1. 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

2. 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 •

3. 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 •

4. 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. •

5. 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 •

6. 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). •

7. 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, •

8. Contentious Issues Distribution and access models
Government monopoly vs. commercial
Home cultivation
Non-profit alternatives •

9. 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. •

10. 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 •

11. 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
ext. 228
@CCSAcanada • @CCLTcanada
INSPCQ – have recently published a nice report local at non-profit distribution models. •