Thank you, Mr. Chair, and members of the committee, for inviting me to speak in front of you today, with the wonders of modern technology. I very much appreciate it.
I'm here wearing a few different hats. I am the co-founder, along with Congressman Patrick Kennedy, of Smart Approaches to Marijuana. As many of you know, we recently helped launch the Canadian affiliate of that organization, with Dr. Harold Kalant, the professor who I think was in front of you last week. We look forward to continued dialogue with the Canadian government. I also am an assistant professor at the University of Florida, college of medicine, department of psychiatry.
I left some visuals and slides with members of the committee today. I won't follow them verbatim during my testimony, but I think they serve as good reference points, especially since I wasn't able to join you in person.
I'm honoured to serve here, in front of the committee, with both Dr. Smith and Mr. Perron, who have both shown extraordinary leadership on this. CCSA especially has been a wonderful international partner and representative of Canada to many NGO fora around the world, and I appreciate their continued work. I appreciate Dr. Smith's work on the neuroscience side.
I think what we just heard should be taken into a broader context. I would say that the biggest challenge facing both Canada and the United States right now on this issue is that there is a huge divide between the scientific understanding of the harms of cannabis and the public's misunderstanding. So, if there could be something the committee might want to focus on, it would be to try to bridge that divide.
As you can see, I wrote a book called Reefer Sanity: Seven Great Myths About Marijuana that covers much of this. I've been in this field for almost 20 years, and recently served as the senior adviser in the Obama administration for drug policy. After I left my post, I wrote and reflected on my experiences and also on the science of cannabis. That's what my book is about.
Really, the first myth I present to you is this idea that many people believe, which is that marijuana is harmless and non-addictive. Clearly, from what we've just heard, and again what the science says, that's not the case.
To put it in context, we know that one out of every six 16-year-olds who ever try marijuana even once will at some point become addicted to the drug in their life. Clearly, marijuana addiction does not manifest itself the way heroin or cocaine addiction does, but it certainly isn't something that is benign.
As we heard from Dr. Smith, the adolescent brain is essentially under construction up until age 28 or 30. It's clearly a bigger risk when kids start, or when you start earlier in life. That makes sense, if you think about, say, when you want to learn a second language or how to ride bike or swim, you learn those things when you're younger. Your brain can pick those things up, which is a good thing. Unfortunately, on the drug side, it's a bad thing. It means that early use and exposure to substances has the ability to interfere with normal brain processing.
The next slide, slide 5, the one with the bubbles, on the dependence on or abuse of specific illicit drugs.... This is obviously U.S. data, but I think it's important to look at the fact that marijuana is the number one reason kids are in treatment today, more than alcohol and all drugs combined. Also, it's the number two reason for adults, after alcohol.
Slides 6 and 7 are on potency. Although slide 7 comes from American data, the data from Canada is very similar. In speaking to Dr. Kalant and looking at this before coming to you today, we know that 30 or 40 years ago, marijuana potency was hovering between 1% and 2%. Today, the average is between 10% and 11%. Of course, in certain regions, especially on the west coast of Canada and the east coast, we know that indoor-grown marijuana can produce upwards of 30% THC. That is a very different level from someone who might have tried cannabis even 10 or 20 years ago. I think this is part of the reason there is such a divide. Parents today, many of whom might have tried cannabis, tried it when the potency was much weaker so their understanding and experience of it is very different from that of kids today.
Mr. Perron spoke about mental illness. I won't dwell on that, other than to say that this is an area of research we're focusing on, given the increase in mental illness in both our countries. Harmful effects on the lungs, I think, was also stated.
Turning to slide 11, and Dr. Smith briefly referred to this when she talked about New Zealand, when we look at the IQ issues, I think that is really something we would want to focus on. One of the most robust studies ever conducted on people using cannabis over a 30-plus-year lifespan—these are longitudinal studies—essentially found that people who had used cannabis heavily as adolescents, even if they had stopped in adulthood, by age 38 had a significant risk for a six-to-eight point reduction in IQ. That was even after controlling for alcohol and other substances. Clearly, more research needs to be done, but when we start looking at school dropout rates, when we start looking at vulnerable populations, clearly six to eight points is significant, especially for those vulnerable populations who are already having a difficult time at school for various reasons.
Slides 12 and 13 I'm not going to dwell on too long, this idea of whether marijuana is medicine. I think it's important to talk about this here, especially in the Canadian context. We do know that cannabis has medical properties. We know that cannabis has over 500 components. We're learning about all of them every day, but we know that we don't need to smoke or eat crude cannabis to get those medical properties. Similarly, we don't smoke opium to derive the benefits of morphine. There needs to be a very clear distinction between crude cannabis that's smoked by young people, and the components of cannabis that might be used for something like neuropathic pain relief or multiple sclerosis relief.
Slide 14—and I commend Canada for moving so quickly on this, much quicker than its neighbour to the south—looks at cannabis-derived medicines that do not have potential for abuse and really are not being diverted to kids. One of those medicines, nabiximols—Sativex is the trade name—is in the process of being studied in the U.S. but is essentially already approved in Canada. It's administered via an oral mouth spray for spasticity due to multiple sclerosis and also neuropathic cancer pain.
What's interesting about that is that it's a liquid extract, so it's the whole plant, but it's mainly comprised of THC and CBD. CBD is important because it does not get you high. CBD is a component of marijuana, like THC, but because it binds to receptors differently—there's actually controversy about that—it does not get you high, it does not produce psychoactivity. The same manufacturers are also looking at other drugs that could be used for epilepsy, like Epidiolex.
This is an ever-evolving area, as slide 15 talks about. Every week there seems to be studies coming out. A couple of recent studies in the last week are interesting for the committee to note, I think.
One is a peer-reviewed research finding that people who had used cannabis and then went on to cocaine had a much greater severity of their cocaine dependence than those who never tried cannabis and jumped straight to cocaine. Now, we have to figure out why that's the case, and this is early research, but it's very interesting when we want to look at the link between cannabis and other drugs.
I'll skip the second bullet.
The third bullet essentially is a research finding from two weeks ago that made a lot of headlines. It found that casual users of cannabis, not heavy users, had structural changes in their brain that had really only previously been documented in animal studies. It was a small sample of about 20 people, but it was interesting to look at the parts of the brain that were affected, even among casual users. This is the first time research has found this in human studies versus animal studies. This is clearly an area we need to keep an eye on.
I'm going to skip a couple of the other slides.
I'll go to slide 17. With the couple of minutes remaining that I hope I have—and I know we're looking only at health harms here—we do need to look at the role of marketing and normalization in exacerbating health harms. We've known from the history of tobacco in both of our countries about, really, the history of 100 years of deceit and misinformation by an industry whose goal was to increase addiction.
Remember, industries only want to increase addiction. That's how they increase their profit. What I worry about—well, I'm witnessing what's going on in the United States, the elephant in the room being Colorado and Washington—is this idea of big corporations popping up.
I'll just leave some visuals with you. I won't go into a lot of detail here.
Essentially we are in the midst of creating the next tobacco industry of our time here in the U.S. as we move down this path of legalization. For example, in slide 19 you can see the edibles that are used, the sodas. It's important for a committee who's looking at health harms to understand that actually a lot of kids are not just smoking a joint in terms of that's the way they're getting marijuana. They are eating it in different forms. They are drinking it in different forms. They are vaporizing it, and using m-cigarettes. I think the huge unexplored topic on this issue is the role of vapours, vaporization, e-cigarettes, and what we call m-cigarettes right now. We already know that Philip Morris International has its hand in creating the most efficient marijuana vaporizer. It can also be used for tobacco, so you can basically hide both of them.
Slide 21 I think you also need to look at. This is the issue of butane hash oil extraction. This is the idea that you can get close to 100% THC by combusting marijuana through a butane process and inhaling it. If you were to tell somebody 10 years ago that they could get 100% THC, you would be laughed out of any scientific room or conference. It didn't exist: you can't have that much THC in a marijuana joint. But now, due to modern technology, you certainly can have concentrates approaching 100%.
This is a huge public health concern that I would urge the committee to look at. We've now seen mass commercialization through Groupon, and really the intersection of Wall Street and marijuana.
With that, I'll stop talking about commercialization.
The final point I want to make is that if you look at Colorado and look at the developments, as a lot of people are, it's important to understand that Colorado has had de facto legalization for about five or six years through the purveyance of medical stores that have essentially sold marijuana to anybody, really, who reported any kind of pain at all. Research is now just coming out. I've left you with some peer-reviewed sources. I won't dwell on all of the issues and problems that have been looked at—I don't have the time—but essentially it has not looked good in Colorado in the last five years since they really went down this path of legalization.
There's clearly a lot more to talk about, but I will stop there and yield the floor back to the committee.
Thank you for having me.
