In her recent editorial, Dr. Diane Kelsall proposes a simplistic standard for evaluating cannabis legalization: if cannabis use rises, then legalization fails. That does a disservice to medicine and to Canadians, because such a standard is unachievable, narrow-minded and counterproductive.
It is unachievable because cannabis use will rise with any liberalization. Decreasing the cannabis “price” (i.e., its legal penalties) will result in increased use; that is basic economics. The extent of business involvement and product advertising might affect the size of that increase size, but not its occurrence.
It is narrow-minded because it implies limiting cannabis use is society’s only objective. But legalization affects the well-being of Canadians in many ways. For example, reducing incarceration rates and criminal revenues are also valuable societal goals. A good public policy does not pursue perfection along a single dimension. Rather, it achieves the best compromise among many competing goals.
It is counterproductive because what is important to reduce is not cannabis use, but rather its harms. Legalization allows more openness around cannabis, possibly encouraging problematic users to seek treatment. It lets users buy regulated products, rather than products possibly contaminated by mould, pesticide or fentanyl. It is therefore possible that even increased use could be accompanied by decreased overall harm.
Personally, we neither use cannabis nor promote its use. But professionally, we encourage governments to implement realistic policies offering the “least bad” way of dealing with cannabis. We encourage Dr. Kelsall to do the same, rather than foredooming legalization to failure.
Footnotes
Competing interests: None declared.