1. Ambassador Paul Simons Executive Secretary Inter-American Drug Abuse Control Commission (CICAD) SAM Conference Atlanta, GA 9 April 2015 Hemispheric Trends in Cannabis Use and Policy Reponses

2. Inter-American Drug Abuse Control Commission 28 Years of Accomplishment : Policy Development Multilateral Evaluation Institution Building Capacity Building Strengthening research and evidence

3. Hemispheric Drug Strategy and Plan of Action 2011-2015 – Human rights – Vulnerable groups – Gender – Public affairs efforts – Drug dependency as a chronic, relapsing disease – Evidence-based policies – Inclusive, multi-stakeholder approach – Member state progress – Sixth Round of Multilateral Evaluation Mechanism

4. Our People: Key to CICAD’s Success Executive Secretariat: - 40 top-notch professionals drawn from across the drug control spectrum: statisticians, public health professionals, lawyers, social workers, pharmacists, prosecutors, political scientists and economists. -Multinational, multilingual staff drawn from 13 countries, united in passion and commitment to public service.

5. Cannabis Use in the Americas Cannabis is the most commonly used illicit drug in Latin America and the Caribbean Nevertheless, there is a great deal of diversity across countries regarding the prevalence and patterns of use Diversity across countries, across populations, and even across geographic regions within countries.

6. Diverse patterns across Latin America and the Caribbean General Population LowestHighest % who used marijuana in the past year. 0.13%8.45% % who used marijuana anytime in their lifetime 1.2%20.0% Ratio of use between males and females 1.7 to 181 to 1 * The amount of information available varies by country

7. Marijuana -- Past Year Prevalence – General Population World Average, 5.2%

8. Marijuana – Past year prevalence --Secondary School Several countries with past year prevalence above 15%

9. Past Year Marijuana Prevalence - 8th grade

10. USA: Past year Marijuana prevalence by Grade Source: Monitoring the Future, National Survey Results on Drug Use 1975- 2013 10th 12th 8th

11. Chile: Lifetime, Past Year and Past Month Marijuana prevalence among school aged children Source: Chilean Drug Observatory, SENDA, 2014, grades 8 to 12

12. Uruguay: Annual prevalence of marijuana use among secondary school students compared with perception of risk of occasional use Source: Uruguayan Drug Observatory, 2011 Annual prevalence of marijuana use among school aged children in Uruguay in 2011, 12%

13. Source: University of Michigan, Monitoring the Future Study, 2013 U.S. : Past year prevalence vs. Risk Perception 10th graders Prior year prevalence Risk of Frequent Use Risk of trying

14. Chile: Past year Prevalence vs. Risk Perception, school age children, 2003-2013 Risk of Experimental Use Risk of frequent use Past Year Prevalence

15. Caribbean: Perception of great risk of smoking marijuana occasionally (% students)

16. Caribbean: Perception of great risk of smoking marijuana frequently (% students)

17. Costa Rica: Past year prevalence vs. perception of great risk of occasional consumption, secondary school students

18. Argentina: Past year prevalence vs. perception of great risk of occasional consumption, secondary school students

19. Past year use tracked against perception of ease of access, various countries, secondary school students Past yearprevalence ofmarijuanause (%) Perception of ease of access to marijuana (%)

20. Cannabis Debate in the Hemisphere Legalization moves in Uruguay and U.S. States have expanded debate in hemisphere. Greater attention from civil society groups and media. International media, economists, academics, and former government leaders more enthusiastic about legal changes than general public, drug authorities, current government leaders or treatment community.

21. Cannabis Debate in the Hemisphere Public opinion in hemisphere remains largely opposed to marijuana legalization, even in Uruguay, where top down process has been led by government and elites. Legalization debate most lively in Caribbean (Jamaica), Chile (Congress), and Mexico City.

22. Definitions Legalization/regulated market - Supply is permitted, possession is allowed. Decriminalization - Supply is not permitted, possession will still be punished, but with minor penalty. Medical use - under supervision (?!) of doctor or similar Recreational use - no supervision necessary. Distinction most recently made by Prime Minister Golding of Jamaica following misreporting of the new law. Cannabis Debate in the Hemisphere

23. Uruguay Government initiative, law passed 12/2013 Policy goals: No increase in consumption; decline in organized crime Non-commercial, regulated market with 3 methods of supply: licensed pharmacy retail, at home and cannabis clubs. Access for citizens and residents 18 and older who are inscribed in registry. Bans all forms of promotion. Limited access of up to 40 grams/month per person. Currently operational: at home cultivation and cannabis clubs. Pharmacy retail faces regulatory challenges. Currently not implemented. Creation of federal regulatory entity (IRCCA). Public opinion remains opposed (only 37% support ).

24. Comparison of Colorado and Uruguay models

25. Colorado Model: Concerns for Hemisphere “Recreational” focus downplays health risks Law enforcement costs – where is the “security dividend”? Edibles focused on child-friendly “gummies” and brownies. Unrestricted advertising : alcohol precedent Benign labeling No restrictions on THC content Prevention programs? Tax imperative creates incentive for greater consumption. Drug tourism encouraged by minimal restrictions No restrictions on purchases or registry

26. More General Hemispheric Concerns with U.S. State Models Popular initiative ballot measures – limited accountability by Executive Branch Commercial models – incentives for consumption growth Drug Tourism Permissiveness in Advertising Skepticism about extent of regulatory challenge Prevention – limited health seat at the tab Spillover to neighboring states Sympathetic media Focus on tax revenues vs. actual and prospective costs Limited measuring potency of products Expansion of edibles/vaporized marijuana

27. Jamaica Government initiative Amended drug law to decriminalize personal possession (minor fine). Creation of medical marijuana industry. Permission for religious and medical use. Permission for at home cultivation. Regulations will be developed in coming year

28. Chile Pending Congressional initiative to decriminalize personal possession, reschedule cannabis, create framework for medical marijuana, and allow for at home cultivation (6 plants). No Executive Branch response to date.

29. Colombia and Costa Rica Currently, both have decriminalized personal possession. Government initiatives, bills in congress to allow for medical marijuana Details will discussed in legislatures.

30. Areas of Concern for CICAD commissioners Ability to put into place effective regulatory systems Youth prevalence trends, given alcohol precedent and limited ability to control diversion. Effects on health of different products and routes of administration – vaping, dabbing, edibles Uncertainties regarding medical efficacy and therapeutic effects: more research needed. Impacts on neighbors Impact on perception of risk and availability

31. Areas for Future Analysis Rigorous cost-benefit assessment of legal changes Effects on health of different products and routes of administration Medical efficacy of different cannabinoids Youth prevention approaches with availability on increase and perception of risk in decline. Impacts of increased availability on neighboring jurisdictions

32. CICAD’s Cannabis information portal Link from our main website at: www.cicad.oas.org

33. Ambassador Paul E. Simons Executive Secretary Inter-American Drug Abuse Control Commission (CICAD) Organization of American States Washington, DC PSimons@oas.org www.CICAD.OAS.org Inter-American Drug Abuse Control Commission Secretariat for Multidimensional Security Organization of American States 1889 F Street, N.W. Washington, DC 20006, USA Tel: +1 (202) 370-9895 ~ Fax: +1(202)458-3658