“Cannabis ban is a trafficker’s paradise and an attack on public health”

The debate over legalizing recreational cannabis is exhausted. The arguments are well-known, the reality is evident and only through some form of financial interest (from drug trafficking to rehabilitation centers there are many interests), ideological fundamentalism or absolute ignorance on the subject, is anyone able to continue to defend prohibitionism.

The formula is simple and has been proven time and time again:

1. Decades of prohibitionism have not ended consumption. On the contrary, in Portugal it has increased over the last decade;
2. Not being legal, the only beneficiaries are drug dealers;
3. Under the control of traffickers, it is not possible to control the quality of the plant, which is often adulterated, with consequences for the health of consumers;

The cannabis ban is a dealer's paradise and an attack on public health! And these facts are not unknown to the biggest Portuguese parties: they know that the international legalization movement is based on positive results and that sooner or later it will be inevitable in Portugal. The political center does not ignore this inevitability, it simply does not want to expose and be electorally harmed by what they think is the majority of the Portuguese population: ignorant. The center lacks political courage to defend what is right. And, most likely, you are making a mistake of analysis by considering the majority of the country ignorant – nothing tells us that the majority of Portuguese are still in the dark. 

But the path to legalization contains some dangers, if we are not able to discuss ways of regulating the market and consumption right away. BeauKilmer, in a 2019 article published in the “American Journal of drug and alcohol abuse” discusses some of the contradictions of legalization. How the future cannabis market works is one such discussion. 

Lecture by Bruno Maia at the PTMC – Portugal Medical Cannabis conference, in Porto. Photo: Renato Velasco

In the legal market, there are quality and safety requirements that require significant investments from producers, which is not the case on the black market, eventually resulting in lower prices for the cannabis that is purchased from the dealer. 

A liberalized cannabis market means the presence of several companies competing with each other for the best price. The survival of producers depends on the level of consumption – the higher, the more profit. And this is a contradiction from a public health point of view: the objective must be to prevent problematic consumption, if possible, by reducing it. We cannot have, in the same public space, producers using advertising to increase consumption and health institutions trying to prevent it. 

The potency and type of product that is legal also deserves reflection. In an excessively liberalized cannabis market, the possibility of manipulating the potency of the plant in THC or even the type of products that are commercialized (nowadays we already know everything: oils, ointments, teas, foods, waxes, vaporizers, among others), directly clashes with the risk reduction strategy that we want to see implemented. Although there is little scientific evidence, what does exist seems to point to an increased risk of mental disorders with the use of plants manipulated with high THC potency.

Different legalization models are under development in different parts of the world, with different results. And some of these “dangers” have already been identified and are clearly related to highly liberalized and poorly regulated markets. However, there is one example to which we should turn our attention: Uruguay. In Uruguay, an adult cannabis user (consumption by minors is prohibited) is required to register as such with the State. There are only 3 ways to obtain cannabis: by self-cultivation, through small producer cooperatives, with an annual production limit, or through an authorized pharmacy. There are only two licensed companies; the state determines the price and quantity of cannabis produced; all cannabis advertising is prohibited; only a small set of plant strains is authorized and limited to 9% THC concentration.

To overcome the serious problems that a liberalized market triggers, we do not have to fully copy the restrictive regulations of Uruguay, but thinking about a “legalize” future requires the responsibility to prevent a just cause from drowning in the traps of the free market.

This opinion piece was originally published in #2 of Cannadouro Magazine
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* Specialist in Neurology and Intensive Care at Hospital de São José, in Lisbon, Bruno Maia works in the acute treatment of patients with stroke, and is also responsible for the Neurovascular Ultrasound Laboratory at Centro Hospitalar de Lisboa Central. Coordinator of the organ donation program at the same hospital, Bruno Maia also coordinates the Emergency and Resuscitation Medical Vehicle in Almada. Postgraduate in Emergency and Intensive Care at NOVA Medical School, Bruno Maia is one of the doctors who most intervened for the legalization of cannabis for medicinal purposes in Portugal.