohol is legal, yet Australia recognises the enormous harm that alcohol can cause. Tobacco is legal, yet its health consequences are well established. The fact that something can be regulated does not mean that regulation removes all of its consequences.

Cannabis therefore deserves the same level of seriousness.

My position comes partly from personal experience, but it is also a request for better evidence. Before making a major change to the law, I would like to see the government and the public presented with a comprehensive assessment of the likely benefits and harms.

What happens to criminal activity?

What happens to cannabis use?

What happens to young people?

What happens to people vulnerable to psychosis?

What happens to families?

What happens to road safety?

What happens to the health system?

And perhaps most importantly, what happens to the people who would never have used cannabis under the existing system but may choose to do so when its legal and social status changes?

Those questions do not automatically prove that cannabis should remain illegal. But they do demonstrate why legalisation should not be presented as a simple solution to the problem of criminalisation.

I have seen the devastating consequences of severe addiction and psychotic behaviour. I would not want to see other families experience what I have witnessed.

That is why my concern about cannabis legalisation is not simply a concern about drugs or criminal law. It is a concern about the people who may be affected by a decision made today, including people whose lives have not yet unfolded.

If Australia is going to change its cannabis laws, it should do so with open eyes, careful research and a willingness to acknowledge both the apparent benefits and the potential harms.

The question should not simply be, “How do we stop treating cannabis users as criminals?”

It should also be:

“What kind of society and what kind of future are we creating by changing the law?” and “Are we developing common sense and researched approaches to proposed new laws?”

Author’s note: I am not writing this in order to receive comments, support or opposition. I felt it important to give a perspective because of what I have experienced and observed, and now that there is medical supporting evidence. Previously, as with certain other health conditions, people may have disregarded medical experience or advice as medical evidence was not sufficiently known or published.