Last week the political party Más País took a proposal to the Congress of Deputies to adapt the Spanish regulations on the cultivation, marketing and use of cannabis. From a public health perspective, this regulation should take into account the consequences that can generate the consumption of this substance, both in health and those derived from its illegal market. Cannabis use is not irrelevant. For example, in Spain, according to the EDADES 2019-20 survey, in the group between 15 and 64 years old the 14.6% of men and 6.3% of women reported having consumed in the last year, being the most consumed illegal drug. It is often a experimental or one-off consumption, but a part of consumers develop problems due to habitual consumption, prolonged in time and / or high amounts. Problems associated with consumption can be physical (ex: respiratory problems, traffic accidents), mental (ex: dependency, psychotic symptoms) or social and economic (eg: school dropout, insufficient labor production, legal problems). These effects are more likely if use begins in adolescence. The fact that access to the substance is frequently through an illegal market implies other added consequences, of equal or greater importance, such as the lack of quality control and product composition waves criminal actions to obtain it, which can be linked to the violence and corruption that illegal markets entail. The impact of negative consequences for health in general, as well as security problems, are not exempt from presenting a pattern of social inequality, being the most socioeconomically disadvantaged people those who suffer the most.
Therefore, you have to prevent or delay the age of initiation of use, try that occasional consumption does not become regular and offer treatment to those who do a problem use. The regulation would have to go further than stop prohibiting the sale, and we must take advantage of the learning obtained with the consumption of tobacco and alcohol, as well as the experiences of cannabis regulation carried out in other regions of the world, despite the fact that there is still not a very broad knowledge of its impacts and scientific research should be expanded.
We consider it appropriate to review and modify the current situation, but it must be done taking into account population health and equity. It is necessary that the regulation contemplates questions about: 1) the production, not facilitating a market based on profit maximization, as well as the type of products and their composition; 2) prices and access, restricting according to age (over 18 years), schedules, etc .; 3) the advertising ban, promotions and sponsorships; 4) ensure prevention, treatment, information systems to monitor the impact on health, and research, and 5) the control systems and resources that will be required for the good enforcement of regulations.
In the case of alcohol and tobacco, very intensive work has had to be done to advance the regulatory restrictions necessary to reduce the negative impact on health. In the case of cannabis, based on the current very restrictive regulation, it would be necessary to relax restraints in a more controlled way, foreseeing a regulation that can be modified according to the results in the collective health.
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We consider it necessary that, prior to the approval of a regulatory change on cannabis, a internationally recognized methodology, the Health Impact Assessment, which aims to evaluate how regulatory changes would affect health and, therefore, to be able to adjust the new regulation based on the results obtained. A change of this style will also require that communication to the population be accompanied, from the beginning, with health education campaigns designed by public health institutions.
And it would be good if scientific societies and public health organizations, both national and international, delve into this issue and provide solid arguments that can be taken into account in the current debate.
Reference-www.elperiodico.com