Hard News by Russell Brown

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Cannabis reform is a serious matter – so be serious about it

I've wondered here several times where an organised "no" campaign in next year's cannabis referendum might come from. Outside of Family First, it's still hard to tell where the opposition emerges. But I think what we are starting to hear is the sound of two hands wringing.

The Listener ushered in the new year with an editorial that seemed to lean heavily on Bob McCoskrie's talking points. What factual claims the editorial makes are both ominous and vague  and it appears that the author has not made any attempt to read source research. There is this passage, for instance:

Rates for use by all people aged 12 and over are nearly twice as high as in non-legal states. Underaged users – those 12 to 17 – are now nearly 50% more likely to have consumed cannabis in the previous month, according to the US Substance Abuse and Mental Health Services Administration.

I had a look at the most recent SAMHSA report, from which I imagine this claim is taken. Yes, adolescent past-month use in legal-weed states is generally higher than those that have not legalised. But the highest rate – 10.75% – is in Vermont, where cannabis was not legal at the time the data were gathered (2016-2017). And the difference in every legal state was evident long before legalisation. In Colorado, for instance, past-month use among adolescents was higher in 2008-2009 than it was in 2017, three years after legalisation (data for all states here). Yup, teen cannabis use has dropped significantly in Colorado since legalisation. The SAMHSA survey also found that past-month youth use had reduced significantly year-on-year – from 11% to 9%.

The story is similar in all other legal states: youth use is either stable or declining since legalisation. It's worth noting that some of those states had forms of decriminalisation and/or loose medicinal laws before they legalised. That could suggest that fully legalising and regulating is more effective than any half-measure. That's actually the potential implication of another statistic highlighted in the editorial:

In Colorado, which legalised the drug, initially for medicinal use, in 2010, youth cannabis-related emergency hospital admissions quadrupled in the decade to 2015.

There is no doubt that cannabis-related emergency admissions have increased in both Colorado and Washington state since legalisation. But at the same time, in both states, admissions to drug treatment programmes and police arrests have declined. That might be about one-off incidents related to the states' initially way-too-strong retail edibles (which have since been reined in). Or it could be that people, and young people in particular, are now more willing to present themselves to ED when they've overdone it.

At any rate, more Americans are using cannabis – but the increase seems to be solely among adults. There are also more near-daily users – yet the number of Americans diagnosable with Cannabis Use Disorder is stable (pages 24-26 here).

Part of the problem is that there's so much epidemiological data that it's easy to cherry-pick in service of a belief. We're all guilty of motivated reasoning – and I don't exclude myself. But I think anyone writing a major editorial has a duty to do more than simply copy someone else's bullet points.

The next contribution doesn't have that problem – because it doesn't bother itself with facts at all. It's by Karl du Fresne on Stuff and it is absolutely fucking execrable. Du Fresne isn't really writing (let alone thinking) about cannabis reform so much as firing off another of his wearisome dispatches from the culture war.

He targets – to the point, I think, where an editor might have had a word – two people: former National Addiction Centre director Doug Sellman and New Zealand Drug Foundation executive director Ross Bell. Both of them believe legalisation and regulation are the best way of getting a handle on cannabis from a public health angle. But du Fresne has a conspiracy theory that says different:

I suspect Sellman and Bell are at least partly motivated by hostility toward capitalism. They certainly share a dislike of the capitalist liquor industry, which in Sellman's case could be described as a fixation.

Given that cannabis and alcohol are both potentially dangerous mind-altering drugs, why do both men display a more forgiving attitude to the former than to the latter? In my opinion the reason is at least partly ideological. It's the capitalist business model, as much as anything, that they object to.

Well, firstly, both Bell and Sellman want to regulate legal cannabis far more carefully than legal alcohol is currently regulated. How that amounts to a "more forgiving" attitude is a matter for du Fresne and whatever the hell's going on in his head.

He witters on, repeatedly confusing legalisation and decriminalisation and objecting to the recent medicinal cannabis bill which which "essentially legalises the use of cannabis by people with a terminal illness", something he says a few lines later can be  "justified on grounds of common sense or compassion". Then:

But there should be no doubt that what we're observing is decriminalisation by stealth, which was why the National Party withdrew its support for the medicinal cannabis bill.

It really isn't, and it makes no more sense for du Fresne to say so than it did when Simon Bridges said it. As framed, the law offers a statutory defence for people in palliative care who possess cannabis without a prescription, as a transitional measure until the new regulations that give the bill meaning are written over the next year. It doesn't protect anyone who sells the cannabis, or even acquires it for a dying relative. But it suits du Fresne's conspiratorial mindset to declare otherwise. If he'd complained the government bill is poorly-written, I'd agree – would a decent explanatory note at the top have been too hard? – but he hasn't. He's too busy rushing around challenging imaginary monsters to a fight.

His actual argument, to the extent that he has one beyond flinging poo at his ideological foes, is an odd one: that there may be risks to cannabis, so we should install a highly commercial sales model because capitalism is good and corporates would be safer than "a backyard dealer" or "a dreadlocked stoner in Golden Bay":

... if a safe, regulated cannabis market is the way to go, and corporates are best-placed to deliver that outcome, what's the objection? It can only be ideological.

There's actually a straightforward and well-founded argument against handing the market to big companies (and especially publicly-held companies, which du Fresne asserts would to the best job): in order to generate profitable growth, such companies need to do two things: recruit new users, and sell hard to problem users. That's what happens  in the liquor industry, where there's a classic 80/20 rule and most profit comes from dependent users. Perhaps we'd want to think twice before replicating that.

The Drug Foundation goes through this in the model drug policy it released last year, proposing regulation in favour of "small-scale community development" which would help "avoid developing a powerful industry lobby" that could influence future policy choices. I think the idea of having these enterprises distributed among, and bringing revenue into, local communities is worth looking at. It's also likely to be important to Māori.

It's also worth noting that the effect of not regulating on scale in the US has not been everyone making heaps of money. It's been a weed glut, where producers in Oregon and elsewhere are quietly supplying out-of-state criminal dealers just to keep going. It's kind of a mess, and something we'd want to avoid.

Although du Fresne declares himself quite unable to think of any alternative, there are other working models, the cannabis social clubs of Europe among them. I think production needs to be commercial – there are costs and regulatory burdens to be borne, capital investments to be made – but it's just stupid to bellow that anything short of weed supermarkets on the high street is creeping socialism.

There is, I should note, a final irony. Who has intoned most frequently and darkly about the threat of "Big Marijuana" in the past year? Is it trade union leaders, the woke of Twitter or the educated liberals who crave subversion from inside the system? No. It's that well-known crypto-Marxist Bob McCoskrie.

I did find one fan of du Fresne's column. Former Act MP Stephen Franks declared it "sensible" and insisted that the slew of errors in the column were mere "technical" points that a columnist could hardly be expected to recognise.

A couple of days later, Franks was was back recommending a New Yorker article in which, he declared, "Malcolm Gladwell deftly questions the woke consensus in fashionable support for cannabis legalisation". Why, one must ask, do these guys have to turn everything into the culture war?

The short New Yorker piece consisted of Gladwell looking at a new book by former New York Times reporter Alex Berenson, Tell Your Children: The Truth About Marijuana, Mental Illness, and Violence and saying "hey, maybe this guy's got a point." Similar promotional pieces have appeared in the New York Times, the Wall Street Journal, Mother Jones and elsewhere. A sensible person could certainly be forgiven for thinking that perhaps Berenson's dire warnings about cannabis should be taken seriously.

Unfortunately, as the headline over a frustrated piece on The Stranger put it, East Coast Media Is Grounded From Writing About Weed. The author, Lester Black, writes:

But almost as soon as journalists started jumping on Berenson’s bandwagon, the actual scientists behind the research Berenson cited distanced themselves from his book. Those scientists say he is distorting their research, mistaking correlation for causation, or he is just outright drawing incorrect conclusions.

To keep things simple, Black focuses only on the New York Times op-ed. He notes that after Berenson claimed that last year's comprehensive National Academies review of the evidence around the health effects of cannabis and cannabinoids found unequivocally that cannabis use causes schizophrenia, Ziva Cooper, a member of the panel that spent years working on the review came forward to say "we did NOT conclude that cannabis causes schizophrenia." Cooper further notes in a Twitter thread that:

we found 1) an association between cannabis use and schizophrenia and 2) an association between cannabis use and IMPROVED cognitive outcomes in individuals with psychotic disorders

She says that since the review was published it has been established that "genetic risk for schizophrenia predicts cannabis use, shedding some light on the potential direction of the association between cannabis use and schizophrenia" (in medical terms this is actually a really big deal) and that:

... under placebo-controlled conditions, #cannabidiol (#CBD) improves outcomes in patients with schizophrenia when given as an adjunct med, showing that cannabinoids (not necessarily cannabis) improve symptoms.

There's a really important point here. Over the last 25 years or so, illicit breeders have been selecting for higher THC levels in cannabis flower. But in doing so they seem to have been inadvertently also selecting for lower CBD levels. That's something that cannabis critics have almost universally missed, but it's significant: there is good evidence now that CBD, the other main cannabinoid in cannabis flower apart from THC, mitigates against psychiatric risk. It's something that Rose Renton talked about when I interviewed her in 2017 and she lamented the "rocket fuel" effect of the black-market weed her kids were offered. In a legal market, it's something that could actually be regulated.

Black also looks at the increase in homicide rates in Colorado and Washington State that Berenson repeatedly highlights. Here's the thing. Those rates are below what pre-legalisation trends in both states suggested. Can we say that legal weed reduced the murder rate? Hell no. It's way too complex an issue for that sort of claim. But we really can't say that cannabis increased the number of murders.

Black isn't the only one to take to the internet in frustration at the ready reception of Berenson's arguments. Jesse Singal in The Intelligencer noted that Berenson's claim that cannabis has led to higher murder rates in legal states is "a case study in how to misleadingly use statistics to make oversimplified arguments about human behavior and public policy."

He also quotes former Washington State pot tsar (and now director of the Crime and Justice Program at NYU) Mark Kleiman's observation that over the  pre-legalisation years since 1992, where we know US national cannabis consumption increased, the US homicide rate has halved.

The most detailed rebuttal I've seen comes from the excellent Maia Szalavitz. She cites a lot of data that don't support various claims by Berenson, from his embrace of the "gateway hypothesis" to assumptions about cananbis potency and international trends in cannabis use and mental illness.

And finally, on Vox, German Lopez concludes:

There are concerns about marijuana and how legalization is playing out. As the National Academies’ report makes clear, there is still a lot about cannabis that we just don’t know, including its harms and benefits. There is a risk to commercializing another product that’s addictive for some and may be harmful in other ways for others, and there may be better ways to legalize or regulate pot that minimize those risks than what we’re doing today.

But Berenson’s book, with its sensationalist claims and shoddy analysis of the evidence, doesn’t genuinely address those concerns. Tell Your Children claims to inform its readers of the “truth” about marijuana, but it instead repeatedly misleads them.

Amen. There are real things to focus and and talk about here. By its nature, legalisation is an experiment. But how many of the harms that can reasonably be attributed to cannabis are effectively addressed by criminalising people who use it? Is the world due a better, smarter form of legalisation than it currently has? I think we can do better. But we don't get there via idle editorialising, blowhard culture wars or misleading use of evidence. If you're going to declare cannabis reform a serious matter, then for god's sake be serious about it.

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