Public Health Implications of Cannabis Legalization: A National Perspective Ontario Public Health Unit Collaboration on Cannabis Rebecca Jesseman, Canadian Centre on Substance Abuse February 10, 2017

About CCSA Vision: A healthier Canadian society where evidence transforms approaches to substance use Mission: To address issues of substance use in Canada by providing national leadership and harnessing the power of evidence to generate coordinated action National non-profit organization Pan-Canadian and international role www.ccsa.ca • www.cclt.ca

Current Context The Controlled Drugs and Substance Act prohibits cannabis production, distribution and possession The Access to Cannabis for Medical Purposes Regulations regulate the production, distribution and possession of cannabis for authorized medical purposes Cannabis production, distribution and possession is prohibited at the international level by the Single Convention on Narcotic Drugs A very complex issue with many layers of legislation in place. In order to help the Federal government wrap www.ccsa.ca • www.cclt.ca

Current Context (cont’d) Task Force on Cannabis Legalization and Regulation: Tabled recommendations in December 2016 These recommendations will inform legislation, but are non-binding The Government of Canada intends to introduce legislation for the legalization of cannabis in spring 2017 Provincial and territorial regulations to implement a legal distribution system will follow The details will be hashed out with the provinces territories and municipalities. www.ccsa.ca • www.cclt.ca

Reducing Public Health Impact Increase: Age of initiation Decrease: Rates of use overall High-risk use in particular Frequency of use Quantity and potency of product consumed www.ccsa.ca • www.cclt.ca

Foundations of Public Health Social Determinants of Health Social Justice Health Equity Substance misuse crosses involves complex factors which must be taken into account. Health Equity – all citizens should have equal access to supports! Those with a legitimate medical need – need to be able to access cannabis Social Justice – should not impact certain populations i.e. if not allowed in public spaces (students, etc will be targeted) Based on the Canadian Public Health Association Working Paper, Public Health: A Conceptual Framework, (November 2016). www.ccsa.ca • www.cclt.ca

Contentious Issues Health interest vs. market demand Age of access Limits on THC potency Product formats Marketing and promotion Plain packaging Advertising Objective – give out of hands of youth and keep profit out of hands of organized crime. But illegal market will continue to fill gaps in demand. Why they choose the age of 18. Potency – not a lot of sound evidence for potency gaps. Products – must balance risk with demand. Advertising – they are lobbying hard to brand and promote their products but from PH perspective we know that advertising increased use. Clear message – limit market and promotion to limit rates of use Marketing – privatized vs/ government control (remember government also profit driven!!!) Home cultivation – very tricky, issue with consistency with use for therapeutic purposes (who can grow). Does not need to be an all or nothing approach – i.e. non-profit cooperatives, www.ccsa.ca • www.cclt.ca

Contentious Issues Distribution and access models Government monopoly vs. commercial Home cultivation Non-profit alternatives www.ccsa.ca • www.cclt.ca

Jurisdictional Roles Federal Legal status Provincial/territorial Distribution models Municipal Local options (e.g., by-laws) CCSA – promotes evidence not advocacy Advise in that direction – who do we need to talk to about what There is a lot to be determines. Need a coordinated and consistent approach across durisdications – consistenct messaging!!! Means greater impact. Federal – legal status, quality control and safety standards, licencing and distribution – i.e. Tobacco Act. Funding and Investment. Surveliience etc. Provinces – where regulations will be implemented in details/ matching minimum age to legal age. Additional restrictions on advertising and promotion, prevention education and treatment ENSURE INVESTMENT IN THIS. Municipalities – by-laws, inspections, enforcement. Outlet locations and density. Authority over communal use spaces – public, festivals etc. Home cultivation – will fall at municipal level if permit based. www.ccsa.ca • www.cclt.ca

Next Steps Operationalize What does a public health approach to regulation look like? Education and awareness Policymakers The public At-risk groups (e.g., youth) Monitor Contribute to research, data collection and surveillance activities What does a public health approach mean – bring it to life with concrete examples. Marketing and advertising restrictions, education and awareness, use among use, use while driving, 20% of population consume 80% of product – focus on this group. Safety sensitive positions and the workplace. Research is important. Is there support for all of the admin and liscencing stuff!!!! – data collections Monitoring. Incorporate questions about marijuana use into standard baseline data collections. ER visits, medical visits, HBHC…. Canadian Public Health Association and Quebec Public Health – Rebecca will share an upcoming webinar re: Quebec publication www.ccsa.ca • www.cclt.ca

Contact Information Rebecca Jesseman Senior Policy Advisor and Director, Information Systems and Performance Measurement Canadian Centre on Substance Abuse 75 Albert Street, Suite 500 Ottawa, ON K1P 5E7 Canada 613-235-4048 ext. 228 info@ccsa.ca @CCSAcanada • @CCLTcanada INSPCQ – have recently published a nice report local at non-profit distribution models. www.ccsa.ca • www.cclt.ca