One of the biggest debates regarding cannabis in recent years has been with regards to the link between cannabis and mental health conditions. This is by no means a new debate, with the construction of the cannabis user as being ‘insane’ or ‘dangerous’ being pervasive during the establishment of ‘modern’ international treaties such as the Second Opium Convention of 1925. Here, the Egyptians convincingly argued the case to include cannabis on the agenda based upon statistics suggesting that up to 60% of insanity cases were caused by the use of hashish. However, looking back at the ways in which statistics were generated in Egypt at this time, the evidence for this link quickly seems rather amateur (see Mills 2003).
But the renewed attention to these links has manifested itself predominantly through increased attention and research in the discipline of psychiatry; and more specifically, there has been a focus on the changing nature of cannabis cultivation and its effect on the pharmacological properties of the plant.
Whereas prior to the 1980s the cannabis market was dominated by imported outdoor-grown herbal and resin cannabis predominantly from the Caribbean, Africa, and South-East Asia, it is now possible to speak of a market dominance by what has been colloquially termed ‘skunk’. Importantly, the case has been made that these new strains of cannabis coupled with new modes of production has led to an increase in the psychoactive component THC, and a decrease in the anti-psychotic element of CBD. According to the Home Office, sinsemilla (‘skunk’) now accounts for around 80% of the market in England & Wales, and by looking at samples tested across both here and in the Netherlands, it becomes clear that this type of cannabis generally has higher levels of THC than either traditional herbal or resin cannabis, and much lower levels of CBD.
Coupled with an apparent shift of cannabis towards ‘high grade’ strains has been a steady increase in the amount of users seeking help for cannabis-related problems, which again is a trend which can be seen across both jurisdictions.
On the other hand, the argument could be made that due to the size of the cannabis-using population, it is clear that a causal link is rather dubious, as most people who use cannabis will never experience any serious adverse health consequences. To add a more social science-grounded view, the upward trends in those seeking help for cannabis-related problems, which started to really occur in the early 2000s, could be related to increased reporting behaviour of the public. In both England & Wales and the Netherlands greater attention was drawn to the issue through media debates and public health campaigns. Such public interest in the issue could have led to greater reporting due to awareness of genuine issues surrounding problematic use, as well as possible ‘misdiagnoses’ by family members or doctors who simply assumed a causal link between troublesome behaviour and cannabis use.
But even so, it is not surprising that the issue has been swept up by politicians and media alike, a new moral panic to which there must be a reaction. It is within this context that ‘skunk’ has come to be seen as problematic and dangerous.
The point then of distinguishing between different strains of cannabis is to problematise the all-encompassing notion of ‘skunk’ which automatically assumes that such strains automatically cause problematic behaviour and that all are the same. The reasons why people use cannabis varies significantly, so by having a better understanding of the particular qualities of a strain, there is a clear and obvious benefit for public health purposes. Here, the coffeeshops of the Netherlands seem to provide a very useful function – often ‘bud-tenders’ have an acquired knowledge of cannabis strains and can advise users on what to take based upon experience/tolerance and desired effects.
Not only is the understanding of cannabis important for recreational and problematic users, but is fundamental for medical uses. For example, one of the experiments that the municipality of Utrecht has applied to conduct involves the provision of hashish to heavy problematic users of cannabis. The basis of this experiment is that by providing specific types of hashish, which contain much higher levels of the anti-psychotic CBD, this may be able to counter some of the negative side effects found with high-THC cannabis.
Whilst I’ve not fully delved into the debate on cannabis and causality, the official reaction to these developments should be considered just as important. In my last blog, I referred to the increasing role of organised criminality in the cultivation of cannabis. And so, despite the sceptics who retain cannabis’ innocence, there must be an acceptance that aspects of the whole cannabis market have changed in fundamental ways to the context which preceded landmark national legislation (1971 Misuse of Drugs Act; 1976 Opium Act).
But if we accept this, then what does that mean for policy?
Within both England & Wales and the Netherlands the notion of greater health harms seemingly equates to greater control and restriction.
When Gordon Brown rose to power in 2007, the item of cannabis classification was one of the first things he wanted to address. The debate surrounding ‘skunk’ had been raging even before the dust had settled on the 2004 reclassification downwards to Class C, and as more research studies started to support the cannabis-psychosis link, there was a definite change in political current once Brown became Prime Minister. In fact, Brown went as so far as to suggest that the government needed to send a message about the more ‘lethal’ use of ‘skunk’ (despite this statement being more applicable to paracetamol than cannabis). The Home Secretary at the time, Jacqui Smith, then echoed these fears by stating that the government needed to ‘err on the side of caution’ by reclassifying cannabis to Class B in order to protect young people.
In the Netherlands, a similar debate has ensued in recent years culminating in the Garretsen Commission which suggested making a distinction between cannabis products which contain a percentage of THC above/below 15%. This recommendation has been taken up by the Dutch government, with plans to introduce a new criteria to coffeeshops which would ban high-strength cannabis.
However, questions remain about the effect of these policy changes and if they will serve the good intentions of wanting to ‘protect’ individuals, and presumably as a result, reduce levels of harm.
Surprisingly, little has been made about the nature of cannabis use with regards to these stronger strains. If we look at alcohol, where there are clear differences in the strength between beer, wine and spirits etc., there are also differences in how these products are consumed – we (usually) don’t drink vodka in pints, or beer from shot-glasses, so why should the use of cannabis be different? Is it not feasible that users can recognise the strength of what they are taking and use less/more to reach their desired level of use? Still the pervasive view of the drug user is the out of control addict looking to get as high as they possibly can.
In England & Wales, the reclassification did little to address the root of the problem: namely the supply of cannabis to users. The stagnant approach from the government is still rooted in the assumption that tougher measures will impact upon rates of use, and therefore by upgrading the classification to Class B, this would deter people from using cannabis. Well, that’s great if such an assumption could be proven true, but as history tells us, such an enforcement-based approach has had little effect on the widespread growth of drug use that has occurred over the past 40 years.
What is perhaps the most surprising part of this tale is that cannabis use had been declining steadily since the turn of the millennium, so the argument to reclassify to reduce intake does not hold much ground, and if anything, has only served to further stigmatise users. If we are to encourage engagement with health and education services by those users who do suffer problems as a result of their cannabis (and/or other substance) use, then further marginalisation doesn’t seem to be the way forward. Additionally, given the lack of choice users are faced with in the UK when acquiring cannabis, the reclassification did little to address the fact that individuals will use cannabis regardless of its arbitrary legal classification. Even if a user doesn’t want to smoke the strong stuff and would prefer hash or a weaker strain, there is usually not a lot of options available. Does this mean that they will ‘just say no’? No, it means that they will take the strong weed.
In the Netherlands, whilst the incorporation of the THC measure into existing coffeeshop practice may allow a better chance at regulating the market and could feasibly have some overall health benefits, there are still many obstacles which could undermine the policy. Having spoken to individuals from a broad range of agencies involved in the cannabis regulation network, it has become clear that enforcing this measure is quite complicated, and ultimately unrealistic with the current resources and infrastructure available.
First, the government intends to test samples in all coffeeshops at a national laboratory. But given that coffeeshops will typically stock between 10-20 different varieties of cannabis at any one time (e.g. sativa, indica and hashish), and these products are constantly replaced/updated depending on supply availability/user demand etc. within a relatively short period of time (coffeeshops may only stock 500g at any one time, and the cycles for cannabis cultivation are usually only a few months).
So the issue of what to test and how often is very important. Assuming that all coffeeshops have to have a sample tested of each type, then at any one time you could reasonably expect to have to test around 6000-12,000 samples. Multiply this by conducting such testing several times across the year and all of a sudden the simple idea of controlling THC content becomes very burdensome indeed. Moreover, there is the added question of when to test – during or after cultivation, or once the stock has arrived in the coffeeshop? The production process of cannabis leaves room for variation even within the same crop, which is affected by the location of the plant in the grow-room – a plant directly under a heat lamp will be more potent than a plant grown on the periphery.
Asides from technical and administrative concerns, there are also legal issues. Due to the fact that the cultivation of cannabis remains unregulated, it seems that the coffeeshop owners will be held to account for the cannabis that arrives at their door, despite a complete lack of regulatory frameworks to ensure product quality. So, if and when this measure does indeed come into force, the first inevitable case of a coffeeshop being closed due to the stocking of ‘hard drugs’ (which is what cannabis over 15% THC will be classified as) will prove to be very interesting from the perspective of the judge – can a coffeeshop owner simply plead ignorance because they have no control over production? Or will this measure be used as an artificial means to follow a more punitive path towards cannabis and coffeeshops?
So if ‘skunk’ is presenting health challenges which do require political action, then the only effective way to ensure that cannabis products meet ‘acceptable’ levels of harm is to regulate in some fashion. This is of course not a simple task, and striking a balance between product availability through licit/illicit channels needs to be considered (for example if the 15% criteria simply drove users to non-tolerated sources instead of conditioning use then this would not be very fruitful). In both England & Wales and the Netherlands the governments have come out and attempted to reinstate political legitimacy by saying ‘we are doing something about this problem’, but the actual policy measures still have gaping holes, in which ultimately the black market is left responsible for ensuring the quality of cannabis.
Department of Health. 2011. United Kingdom Drug Situation. London: DoH.
King, L. and Hardwick, S. 2008. Home Office Cannabis Potency Study. London: Home Office.
Mills, J. 2003. Cannabis Britannica: Empire, Trade, and Prohibition 1800-1928. Oxford: Oxford University Press.
Niesink, R. and Rigter, S. 2012. THC-Concentraties in Wiet, Nederwiet en Hasj in Nederlandse Coffeeshops. Utrecht: Trimbos Instituut.
Wisselink, D., Kuijpers, W. and Mol, A. 2012. Kerncijfers Verslavingszorg 2011: Ladis Landelijk Alcohol en Drugs Informatie Systeem. Houten: IVZ.