1. Cannabis use in the Americas Slides for presentation at NIDA International Forum

2. 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.

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

4. Past year prevalence of marijuana/hashish among age12 and older in the USA in 2012

5. Past month prevalence for marijuana/hashish among age12 and older in the USA was 7.3% in 2012

6. Past Year Prevalence of Cannabis Use among Secondary School Students, Argentina, 2001-2009 Trends in Cannabis use over time

7. Past year prevalence of cannabis use among secondary school students in Chile 2001-2009 Trends in Cannabis use over time

8. Past Year Prevalence of Cannabis Use among Secondary School Students in Uruguay Trends in Cannabis use over time

9. Past year prevalence of cannabis use among secondary school students in three South American Countries Trends in Cannabis use over time

11. Past month prevalence of marijuana use among high school students in 4 Caribbean countries

12. Past month prevalence of cannabis use among university students, 2009 and 2012

13. Percent of students who report daily use by grade and potency (%D9-THC) Fuente: Universidad de Michigan, 2013 Monitoring the Future Study, y Universidad de Mississippi Marijuana Project (datos sobre potencia) SOURCE: University of Michigan, 2013 Monitoring the Future Study; University of Mississippi Marijuana Project, NIDA 2013

14. Ratio of tobacco to marijuana use in Latin America and the Caribbean Ratio of tobacco to marijuana use At a worldwide level 7:1 Ratio of tobacco to marijuana use At a worldwide level 7:1

15. Past month prevalence of cannabis use in the general population by age group

16. Past year prevalence of cannabis use among the general population, by gender Populations: the gender gap

18. Past month Prevalence of Cannabis Use among University Students, by gender

19. 12 th grade, past year marijuana use vs. perception of risk associated with occasional marijuana use SOURCE: University of Michigan, 2013 Monitoring the Future Study

22. Summary on cannabis use Prevalence rates differ greatly across countries However, in the majority of countries, cannabis use is highest among youth The few countries that have trend data show increases in cannabis use over time among high school students, with the exception of Uruguay, where prevalence began to decrease in 2007. In most countries males use cannabis at higher rates than females. However, as prevalence increases, the gender gap shrinks. The perception of risk and ease of access may be predictors of cannabis use. As perception of risk decreases use rises, likewise, as drugs become easier to obtain, use rises as well.

23. Synthetic Marijuana We have not yet seen any synthetic marijuana substances appear in our studies However, we know from our contacts in member states that synthetic marijuana is on the streets Synthetic drug use in general is low in the Latin American and Caribbean regions compared to North America.

24. Cannabis debate in the hemisphere Legal changes existed prior, but debate took off in 2012 with legal reforms in US states and Uruguay. Other members have started internal and regional dialogues to discuss legal changes such as: – Decriminalizing personal possession – Medical access to cannabis – Legalizing production and distribution Debate is taking place in the following jurisdictions: – Chile, Argentina, CARICOM, more US states, Mexican capital (DF)

25. Statutes for personal possession Statutes only, this does not include case law. Application of law may vary. Decriminalization is nominally applied in Brazil and Mexico. About half maintain criminal penalties for personal possession. Most members apply some type of sanction.

26. Brief comparison of Colorado, Washington and Uruguay

27. Different Models, Goals, and Challenges Commercial models in US seek to generate tax revenue. Restrictive access model seeks to quash illicit market in Uruguay Limited medical model restricts access for medical purposes in Canada

28. Areas for further research and evaluation Cost-benefit assessment of legal changes Effects on health of different products and routes of administration Medical efficacy and therapeutic effects Long-term, normative changes Comparative analysis of different models Impacts on neighbors

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