A NUMBER OF years ago a mother called my clinic and asked me if I would see her son who had been arrested for the possession of cannabis for his personal use. I arranged an appointment.

Listening to the young man’s story it became apparent that he was not dependent on cannabis; he reported no negative health impacts of using the drug; he was working and he was getting on with his life.

His solicitor advised him to engage in a treatment programme for his ‘addiction’ as the court would view him more favourably when the time arrived for the case to be heard. The hearing came and went. He was handed probation and required to continue his ‘rehabilitation’ providing regular urine tests to show he was no longer using cannabis.

Here was a young man who didn’t have an addiction or a problem with cannabis and he was put through a court hearing (with the risk of adverse media coverage); he was required to see an addiction specialist; he had to secure the services of a solicitor and a barrister; he was later required to see a probation officer and he was required to provide regular urine tests.

It had me thinking. What was the cost of this conviction? The financial cost was considerable, but there were other costs.

Help not harm

The judicial process and subsequent criminal conviction were stigmatising and affected this young man’s future opportunities – in terms of employment and travelling abroad. And for what? To teach him a lesson not to use cannabis again.

Even if that end was achieved (and it rarely is) that is some price to pay for using a drug that you didn’t even have a significant problem with in the first place. If this young man did have a problem, he should have been able to access treatment without the fear of the law, and therein lies another problem.

Criminalising people who use drugs makes them less likely to seek help when they need it. You only have to look to Portugal to see how decriminalisation and a health led approach to drug use has immeasurably improved the social landscape in that country and made seeking treatment for drug problems little different from seeking treatment for any other health issue.

Ireland has made great strides over the past ten years in putting drug policy firmly on the social agenda. Legislation was signed into law by President Michael D. Higgins on 16 May 2017 to open Ireland’s first medically supervised injecting centre, to allow vulnerable people who inject drugs to do so in a safe medical environment thus reducing overdose risk, viral hepatitis and HIV transmission, stigma and the number of needles and syringes discarded on our streets and alleyways.

There is agreement virtually across the political spectrum that drug use is a health, rather than a criminal justice, issue. Also, medical cannabis has been accepted (at least at Government level) as an acceptable form of treatment for sufferers of a range of chronic conditions.

Sadly, none of these great initiatives have actually come to fruition at all, or in the case of medical cannabis to any significant degree, and that might tell you something about the resistance to such change. However, we need to make people safer, no question.

There are many who believe that, in order to make people safer, cannabis should be regulated and controlled in much the same way alcohol and tobacco are regulated; taxed appropriately and taken out of the hands of dangerous drug cartels. It would also create an industry that would provide jobs for people. The current version of those jobs unfortunately attracts children, many who are not even teenagers yet, into a murky, damaging world of drug running and criminality. A deplorable state of affairs.

Regulating cannabis properly would protect the young who are the group most vulnerable to its harms. It would also allow the drug to be researched with more accuracy; discover more about its positive and negative effects. It is very difficult to accurately study an illicit drug when you don’t know exactly what its constituents are. Contrast this, with the quality of the research into alcohol and tobacco, research that has informed society about the well-established harms of those drugs.

Learning from abroad

Only a couple of weeks ago Malta became the first EU country to regulate and control cannabis even though a number of countries have long since decriminalised it. Germany and Luxembourg are expected to follow suit in the New Year.

The US and Canada has trailblazed cannabis legalisation for many years now. As it currently stands in the US, the medical use of cannabis is legal with a doctor’s recommendation in 36 states and the recreational use is legal in 18 states. The evidence is inconclusive one way or the other regarding the impact of legalisation in the US.

For every study showing benefits there will always be another demonstrating harm. The problem is that each side of this debate will pick the evidence that suits their position. We need to stop doing this and be honest about the evidence. We need to be honest about the harms of cannabis and about its benefits because these polarising views are confusing the public, particularly those people who are not well informed or particularly interested in the debate.

Do I believe that if we made cannabis legal tomorrow that nobody would misuse the drug and nobody would come to harm? Of course not. We know from the legality of alcohol that the drug causes significant harm in our society and that regulation of it is less than ideal. We can be thankful, however, that we don’t have a war on alcohol like the War on Drugs as the harms of such a paradigm for alcohol would be incalculable.

Listen, decide and implement

I appeal to our Government to listen to its citizens, particularly our youth who are far better informed than their predecessors about drug use and other social issues. We have shown during this Covid-19 pandemic that we are a resilient nation and that positive change can happen.

Many of the legislative barriers have been removed to make treatment delivery for people with addiction problems more accessible such as e-prescribing, virtual ‘telehealth’ consultations and a removal of the need to incessantly urine test patients for illicit drugs.

We have taken huge steps but 2022 needs to see the full implementation of drug policies which are already agreed; and brave political leadership on others. Our first supervised injecting centre needs to actually open; we need to actually adopt a health led approach to drugs; we need to actually provide ready and affordable access to medical cannabis; and we need the promised Citizens Assembly on drugs in Ireland – which will set the tone and course of drug policy in Ireland for the decades to come.

Finally, let me be unequivocal on this, I believe our current laws relating to cannabis are causing more harm than good. We need to look towards our friends in other EU and international jurisdictions – like Malta, Germany, Luxembourg, US, Canada, etc. – and begin the process of regulating and controlling cannabis in Ireland.

Dr Garrett McGovern is a medical director and GP specialising in addiction medicine at the Priority Medical Clinic in Dundrum. He has also worked in the HSE Addiction Services in South Dublin and the inner city for 23 years.