Hashing it Out: Can We Learn About Cannabis From What We Know About Alcohol?

On October 25^th, BCAHL hosted a webinar on the parallels between alcohol and cannabis.

Over the last four years, the policy environment for alcohol and cannabis has undergone some massive changes.

Since 2013, when the BC government released its Liquor Policy Review, we have seen a relaxation of regulations on alcohol – which has really changed the ways and places it can be sold.  We can now buy it at grocery stores, hair salons, Farmer’s Markets in addition to getting sale prices on ‘cold ones’ in the Liquor Store. The result is increased availability and access and…changed consumption patterns.

Today, we are in the process of a complete 180° turn in our approach to marijuana.  While many harm reduction advocates say decriminalization is long overdue, others are concerned about managing the legalization process to mitigate potential health harms.

Our first speaker, Dr. Tim Stockwell spoke about alcohol policy in BC and the impact it has had on public health as well as some of the lessons we can take from alcohol as we move forward with cannabis legalization.

• One of his key messages is that alcohol is still far worse than cannabis whether you’re looking at heath harms from accidents to hospitalizations. In fact, he said: mortality attributed to cannabis in Canada is about 200-400 per year, whereas from alcohol it ranges from 4000-8000.
• He made the case that, sales in government controlled outlets result in fewer sales to minors, reduced intoxication and more opportunities to apply minimum pricing and other measures to promote a culture of moderation.
• He also showed how applying a minimum price per unit can help moderate intake for heavy chronic users and recommends prices be set for a standard drink of alcohol as well as a standard ‘dose’ of THC.
• Dr Stockwell ended with an interesting thought, suggesting that the regulation of cannabis may in fact help strengthen health regulations for a much more dangerous substance – which is alcohol.

Our second speaker, Dr. Tista Ghosh shared some of the knowledge she gained in developing a public health framework when Colarado became one of the first states in the USA to legalize recreational marijuana.

• One of Dr. Ghosh’s key pieces of advice is to start data collection before legalization so that public health professionals can understand and track attitudes, behavior and use, and health harms including poisonings and hospitalization rates.
• In Colorado, they did not foresee the amount of edible product that ended up coming on the market and this proved to be a challenge in regulating dose (for example one dose can’t be part of a cookie. It should be what a person would think of as a unit – like one whole cookie). Food safety expertise, monitoring and child-proof packaging turned out to be big pieces of regulation.
• Dr Ghosh spoke about how they were able to use information on use and attitudes to develop health messages for the public and that has been funded from the tax revenues. Public health messages were developed to address such issues as cannabis use and prenatal health and breastfeeding; safe storage to avoid child poisoning and youth prevention.
• Colorado is also investing some of the tax revenues in health research in areas such as driving under the influence.