Could Australia legalise recreational cannabis use while avoiding the same profit-driven pitfalls that have occurred with tobacco and alcohol?
Could Australia legalise recreational cannabis use while avoiding the same profit-driven pitfalls that have occurred with tobacco and alcohol?
In this episode, Sarah is joined by Professor Simon Lenton from the National Drug Research Institute to explore how Australia may go about legalising the recreational use of cannabis, learning from the commercial models seen in North America.
Professor Simon Lenton has worked with the National Drug Research Institute since 1993 in both research and professional roles. He also works part-time as a clinical psychologist in private practice.
His research interests include bridging the gap between drug policy research and drug policy practice, illicit drug use and harm reduction, and the impact of legislative options for drugs.
He has published widely on drugs, health and the law and has given advice to a range of government and private organisations, both in Australia and internationally, on evidence-based drug policy and other drug issues.
Web: ndri.curtin.edu.au
Twitter: @NDRIau
Facebook: @NDRIau
LinkedIn: National Drug Research Institute (NDRI)
YouTube: NDRIau
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Intro 00:00
This is The Future Of, where experts share their vision of the future and how their work is helping shape it for the better.
Sarah Taillier 00:09
I'm Sarah Taillier. And I'll be behind the mic while the wonderful Jess is on maternity leave. Cannabis is classified as a Schedule 1 drug under the United Nations Single Convention Treaty, which means that signatories can allow medicinal use, but that cannabis is considered to be an addictive drug with a serious risk of abuse.
Sarah Taillier: 00:30
However, several countries and 19 states of the USA have legalised recreational use of cannabis. In this episode, I chat with Professor Simon Lenton from the National Drug Research Institute about the impact of commercial cannabis production within the US and what it means for the discussion around legalising recreational cannabis use in Australia. Hi Simon.
Simon Lenton: 01:54
Hi Sarah.
Sarah Taillier: 00:55
Simon, the legalisation of cannabis for recreational use in various US states has created strong commercial industries in many of those states. But given cannabis is still considered to be an addictive drug with a serious risk of abuse, what are the impacts of commercialisation the researchers, like yourself, are seeing?
Simon Lenton: 01:15
Yeah, look, this is a really interesting time to be looking at these questions worldwide now. What's happened in North America, particularly in the US, but also in Central America and Uruguay has really changed the game in terms of cannabis law. Now we're talking about what modes of legalisation are the ones we should be looking at. Whereas before those changes happened beginning in 2013, 2014, it was really just all theory and really off the agenda. So things have really changed.
Simon Lenton: 01:46
And what we've seen in the US in particular, has been profit-driven commercial models of cannabis legalisation, which look much like alcohol and tobacco. And kind of unsurprisingly, we're seeing the same kind of problems that we've seen with high levels of promotion, high levels of use, high levels of harm, and really profit-driven motivation with big international companies getting involved in seeing an opportunity to make profits. And really cannabis users and cannabis growers, small scale people kind of missing out. And we're starting to see the harms start to accrue, but it's probably going to take 10 years or so before the evidence has really piled up to decide on what have been the good things that have come out of that model, but also what are the downsides.
Sarah Taillier: 02:36
Given some of the evidence that's coming out already that you've just touched on, what options for cannabis legalisation do you think we should be considering in Australia?
Simon Lenton: 02:44
Well, yeah, I mean, I'll summarise some of the evidence in a minute, but essentially there's a huge range of options between strict criminalisation at one end, which we're all familiar with in Australia, and full-blown commercial profit-driven legalisation at the other. And we think that in the middle range, there's some options which are likely to be beneficial for cannabis users, reduce the harm at a community level, and allow us to kind of very carefully take steps rather than going to a model that looks much like alcohol or tobacco.
Simon Lenton: 03:15
So these are things like cannabis social clubs, where small numbers of users and growers kind of get together, have a registered club, grow for their members, harvest and consume themselves without any profit-driven marketing, commercialisation or sale. And there are other options such as what operates in Uruguay, which is a mix of cannabis social clubs, people growing for their own consumption and for the consumption of their friends, and people being able to buy through outlets, which in Uruguay are pharmacies, but the supply is controlled by the government. Quality testing is done and all that kind of thing.
Simon Lenton: 03:56
And then there are new models such as community trusts, which are being talked about in New Zealand where at a local community level, community groups get together and organise under government control the growing and sale of cannabis with the benefits going back to the community at a local level and the community decides how much is available, what the price is and that kind of thing. So we think there's a lot of other options other than the sort of alcohol and tobacco model, and we think we should be looking at those because the evidence is suggesting that we are seeing some adverse consequences out of commercialisation in North America.
Sarah Taillier: 04:33
And what is some of that evidence that you've seen so far?
Simon Lenton: 04:36
Well, what we have seen, which is really great is that there's been a 75% reduction in the number of cannabis users who are getting criminalised as a result of their use. Now that's a great outcome because we know that criminalising cannabis users doesn't result in a decrease in their use, but does have a huge impact in terms of travel, employment, family issues, and a whole range of social impacts. So stopping criminalising cannabis users is a great outcome.
Simon Lenton: 05:05
The other thing that we have seen from the North American experience has been that there hasn't been an increase among people using who we would be particularly concerned about. So no evidence yet of increased use among under 18s, no evidence yet of increased use among pregnant mums, for example, where there's issues in terms of impact on the foetus.
Simon Lenton: 05:25
So those have been some of the benefits, but some of the adverse consequences that are starting to emerge have been such things as we've seen prices falling sharply. So in Colorado, we saw prices fall by 50% in the first four years. And we know that in legal markets, price is a key driver of the amount of use and also the associated harm. So you'll be familiar with as alcohol prices go down, use goes up and harm goes up. And we're seeing the same thing in the cannabis industry in North America. So prices drop rapidly.
Simon Lenton: 05:59
The other thing that we've seen is that high-potency products, which have emerged in those markets, things like shards and waxes and vape cartridges. And some of the shards and waxes have THC content of 75%, 85% and higher compared to kind of 10 to 15% of kind of street grade, herbal cannabis heads, basically.
Simon Lenton: 06:22
So these high potency products are basically doubled in use from around about 10% when the schemes first came into being, to around 25% in the first one to two years of the schemes being in operation. So there's been a rapid increase in the use of those high potency products, which is of significant concern.
Simon Lenton: 06:42
We've also seen increases in some of the adverse consequences associated with driving under the influence of cannabis. And so we're starting to see increase in motor vehicle accidents and increase in accidents in other sort of traffic violations, people affected by cannabis. And it seems to be related, much like with alcohol, to how many outlets there are per square kilometre, right? So the more pubs you have in an area, the more likely there are to be drunk people driving in cars. And it looks to be the same with the cannabis laws in North America. The more retail outlets there are, the more motor vehicle accidents and offences related to cannabis consumption are being seen.
Simon Lenton: 07:26
So it's looking very much like we've seen with alcohol and that's the reason for us, we think to go down a different path.
Sarah Taillier: 07:34
What are some of the alternative paths that you would see working in Australia?
Simon Lenton: 07:38
Yeah, so there's been some really interesting stuff that's been done in some European cities around cannabis social clubs that I mentioned earlier. So these began in Spain and they were kind of a way of getting around a loophole in Spanish legislation. And they weren't really controlled by government and that became a problem. But in essence, the idea is that you get together a small group of people, maybe a hundred or less who are regular cannabis users. They have a registered association, which is registered with the government, but the individual members remain anonymous. They have a premise where they can grow cannabis and they can consume it. And if I'm a member of that club, I would have maybe three plants that are barcoded, that I give the club my permission for them to grow on my behalf. So those plants are grown and they're harvested. And at harvest time, I get the cannabis that's been harvested from those three plants. I can't sell to anybody else. There's no promotion.
Simon Lenton: 08:39
The club monitors what chemicals are put in, what fertiliser use and all that sort of stuff. So there's quality control. The club also would ask me about my use and provide advice on how to reduce harm if I'm smoking too much or smoking in dangerous situations and other things. So there's some kind of harm reduction information that's provided. And there's controls on where it can be used and how it can be used in order for the club to maintain its right to grow on behalf of its members. So it's kind of a nice middle ground option. Because what we know is that when you legalise cannabis, like we've done recently in the ACT in Canberra, although it's legal to consume and to grow your own use, it's not legal to supply.
Simon Lenton: 09:27
And what we know is that most people that smoke cannabis, even regular users, either can't be bothered growing for themselves, or they don't know how or it's just too patchy for them to grow for their own consumption. So you need to have some sort of mechanism of legal supply, otherwise, legalisation doesn't work.
Simon Lenton: 09:43
Now the commercial model we know provides legal supply, but it has all those problems associated with it, like commercial supply of alcohol. But if we're going to have a system for regular users to smoke cannabis, they need to have access to regular supply. And cannabis social clubs provides one method for regular users to get access. And that's one of the models.
Simon Lenton: 10:05
But having a mix is probably important. So just like in Uruguay, having laws that allow people to grow for their own consumption is probably going to be important. But given that not all people are going to be able to do that or want to do that, having something like cannabis social clubs helps, and maybe having a government regulated supply mechanism. In Uruguay it's pharmacies. That might not work in our country, but having shops where people could buy, if they're over 18 and so on, a product of non-potency and without any impurities and so on, might be part of the mix.
Simon Lenton: 10:40
So those kind of middle ground options have a lot of benefits. They don't produce increased rates of harm in the community, as far as we know, and you can kind of titrate how far you go with them, rather than going all the way to full commercial profit-driven systems, and then spending decades trying to kind of wheel them back like we've done with tobacco and with alcohol.
Sarah Taillier: 11:08
Simon, you've spoken about the impact that the industry in terms of commercialising has had on alcohol and tobacco. We know the case for how that played out for tobacco. Is there any similar examples with what you're seeing in the cannabis realm?
Simon Lenton: 11:25
Yeah, it's really interesting. We've seen the cannabis industry really adopting the playbook of the tobacco industry and the alcohol industry. And that's played out in a couple of ways. The first thing is that we saw very quickly that large international multinational companies, tobacco companies, alcohol companies, and soft drink companies bought in to the cannabis market, buying up companies very quickly, particularly in Canada, where they thought they had had a public health model within the early months of the scheme coming into place. Constellation Brands, which markets the Mexican beer that's name I've forgotten. Corona, which markets Corona bought, I think five to 8 billion worth of shares in companies in Canada, because they saw it was an opportunity to make money and they got in there quick.
Simon Lenton: 12:20
And what we've seen is that the industry knows that regular heavy users are where most of their sales are. So they've targeted those people just like they've done it with tobacco and with alcohol. And what we've seen in Colorado where we've now got sales data, is that 70-odd percent of the total cannabis market is due to the consumption of the top 22% of cannabis users. We've never had this data before, because it's never been available because it's been illegal. But the top fifth of cannabis users, the people who smoke the most are responsible for 71% of the cannabis that's sold and the profit for those companies.
Simon Lenton: 12:58
Those companies know that and guess what? They're targeting those consumers. And those are the people that are most likely to be experiencing problems. And we just think from public health point of view, we shouldn't be putting this drug, for all its benefits and all its adverse consequences, in the hands of people that are really about making profit. That's what they're about.
Sarah Taillier: 13:19
From a public health policy perspective, how could you get ahead of that?
Simon Lenton: 13:24
Well, it's about getting the settings right before you open up the scheme and making sure that you exclude those players from being involved in the market. And if you have a commercial market and you have it listed on the stock exchange, there's no controls. And that's what's happened in North America.
Simon Lenton: 13:39
But if you have these more modest schemes where you have checks on who can buy in, for example, then you're able to keep those players out and have a scheme that's much more public health oriented, which really is much more closer to cannabis consumers and cannabis growers rather than multinational companies that are wanting to maximise profit for shareholders.
Sarah Taillier: 13:58
You mentioned this earlier, Simon, about some of the risks around drug driving, essentially with areas that have moved in that direction.
Simon Lenton: 14:07
Yeah.
Sarah Taillier: 14:08
If cannabis was legalised in Australia, how would you see us approaching the risk of drug driving?
Simon Lenton: 14:14
Yeah, it's an important question because it's one of the major areas of potential harm. And although the evidence around the effect to which cannabis affects driving is kind of mixed, it probably doesn't affect driving as much as alcohol does, but it probably does affect driving. And the evidence is growing on that.
Simon Lenton: 14:30
What we don't have is a really good system for roadside drug testing. So in Australia, Australia's one of the only jurisdictions that does random drug testing in as comprehensive a way as we do, and it's for THC, for methamphetamine and for ecstasy in most jurisdictions. But the mechanism is a saliva swab, so an oral mouth swab. And the issue with THC is it doesn't transfer from the blood back into saliva very readily. So it's not like alcohol. So it's kind of not a perfect system.
Simon Lenton: 15:04
And in the US, you'll remember from movies and stuff like that, they kind of have what they call sobriety tests. Like touch your finger on your nose and stand on one leg or walk the line or whatever. And they've kind of integrated that approach with saliva testing, for example. So they get people to do a performance test first, and if they fail, they test them for blood alcohol, test breath alcohol, and then they'll test for other drugs like cannabis. So they look at impairment first and then look at what drugs are present or absent.
Simon Lenton: 15:36
Whereas we've gone the other way. We've gone with the sort of like the breath alcohol model and that's not so great for cannabis. So we need to sort that out. There needs to be some work that's done on that.
Simon Lenton: 15:47
But looking at the other side of it again, we know what kind of models are likely to produce the most amount of cannabis impaired driving, and that is commercial profit-driven models with lots of outlets like pubs. And if we don't go down that path, then the problems associated with cannabis driving are likely to be a lot less, but we also need to find a technology that works in terms of making sure that there aren't increased numbers of people driving their vehicles and endangering themselves and their passengers and others because they've got too much cannabis on board.
Sarah Taillier: 16:20
A lot of thought obviously required if these changes were to move through. Simon for about 30 years, you've been researching cannabis policy and law. When it comes to legislation, how does Australia's legislative framework around cannabis compare to the rest of the world, just broadly speaking?
Simon Lenton: 16:40
Yeah. So we were early in terms of introducing what's called prohibition with civil penalties. People sometimes talk about in terms of decriminalisation. So under those schemes, it remains illegal, but instead of getting a criminal record, you get a fine or an infringement notice. And if you pay that fine by a certain date, you don't have a criminal record recorded. Now we bought those schemes in for cannabis beginning in South Australia in 1987. And we've had them in place in South Australia, the ACT and the Northern Territory, basically since the late eighties and early nineties.
Simon Lenton: 17:14
We had a scheme like that for a short time in WA that I was involved in working with the government on, which was in place from 2004 to 2008. Cannabis use remained illegal, but if you were in possession of less than 30 grams and you had less than two non-hydro plants in your possession or in your property, then you got an infringement notice. If you paid that, then you didn't get a criminal record.
Simon Lenton: 17:39
And the criminal record is the thing that really produces the most adverse social impacts on people's lives. So that was in place to 2008. And since then, we've now got this new scheme for legal cannabis growing and consumption in the ACT since 2021. And yeah, that's where things are at in terms of cannabis law.
Simon Lenton: 18:05
We've also had legal medical cannabis schemes in place since I think 2016, and I might be wrong, but around about then. And those schemes have been kind of growing over time. But on the recreational front, we have civil penalties in some jurisdictions, strict criminal penalties in others and cautioning for first, second, third offences with a requirement for people to attend an education session in other jurisdictions.
Sarah Taillier: 18:35
When we're talking about recreational, so a lot of the focus regulated legal markets for adults' recreational use have been on fully commercialised, profit-driven models of cannabis regulation, which you've touched on a little earlier. What are the options for cannabis regulations that emphasise public health over profit? I think you may have mentioned a few already.
Simon Lenton: 18:57
Yeah. So it's really those middle ground options that we talked about, which recognises that people that use cannabis need access to cannabis in a legal market. Recognises that like any drug, there are health consequences from using cannabis like alcohol, like tobacco, like pharmaceuticals, like coffee. You drink too much of it, you have problems. All substances are like that. They have benefits, but they also have adverse consequences. We need to manage them for public health benefit.
Simon Lenton: 19:26
And the evidence, our experience with now many decades of tobacco and alcohol, is that putting the supply of these substances in the hands of companies that are doing what they do, which is trying to make profit, really isn't the best thing from a public health perspective. So we don't want to go down that model for cannabis. We want to keep it in the hands of people who are very close to the ground, who use it and who can consume it under regulation from government without a motive for maximising profit outcomes.
Sarah Taillier: 19:59
With all that in mind, Simon, if you're looking at something between your hope and the reality of what will play out, what do you think is the future for cannabis and marijuana use in Australia?
Simon Lenton: 20:14
Well, I think there's no doubt that the legalisation of cannabis in many other countries is going to result in changes here. And we've already started to see that. So I think we're heading towards a legalised model. I think that there's now good discussion starting in the public realm about some of these other options, some of these middle ground options, rather than just thinking about that commercial model. And lawmakers, the public and so on, starting to get interested in some of these. And I think a great outcome would be to have some of these in place in some jurisdictions and to be evaluating whether they meet the needs of people that smoke cannabis and minimise the adverse effects at a community level.
Simon Lenton: 21:00
I think that's the foreseeable future. And I'd much rather we go down that path than trying to think about maximising tax profits, which is the seductive element of the commercial model.
Simon Lenton: 21:13
And what's happened in the US, is that as it's kind of worked through, those tax benefits have been a lot less than what people anticipated. So a recent study estimated they're probably about 50 US dollars per head of population. So only about 1% of state revenue has come through from the legalisation of cannabis. Now that's still many millions of dollars, but it's not a bigger tax take as people thought. And there are a whole lot of these adverse consequences, which have impacts on individuals, the health service and families and so on. So we think the middle ground option, rather than the seduction of commercial models, is the way to go.
Sarah Taillier: 21:51
And Simon, you have a background in clinical psychology.
Simon Lenton: 21:55
Yeah.
Sarah Taillier: 21:56
What actually brought you to researching this area of policy?
Simon Lenton: 22:00
Yeah. So look, I began working as a clinician, working with people with drug problems, sitting in a room, talking to them about their problems and particularly around in starting around injecting drug use and in the early days of the HIV crisis and hepatitis C issues and so on. And what became very clear was no matter what individuals did to change their behaviour and what I could do to help them, was there were things that were wrong with the system. There were problems at a macro level and really it wasn't about the individual responses so much. It was about starting to identify what are the things that needed to change.
Simon Lenton: 22:33
So in the early days, it was increasing access to clean needles and syringes, and doing advocacy work in community pharmacy to get pharmacists selling needles and syringes to people who inject drugs. Now that's now just accepted commonplace. But the reality is that individuals' choices are very much affected by the context in which we live. And so I got interested in that. And when a job came up in 1993 to do research that looked at some of these macro influences on drug policy, I took the risk and jumped. And I still see people in private practise as a clinical psychologist, but most of the impacts I've had, have been around trying to get these macro settings better than they currently are.
Sarah Taillier: 23:16
Well, we're glad you took the leap. We've inherited a lot of really valuable research. I just wanted to ask finally, Simon, what would be the cannabis related policy you would immediately change in Australia if you could?
Simon Lenton: 23:30
I would stop criminalising people for the consumption of cannabis, would be the first thing I would stop. That would be the first thing. And the second thing would be to be exploring options for non-commercial access to cannabis and for us to monitor that.
Sarah Taillier: 23:50
Why is that so important to you?
Simon Lenton: 23:51
Because I think that we know that criminalising people doesn't reduce cannabis related harm in the community, but it has huge impacts on people's lives that can affect them for right through their life in terms of their career options and so on. If criminalising people worked, I'd be in favour of it. The evidence is that it doesn't. And we need to take that on board and start to think, put out our cleverness and our enthusiasm to find better ways of managing drug use in our society.
Sarah Taillier: 24:22
Thank you so much, Simon.
Simon Lenton: 24:23
You're welcome.
Sarah Taillier: 24:24
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