Book review: Regulating cannabis: A detailed scenario for a nonprofit cannabis market
University of Helsinki, Finland
Cannabis is one of the most commonly used drugs globally, and during recent years legislation related to cannabis has been widely debated in several countries. New regulation models of cannabis are emerging worldwide as alternatives to prohibiting cannabis supply, raising numerous questions concerning cannabis policy reforms. Why do we need to consider regulation of cannabis markets? Why have several countries changed their cannabis policies? What would be the best option to regulate cannabis from the perspective of public health? In his book, Regulating cannabis: A detailed scenario for a nonprofit cannabis market, criminologist and anthropologist Tom Decorte (Ghent University, Belgium) discusses this current topic by examining the different regulative options for cannabis markets. He also presents a framework for regulating cannabis via a strict, non-profit corporate model.
The book begins with a short presentation of Belgian drug policy and the recent trends and debates on cannabis in Belgium. These serve as background context to the author’s scenario for a non-profit cannabis market. Together with his colleagues, Decorte evaluated critically the Belgian cannabis policy in an academic vision statement that was published in 2013 (Decorte et al., 2013). The authors argued that the Belgian cannabis policy is based on honourable objectives, but that it does not succeed in realising its goals based on harm reduction, such as decreasing physical and psychosocial damages caused by cannabis abuse and misuse. In addition, the authors argued that the policy option for a regulated cannabis market should be taken seriously and studied in the future. In 2016, the same authors released a concrete and detailed scenario for a regulated cannabis market (Decorte et al., 2016) and this book by Decorte summarises their proposal. The principal aim of the book is to contribute to the current debates on cannabis policies in different countries. For this purpose, Decorte examines ways of designing and implementing approaches to legalisation of cannabis. To this end, he presents a concrete scenario for development of a non-profit-driven legal cannabis market.
The book is written concisely, and it consists of five well-structured chapters with short content descriptions at the beginning of each chapter. The first two chapters guide the discussion towards different regulation models of cannabis markets and present the principles of the author’s own scenario. This scenario for a non-profit regulation model of cannabis is presented in the third chapter. The fourth chapter focuses on the evaluation of the suggested scenario for a cannabis policy reform. In the final chapter, Decorte examines preconditions he believes to be necessary for fulfilling the suggested scenario and its implementation, such as supervisory bodies, a clear and proportionate sanction system, and price policy and taxation on cannabis products.
An alternative to stricter regulation and lessons from the past
In the second chapter, the principles of different kinds of cannabis policies in most countries, and terminology concerning regulation of the cannabis markets, are discussed. Decorte describes that most cannabis policies around the world are based on a combination of prevention, treatment and repression, while criminal law and enforcement efforts of the police and justice system are described as “the spearheads” of most cannabis policies. Decorte, who has published several articles on substance use and cannabis markets, criticises repressive cannabis policies, arguing that the prohibitive model has failed the major harm reduction and public health goals set for these policies during the past decades. He sees the current policy trend towards legal regulation of the cannabis market as a more promising model for protecting people’s health and safety.
The aspects of public health and harm reduction are both emphasised repeatedly in the book, and these form the main objectives and principles of the author’s scenario. Decorte argues that in the long term, cannabis policy has to lead to a decrease of the general prevalence of cannabis use and postponement of the first-time use of cannabis. According to him, a regulated market aims to control all aspects of the production of cannabis and the availability of cannabis products; pursue a price-conscious policy concerning cannabis products; control the sales outlets of cannabis and increase controls on the users and the locations where cannabis can be used (p. 19). The reform of cannabis policy and the development of a detailed blueprint for a regulated market are described as “an exceptionally delicate balancing exercise” (p. 24): it includes various aspects which should be taken into account, such as the international and juridical context, human rights protection and obligatory policies of discouragement, limitation and risk awareness of recreational cannabis use.
In the book, one of the essential points is the author’s way of presenting the various available legal and political models of regulating production, supply and use of cannabis as a spectrum. Decorte argues that prohibition and commercial promotion, which can be seen as the extremes of the spectrum, create non-regulated markets and are connected to high social and healthcare costs. Alternatively, he suggests a restrictive model with a far-reaching form of government control and strict regulation. In this book, he calls these other regulatory options for legal cannabis markets “in-between” models, which, in practice, could vary from home growing for personal use to non-profit organisations and government monopolies.
The second essential and repetitive aspect in the book is the way the author presents and uses regulatory models for other substances, such as alcohol and tobacco markets, but also the previous experiments concerning decriminalisation and regulation of cannabis as comparable examples for cannabis regulation. These other regulatory frameworks can offer inspiration and guidance for developing the regulation of cannabis markets. According to Decorte, “we can start from the beginning by setting up optimal regulatory frameworks, in which all aspects of the market will be controlled” (p. 33).
Compared to the examples of alcohol and tobacco markets, strictly regulated in-between models are seen as safer options: a commercial cannabis market with profit-driven companies (cf. alcohol and tobacco markets in many countries) has more disadvantages compared to in-between models, if the aim is to undercut the black market without promoting greater use.
The scenario of the non-profit model: Reforming the cannabis policy slowly and by stages
Before presenting the scenario, Decorte underlines the importance of a preparatory phase in the implementation process of a new regulatory framework. In practice, this would mean that the whole scenario is worked out in detail, an information campaign is launched and preparatory scientific research is implemented.
His proposal for a cannabis regulation concerns a decriminalisation de jure, which would mean that “apart from the penalization for cannabis possession, penalization for certain forms of cannabis production and distribution would be abolished and replaced by legally regulated channels” (p. 23). Chapter three concentrates on presenting this non-profit regulation model, which consists of three legally regulated channels for cannabis production and distribution: home growing for personal use, Cannabis Social Clubs 1 and the supply of medicinal cannabis to particular groups of patients. All three channels are discussed and presented in detail. In addition, the different functions of the cannabis market such as cultivation, the safety and quality of cannabis products, transporting, storage and distribution of cannabis are taken into account. Decorte emphasises that it is easier to have a strict model first and make it less strict later on, compared to the examples of the other regulation frameworks, such as alcohol markets.
The scenario is based on previous international scientific research, and the importance of knowledge based on scientific research and its application to policymaking is emphasised repetitively in the book. However, an academic reference style is not used in the book, which Decorte justifies by the readability of the book. This gives an impression that the target group of the book does not consist only of scientists working in the drug policy field but also authorities and policymakers. Despite of this point of view concerning the readability, it would be useful and essential, especially in some parts of the book, to have the direct references for instance as footnotes even though all the referenced literature is listed at the end of the book.
One concrete example in which referencing would help the reader is a case in the section on the supply of cannabis for medical purposes. It includes, for instance, ideas about how recreational and medicinal cannabis use should be strictly divided and “a broader, legally-regulated availability of cannabis for medicinal use for specific groups of patients is desirable” (p. 66). However, the section discusses the medical use of cannabis and the current evidence on the effectiveness of cannabis for medicinal purposes in a rather narrow way. As Decorte writes, scientific literature offers some evidence on the effectiveness of cannabis for medical purposes, but the section gives the impression that there would be a clear consensus on the issue in the field of drug research. Generally, the discussion of the effectiveness of cannabis in medical use has mostly been controversial. For instance, a report by EMCDDA (2018) finds that the evidence base is evolving rapidly, but is currently quite limited and fragmented, and there is a need for additional research and clinical studies (pp. 11, 14).
The second phase of the scenario, discussed in the fourth chapter, focuses on the evaluation of the implementation process. In practice that would mean that the new cannabis policy and its side effects would be evaluated by independent scientists with formulation of relevant and measurable indicators, which would take into account all aspects of cannabis markets and their functioning. After the evaluation, the model can and should be adjusted. In practice, that could mean for instance creating additional channels for cannabis production and distribution. Due to uncertainties regarding the consequences of the cannabis policy reform, the author emphasises implementing the legalisation process slowly and in stages.