Health Committee on May 6th, 2014

[Terence Young, Conservative, Oakville, ON]

Of course.

[Dr. Kevin Sabet]

—which certainly could happen when you are intoxicated.

[Terence Young, Conservative, Oakville, ON]

A witness with a Ph.D. in pharmacology testified before this committee last week that the regulation of alcohol has been a failure. We heard evidence that the high percentage of our teens, even young teens, even as young as 12 years old, are abusing alcohol and binge drinking—over 50% in some age categories.

Dr. Sabet, would legalizing and regulating marijuana keep it out of the hands of children and teens?

[Dr. Kevin Sabet]

I don't think so at all, because when we've seen a version of regulation like the medical situation in Colorado, or California, or Washington state, many states have had this sort of regulatory framework over medical.... For example, we've seen great diversion to young people.

One study showed, as I think I put on here, that 74% of Denver area teens reported their marijuana use came from a medical marijuana dispensary at least 50 times, and these were teens in treatment for marijuana addiction. These were heavy users who were getting their marijuana from...and that was supposed to be regulated for cancer patients and HIV patients only. Even in that supposedly tight regulatory regime, kids were getting access. Again, alcohol, tobacco, and prescription drugs are great examples of how easily, when availability flows, when promotion flows, when commercialization, advertising, and normalization flows, so then do the drugs to young people.

[Terence Young, Conservative, Oakville, ON]

How would you describe legalizing and regulating marijuana thus far in the U.S. experience?

[Dr. Kevin Sabet]

I think so far, the only place to do it recreationally has been Colorado. I think the results have been extremely troubling, with young people using it, with more attention that police have to now spend on public use, on nuisance crimes, as well as on crashes and poison control calls. Clearly, it has only been three or four months, but when we look at the last three months as well as the last five years since they've had de facto legalization, it has not been something that I think folks would want to replicate.

[Terence Young, Conservative, Oakville, ON]

Our concern is the addiction and the harm, such as risk of cancer, of psychosis, as well as diminished brain function, decision-making, organization, planning, setting goals, in the 18-year-old to 29-year-old group. That's one of our primary concerns, because these people are at a critical junction in their lives. They're going to college. They're going to university. They're making decisions that will affect the rest of their lives. Some of them are starting careers, buying homes, getting married, and they're being targeted for votes with a policy from the Liberal Party to legalize marijuana, yet they're the ones who will suffer the most. They will also have double the risk of vehicular accidents, and the most dangerous thing of all is that they think it's harmless.

Would you please comment on that, Dr. Sabet?

[Dr. Kevin Sabet]

Having worked for multiple different parties, I certainly have a non-partisan stance here, but we certainly wouldn't want people of influence, whom we would rightfully look up to, talking about this in such a casual way or glorifying its use. We need to discourage use among young people.

I agree with Mr. Perron that we don't need to overstate the case, because then we're not credible and we don't want to be Reefer Madness.

If I were to send one message to the government, it's that we need to realize that we do not have only two choices when it comes to cannabis policy. We don't have to choose between legalization or incarceration and prohibition. There are many other policies in the middle.

We haven't talked at all about physician education on this, because I tell you, if we think parents are uninformed, we should talk to the people in medical schools and physicians on the actual health effects. We need to educate physicians so they can intervene early with young people when the young person goes to see their pediatrician. They can intervene early and ask the right questions about early cannabis use, because if we can stop the progression to addiction and stop it when it's lighter and supposedly in casual use, we will save much more money and heartache than dealing with it down the road when someone has severe addiction and needs full treatment. We need a robust education campaign, not only for parents and young people, but also for physicians and those of influence to be able to change this.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

Ms. Fry, go ahead, please.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you very much, Mr. Chair.

I think what we're talking about here is the harms that you have discovered in young people, very young people. We're talking about a particular age group, which I think is really important to note. It's not like if everybody uses marijuana this is going to happen. It's an age group thing we're talking about. I think we need to differentiate between the medicinal properties of marijuana, medical marijuana, and recreational marijuana.

That's something I would like to clarify here, that there are actually benefits of marijuana medically. We know that we have drugs made that will create those benefits. But as I keep saying, we have two legal drugs, tobacco and alcohol, which have, with the exception of the odd glass of red wine that we keep hearing will help to bring down a person's cholesterol, no positive medicinal properties, unless you want to talk about rubbing alcohol.

The bottom line is, and I know that people have discussed this, if you want to utilize the medicinal properties of marijuana, there is a way to do that. We've heard Dr. Sabet talk a little bit about different ways one can use marijuana in an appropriate manner. I have the concern he has about e-cigarettes and these sorts of vaporization, etc., but I think we need to focus on the reason for this particular study which focuses only on the risks and not at all on any benefits.

When we look at the three drugs which you cannot separate, the three drugs that are used recreationally, at least we know one of them has medicinal uses. The big question then is how do you utilize the positive aspects of marijuana? How do you also in terms of the recreational use of marijuana recognize that you have a whole group of young people smoking it, and therefore there might be a need to regulate the age at which they can get it? I think this is what people talk about when they talk about regulating marijuana. It's like you can't buy alcohol...well, you can if you wanted to, but you're not allowed legally to buy alcohol under a certain age. You're not allowed legally to buy cigarettes under a certain age. But what we have seen time and time again is that every time prohibition has been tried, organized crime has stepped in. We only have to look at the 1920s and 1930s in terms of alcohol. We have to see what happened with heroin which used to be a usable drug back in the Victorian era, which then because of trade disputes became an illegal drug.

The question is how you square the circle with a drug that has certain properties that we may want to use them for, but we know there are certain modes of usage that are dangerous and we know there is an age group that we have to cut off, unless of course it's prescribed by a physician for a specific reason. So how do we square that circle? That's basically what I'm trying to say. I'd like us to just take the elephant in the room and put it smack on the table and dissect it and say, “What do we do if we turn to prohibition?“ Then we have no way of controlling the young kids who use it. Just like when we increased the tax on cigarettes and the price increased, we saw this cross-border thing happening and young people were buying them on the black market. Tobacco became a drug that was pushed.

I would like to hear some thoughtful ideas from you about how we utilize a drug that has positive impacts, stop the use below a certain age, and how we find a way of talking about the problem that we're discussing here, the recreational use of it.

[Dr. Kevin Sabet]

We don't do that by regulating and legalizing. When you look at alcohol and tobacco, the usage levels of alcohol and tobacco are far greater than the usage levels of cannabis. We may think we're regulating it by putting laws on it, but as you sort of said very openly, which is true, kids are getting alcohol today as they are getting cigarettes.

The reason the reduction in cigarettes has been found—which is a great success as Mr. Perron pointed out—is not because the substance is legal; it's because we've had a massive education and de-normalization and stigmatization campaign on smoking. I mean it's hard to find people who smoke who even agree with the fact that they're smoking, who even like the fact that they're smoking. It's been a huge change in our society.

Right now we have the opposite for cannabis. We have all this information about how it must be helpful and that it's not that bad. With regard to medical use, let's not forget, Madam Fry, that most of our illegal drugs also have medicinal properties. Cocaine has medicinal properties. In fact in the U.S., it's used in limited settings for anesthetics and certain surgeries. Clearly opiates have medicinal properties. The number one pain reliever that we know of is morphine, which comes from opium.

Cannabis, as you said and I said earlier, has medicinal properties. The question is how we make sure that we are separating the recreational use, which is what we're mostly talking about today, and the medicinal use, which can delivered in a non-smoked way. As I commended Canada for having Sativex available, I'm not sure why there needs to be a whole thing for smoked cannabis for “medical purposes” if you have the liquid extract that actually delivers the positive benefits without the negative aspects. I'll stop there.

[Hedy Fry, Liberal, Vancouver Centre, BC]

Thank you, Dr. Sabet. I have only a short period of time and Ms. Porath-Waller had put her hand up to answer as well.

Thank you.

[Amy Porath-Waller, Senior Research and Policy Analyst, Canadian Centre on Substance Abuse]

Thank you for the question.

I just wanted to provide a point of clarification and I'll let my colleagues jump in. The harmful effects—the risks that we've been talking about with regard to mental health, the cognitive deficits we've been discussing, the increased risk of motor vehicle accidents—aren't just unique to young people. These are effects that have been demonstrated in studies of adults as well as youth.

What the research is suggesting is that these risks are greater for young people because of their developing brains. I just wanted the committee to keep that in mind. It's not just young people who are at risk of cognitive deficits. Adults also show those deficits in attention, memory. Adults are also experiencing respiratory impairments. There's also the risk for cardiovascular impairments with adults, particularly those who are at risk for heart disease.

I just wanted to point that out to the committee.

[The Chair, Conservative, Ben Lobb]

Ms. Fry, we are over time.

Mr. Perron, did you have something to add briefly? Then Mr. Wilks has a brief question.

[Michel Perron]

If you'd permit, just very briefly.

I think the question posed by Dr. Fry is quite relevant, actually. There are a number of truisms and policies that we live with in the alcohol world that never seem to translate into the cannabis world. One is the greater the availability, the greater the use, the greater the harm. Public health deals with this in alcohol all the time, and yet we don't seem to want to apply the same to cannabis at times. I think we need to look at the issue of availability and its use, and therefore the harms and certainly whatever scheme allows for that to be more prevalent.

I think the issue of medicinal use and benefits, and its application to recreational use is a bit of a confound. I think simply because a substance has a particular benefit, it doesn't necessarily mean that we wish to promote it or make it available in a legal structure. I think the committee's report on prescription drugs states that quite clearly.

I think there's also an important element to say that alcohol and tobacco are different in the sense that, in a black market, it's much easier to produce cannabis at home than it would be for alcohol or tobacco. That notion of just because we were to regulate it, there would no longer be that black market at home, is perhaps underestimating the ability of this particular product to be manufactured that way.

[The Chair, Conservative, Ben Lobb]

Thank you very much. We are over time.

Mr. Wilks, a brief question and that will conclude our meeting today.

[David Wilks, Conservative, Kootenay—Columbia, BC]

Thank you very much, Mr. Chair.

Mr. Perron, Dr. Sabet had brought up different ways of looking at how we can deal with the marijuana issue. Can you briefly speak with regard to how CCSA has reacted to the Canadian Association of Chiefs of Police motion with regard to a ticketing regime for small amounts of marijuana found in schedule II subsection 1(8) of the CDSA?

[Michel Perron]

Specifically, in terms of the proposal put forward by the Chiefs of Police, CCSA would agree with the fact that we don't need to criminalize simple possession.

I think the issue of ticketing is interesting, in the sense that if we look at some of the successes around drinking and driving, what we saw at the time—and what has resulted in a change in behaviour—is the convergence of a few things: one, a clear regulatory regime; two, clear prevention messaging—don't drink and drive—; and three, societal attitudes.

Currently, we have a law that is not being applied. A law that's not being applied isn't much of a law. The severity of the law is not so important as the certainty with which it will be applied. A ticketing approach, in terms of providing a reasonable infraction and notice to people who are in possession would be certainly consistent with how we treat alcohol.

Today, if people are stopped in a park, and they have an open bottle of alcohol and a joint, the person with the alcohol will get a ticket. Having a consequence for cannabis use is appropriate and we would support that. Also, it has to be teamed with appropriate prevention messaging and clear access to resources for not only parents but youth. Access to treatment is an important element as well. We also need to measure what is, in fact, the import or the effect of any policy shift in this regard.

[The Chair, Conservative, Ben Lobb]

I want to thank all our guests here today for a good discussion.

I'd also like to thank our members for their respectful and courteous manner, and great questions.

The meeting is adjourned.