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Great ganja debate
Story Created: Sep 22, 2013 at 1:38 AM ECT

Story Updated: Sep 22, 2013 at 1:38 AM ECT

Legislation to decriminalise marijuana will be another Section 34.

This is the view of Psychiatric Registrar and Secretary of the Psychiatrists Association of Trinidad and Tobago, Dr Varma Deyalsingh. “The same way that Section 34 was intended to reduce court cases, so because of inefficiencies in the system, the Chief Justice wants to clear the backlog,” he told the Sunday Express, adding, “When you unleash this, you might be unleashing a Pandora’s box.”

In his address for the Law Term opening last week, Chief Justice Ivor Archie called for the decriminalisation of marijuana. “Addiction is a disease and is as much a public health issue as it is a criminal problem,” he said. “This is not a moral judgment although one might observe that marijuana consumption probably wreaks no more havoc than alcohol addiction, but we provide support for one and punishment for the other. The economic and social consequences of incarcerating large numbers of our youths for possession and/or consumption of small amounts of drugs are immense.”

At present, 36 per cent of all inmates in T&T are in jail for narcotics offences.

Deyalsingh, however, sees few benefits to decriminalisation. While he admits that the policy has worked in other countries, such as the Netherlands and Denmark, he says, “In Trinidad and Tobago we have a different situation. We have people here who don’t know how to handle limitations. Look at the speeding on the roads, obesity, the promiscuity. Ours is a culture of excess.”

But Professor Gerard Hutchinson, head of UWI’s Psychiatric Unit in the Department of Clinical Medicine Sciences, thinks decriminalisation would help addicts.

“I am for decriminalising and accurately distinguishing use from trafficking, so that the former can be treated if needed,” he said to the Sunday Express. “It is already almost decriminalised because it is quite commonly used and is probably less dangerous than alcohol, so people should not be punished for it and heavy users should be assessed and referred for some kind of intervention.”

Criminologist Professor Ramesh Deosaran says that the effectiveness of decriminalisation depends on how it is done. “Whether decriminalisation is good or bad depends largely on the extent to which use or trafficking of the substance will be decriminalised,” he noted, “and how restrictive or liberal will the regulations be. In other words, if decriminalised, to what extent will it be regulated? And then what the cut-off points for use and trafficking will be? This is where policing will still face challenges.”

Deyalsingh is also concerned about the effectiveness of the police if marijuana is decriminalised. “They can’t even police alcohol,” he noted. “Marijuana causes delayed reaction time and impaired judgement. If a driver is arrested while high, the police have to administer a blood test. There aren’t even any test kits at the St Ann’s Mental Hospital!” (Box summarises recent research on some of the effects and uses of marijuana.)

Hutchinson voiced similar concerns. “It is not clear how effective decriminalisation would be—the critical point would be effective control and monitoring mechanisms and a clear pathway for those who are in need of treatment and rehabilitation,” he said.

American psychologist Gene M Heyman, in his book Addiction: A Disorder of Choice, summarises the contradiction between treating drug addicts and punishing them: “Addiction is the only psychiatric syndrome whose symptoms—illicit drug use—are considered an illegal activity...If treating addiction is the right approach, then punishing addicts for drug use has to be at least somewhat ineffective, if not counter-productive. Conversely, if punishing drug use is the right approach, then treatment programmes that do not offer or facilitate differential consequences for abstinence are likely to be less effective than they could be. Put more generally, it seems unlikely that approaches as different as punishment and treatment effectively complement one another.”

A key issue is whether removing punishment would cause more people to become addicted to marijuana. The seminal paper on this issue was written, not by psychiatrists, but by economists Gary Becker and Kevin M Murphy in 1988. (Becker copped the Nobel Prize four years later.) Titled “A Theory of Rational Addiction”, Becker and Murphy argued that people who consume addictive products —cigarettes, alcohol, slot machines —calculate that the pleasure of the habit will outweigh the pain. They also demonstrated this effect through statistical analysis, showing that cigarette consumption, for example, drops when a price increase is expected but before the price actually rises.

The logical inference is that punitive measures should discourage addiction by making narcotic usage too costly. But, an article in the January issue of the Wall Street Journal, Becker and Murphy argue that “Full decriminalisation on both sides of the drug market would lower drug prices, reduce the role of criminals in producing and selling drugs...The lower drug prices that would result from full decriminalisation may well encourage greater consumption of drugs, but it would also lead to lower addiction rates and perhaps even to fewer drug addicts, since heavy drug users would find it easier to quit.”

The American political scientist Horace A Bartilow, who has studied the drug trade in Latin America and the Caribbean, in a paper titled “Does drug enforcement reduce crime?”, has a different perspective, arguing that while marijuana may have price elasticity (meaning that fewer persons will buy it if it gets more expensive or if punishment is more drastic), this does not apply to more addictive drugs like cocaine.

In fact, countries which have changed their weed laws have found little or no increase in users. In the United Kingdom, although selling weed is still illegal, hardly anyone is jailed for possession of marijuana. In the past eight years, the percentage of persons who have used marijuana, according to Arthur Snell, the British High Commissioner to T&T, has dropped from almost 11 per cent to under seven per cent. “The UK experience appears to be that reducing the penalties has also led to reducing the abuse,” he writes on his blog.

Similarly, since Portugal decriminalised narcotics, according to Becker and Murphy in their WSJ essay, “imprisonment on drug-related charges has gone down; drug use among young persons appears to have increased only modestly, if at all; visits to clinics that help with drug addictions and diseases from drug use have increased; and opiate-related deaths have fallen”.

But Deyalsingh believes that, in Trinidad, addiction would increase if the law is changed and that adolescents who at present express rebellion by smoking weed would move on to harder drugs if marijuana was decriminalised. He also thinks the Government is in favour of legalising weed. “Any government would love to have a nation of happy zombies. If people are happy, they not going to question corruption and so on,” he said.

Heyman, however, notes that “Most people who use addictive drugs do not become addicted to them...On average about five percent of those who used an illicit drug became a drug addict, whereas about 15 per cent of those who ever had a drink went on to become an alcoholic.” No data on marijuana users in T&T are available, but surveys of secondary school students suggest that between eight per cent to 17 per cent have tried weed.

Some commenters have also raised was the issue of marijuana being a “gateway” drug—ie, a milder narcotic whose use leads to cocaine or heroin addiction. But there is not enough data available to prove this claim, which is based on an error in statistical reasoning: people assume that, because most cocaine users have also taken marijuana, then the latter leads to the former in search of a more potent high. However, the logical error here is easily demonstrated: nearly all marijuana smokers are also cigarette smokers, but the obverse is not true—the majority of cigarette smokers do not smoke marijuana.

Deosaran says, “I suggest that any intended policy must be driven by reliable empirical evidence from this country. The question as to whether it is a gateway drug or not may well be answered this way.” In a response to Archie’s call for decriminalisation, Prime Minister Kamla Persad-Bissessar said that research was needed before any action was taken. Some of this research has already been done by Deosaran himself.

“In a 2003 study by graduate student Ian Ramdhanie and myself on our prison population revealed that the highest proportion of prisoners —35 per cent—and recidivists came from drug-related offences, including a high proportion of marijuana users and traffickers,” he said. “This 260-page report, submitted to the Government then, recommended that such drug offenders be subjected to a rehabilitation programme since we felt that drug abuse was partly a public health issue as well. We also recommended that such drug-use prisoners be treated after their release.”

Bartilow in his study concluded on the basis of statistical analysis that “US sponsored drug control enforcement toward Latin America has facilitated an increase in violent crime.” He also noted that “Relative to cocaine or heroin, marijuana is far less psychopharmological addictive and largely inhibits violent behaviour among users and generates significantly lower profits for traffickers [thus] drug control enforcement of marijuana will have little or no effect on violent and property crimes.”

But Deyalsingh wants a different kind of research from the government before marijuana is decriminalised. “I don’t think they have proven that we are responsible, nor that the social services are adequate,” he said.

Marijuana–effects and uses

A number of epidemiological research projects have shown links between dose-related cannabis use and an increased risk of development of an enduring psychotic illness. However, it is also known that not everyone who uses cannabis is affected adversely in the same way. What makes someone more susceptible to its negative effects is not yet known, however there are some emerging vulnerability factors, ranging from certain genes to personality characteristics.

Cannabidiol [one of the three compounds which make up marijuana] has also been proposed to have antipsychotic effects and is considered a potential antipsychotic medicine, particularly due its relatively low side-effect profile. Furthermore, it is also being developed as a possible ‘medicine’ for various other conditions, such as inflammation, diabetes, cancer and neurodegenerative diseases [and] also exerts potentially useful actions in the treatment of epilepsy and obesity...may have potential for the management of disorders such as chronic liver disease and obesity, particularly when these are associated with inflammation.

In relation to people with psychosis, health risks are even higher with stronger variants of the plant. In a recent study of people with a first episode of psychosis, it was found that patients used higher-potency cannabis for longer durations and greater frequency compared with a healthy control group.

However, only a small minority develop a full-blown psychotic illness in the form of schizophrenia or bipolar disorder, whilst a larger group, ranging from 15 per cent to 50 per cent, experience transient psychotic symptoms of brief duration, from a couple of hours to up to a week, and usually recover without requiring any intervention. Indeed, it has been shown that people scoring high in schizotypy who use cannabis are more likely to have psychosis-like experiences at the time of use, together with unpleasant side effects.

Extracts from: Cannabis, a complex plant: different compounds and different effects on individuals

Zerrin Atakan

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736954/