Take the blindingly obvious and write a report about it!
Thirteen years ago, Uruguay became the first country on the planet to officially legalise cannabis for recreational (adult-use) purposes. In December 2013, state-controlled cannabis retail sales, home cultivation, and social clubs were fully legalised by President José Mujica.
Unlike the growing number of countries across the world that have legalised one or more of these elements in the years since, this was not the result of a zeitgeist shifting towards more liberal drug policies. It was a reluctant security measure, emerging from a region that, in Mujica’s own words, was ‘losing the battle against drugs and criminality’.
At the time, the move was criticised both internationally and domestically. Raymond Yans, then president of the International Narcotics Control Board (INCB), accused Montevideo of ‘pirate attitudes’ and said the government had ‘knowingly decided to break universally agreed and internationally endorsed legal provisions’ of the 1961 Single Convention on Narcotic Drugs.
More than a decade later, data from Uruguay and the growing number of countries that have since reformed their cannabis laws allow us to examine the impact of cannabis liberalisation on public health, and whether the critics have been proven correct.
A landmark review of global cannabis policy
Last week, a new landmark ‘narrative review’ published in The Lancet Psychiatry (vol 13: 615–26) synthesised 25 years of existing research from the Americas, Europe, Africa, Oceania, and Asia, drawing on natural experiments created by policy changes to assess what actually happened in each case.
The study, led by Professor Tom Freeman and Dr Rachel Lees Thorne at the University of Bath, who collaborated with 11 research institutions, sought to measure three outcomes: changes in cannabis use prevalence, rates of cannabis use disorder, and hospital admissions for psychiatric conditions.
It provides the most comprehensive international assessment ever conducted on what tends to accompany different types of cannabis reform, illuminating consistent patterns, but never claiming to establish causation.
Ultimately, it found that public health outcomes are less associated with whether cannabis is legal, and far more with how the market is structured and regulated.
