Thank you for including me in this conversation. It's a pleasure to be here.
I worked for 12 years in the Downtown Eastside of Vancouver, which I think is notorious throughout North America as the continent's most concentrated area of drug use; and right now I travel extensively internationally to speak on addiction and related issues.
In terms of cannabis, first of all, I welcome the legislation that's going to bring some rationality to the policy around this substance. Drug laws in general—and I'll refer to that later—are quite irrational, in the sense that they have no connection to logic and very little connection to science whatsoever.
When it comes to marijuana, it's a substance that's been around for a long time. I think the first archaeological evidence of its use by human beings goes back 4,000 years, and it was first mentioned in a medical compendium published in China in 2,700 BC, so that's how long its use goes back.
In modern times, it was well known to the British in India, where physicians studied it and found it to be helpful in tempering nausea, relaxing muscles, and treating pain. As a matter of fact, Queen Victoria herself was prescribed marijuana for menstrual cramps, so the medical use of the substance and what you might call its recreational use go back a long time.
In terms of its addictive potential, it's just a misbelief that the plant is either in itself addictive or that it's a gateway plant for other addictions. If there's a gateway substance to addiction, it's tobacco, because most people who end up addicted to anything have used tobacco first. But it's not a question of gateways. The fact about any substance, whether it's marijuana, heroin, alcohol, food, or stimulants like cocaine, is that most people who try it even repeatedly never get addicted, but a minority will.
The question always becomes whether the substance is addictive. The answer is yes or no. In itself, nothing is addictive, and yet potentially everything is addictive. Whether something becomes addictive or not depends very much on the individual susceptibility. Now those susceptibilities may be to some extent genetically determined, but for the most part I don't think that's where the answer lies. I think fundamentally that substances that people use serve a function in their lives.
If you take the case of ADHD, for example, it's well known that kids with attention deficit hyperactivity disorder are more likely to use marijuana. Why? Because it calms the hyperactive brain. Very often addictions are self-medications; they begin as self-medications.
Marijuana also soothes anxiety. Now does that mean therefore it's benign? Not necessarily, because some people will start to self-medicate and they start using it to the point that now it creates a problem in their lives. Now it's an addiction. So the question of a substance being addictive is not to do with the substance itself, but whether or not a person uses it to the degree that creates a negative impact on their lives. Like any other substance, marijuana can do that, so it's neither true that it's addictive, nor is it true that it's not addictive. Again, it's a very individual matter, and the question is how we approach that.
First of all, we have to approach it rationally. This may be shocking or surprising to non-medical personnel, but legal substances like tobacco and alcohol are medically far more harmful than almost any of the illegal substances. For example, if you take 1,000 people who are heavy smokers or heavy drinkers and compare them to 1,000 people who use heroin in a non-overdose amount every day, and you look at those people 10, 15, or 20 years later, you will see that there's going to be much more disease and death in the alcohol and tobacco users than amongst the heroin users. This is especially true for marijuana.
Long-term studies show that over time marijuana users just don't suffer significant consequences, with one significant exception, and I hope the committee takes this into account, which is that there's a very persuasive study out of Britain that showed that if adolescents use marijuana extensively during the period of brain development, that can actually have deleterious effects on their long-term psychosocial and cognitive functioning. In other words, while it's true that marijuana is not as harmful as the already-legal substances of tobacco and alcohol, it's also true that if it's used extensively during the stage of brain development in adolescents, it can have negative long-term effects.
The question is how to address these problems. The trouble with adolescents and marijuana is that even when the substance has been completely illegal, as it has been up until now, it has not stopped adolescents from using it. In fact, it's the easiest thing to get for almost anybody aged 12 onward.
I don't know what, in the legislation, can possibly address that issue. I don't know what legal measures can stop the use by adolescents. In other words, when we're looking at prevention, we really have to look at why people use a substance, what's in the culture that's driving their use, and how we can address those issues.
Unfortunately, when it comes to drug prevention strategies, the idea of telling kids that stuff is bad for them just doesn't work. The reason it doesn't work is that the kids who will listen to adults are not at risk; the kids who are really at risk are not listening to adults. The real issue is how do we create conditions in our homes and our schools so that children will actually listen to what adults tell them. Without that connection, that trust on the part of the adolescent, they will simply listen to their peer group far more closely than to adults.
There is such a thing as marijuana addiction, and I'll define addiction as any behaviour, substance related or not, that a person craves doing, finds temporary pleasure in, or enjoys, and finds relief temporarily from, but which causes negative consequences in the long term and the person can't give it up. That is what an addiction is.
When it comes to treating any addiction, simply trying to address the addiction itself is inadequate, because there's always a reason why people use a substance or engage in a certain behaviour. When you ask somebody why they use marijuana, they'll say it makes them more relaxed. When you ask somebody why they use heroin, they'll say because they won't feel emotional pain.
In other words, the real problem is not the use of the marijuana or the heroin, the real problem is the emotional pain that person feels. The real problem is the overwhelmed state of their brain. In other words, the addictions are always a secondary attempt to solve a problem. Addiction treatments in this country, I have to say, for the most part don't address the real issues. Addiction treatments, for the most part, address the behaviour of addiction but not the underlying causes of it—not the underlying purposes that the individual finds in their behaviour. Those treatments will be insufficient.
When it comes to prevention, I think we have to look at what conditions in this society promote substance use in large numbers. If we look at the statistics for children, the number of kids who are anxious and depressed, alienated, troubled, or diagnosed with this, that, or the other thing is going up and up all the time. Every year the statistics are more and more dire. That's the real issue.
The drug use is a secondary phenomenon. It's those primary issues in our society that are driving the mental discomfort of our youth that we have to address. Those are broad social questions.
When it comes to treatment, again it's a question of how do we address the trauma, stress, and emotional distress of individuals who then use substances to soothe those factors. Again, we have to look into causes rather than just behaviours. I don't know where I stand in my 10 minutes. I'd like to bring it to a close.
I'm going to say that I'm encouraged by Parliament's willingness to take a rational perspective towards something about which our attitude has been completely unscientific and irrational. I just hope that the same open-mindedness and willingness to be realistic will soon be extended to drug policy in general, because all the irrationality that has characterized marijuana policy in this country for decades still characterizes opioid policy, for example. The current epidemic of opioid overdoses could be addressed effectively, but only if we take science and experience into account and only if we actually look at the evidence.
Some years ago I was asked to speak to a Senate committee on an omnibus crime bill and I said to the honourable senators that as a physician I'm expected to practise evidence-based medicine, and that's a good thing. When it comes to drug laws, I wish Parliament would practise evidence-based politics, because the evidence internationally is that the current approaches to drug use normally do not work. They make the problem worse.
Thank you for your attention. I'm very encouraged to see this moving forward and I hope there will be more to follow.