UNITE co-sponsored a conference on Cannabis and Adolescent Health in the Portuguese Parliament (Assembleia da República). The 1-day conference was organized by the Citizens Initiative on Cannabis and featured presentations by experts and researchers, as well as a roundtable discussion of representatives of all parties in parliament, sharing their perspectives on the legal regulation of Cannabis for recreational use.
Cannabis continues to be the most widely used illicit substance, with an estimated 219 million users (4.3 per cent of the global adult population) in 2021. As consumption of cannabis has been steadily increasing globally in the last few decades, evidence suggests that currently dominant prohibitionist drug policies, such as the criminalization of cannabis use, have failed to reduce consumption and the availability of cannabis on the illegal market.
In this context, proposals for the legal regulation of cannabis for recreational use are being implemented in some places and discussed in many others, including many European countries such as Germany, Malta, the Netherlands, and Portugal. One of the key questions that legislators seek to address in discussions of regulatory models is how to protect the health of adolescents and young people from the potential negative impacts of cannabis consumption.
On September 19, 2023, UNITE co-sponsored a conference on Cannabis and Adolescent Health in the Portuguese Parliament. The 1-day conference was organized by the Citizens Initiative on Cannabis, under the High Patronage of His Excellency the President of the Republic of Portugal, and with the institutional support of the Ministry of Health, and the General Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD).
The event featured presentations by experts and researchers on the health impacts of cannabis on adolescents and discussed the policy implications of the findings, including experiences from cannabis legalization in Canada. The conference also featured a roundtable discussion of representatives of all parties in parliament, sharing their perspectives on the legal regulation of cannabis for recreational use in Portugal.
Dr Will Lawn from King´s College London presented the findings of their multifaceted study on cannabis and adolescent health, CannTeen.
He explained that adolescence is a formative time for brain and social development, and therefore it’s important to study the health impacts of regular cannabis use during this time, including brain connection and functioning on different levels. Studies presented have found that at a minor level, people who regularly used cannabis in adolescence show small deficits in learning, executive functions, verbal memory, and attention in adulthood, however that association was not found with people who started using cannabis after adolescence.
In studies on the associations between cannabis use and psychosis, they’ve found that there is a potential effect that the risk of developing psychosis increases about four times in daily high-potency cannabis users as compared to regular cannabis users. In studies comparing adulthood and adolescence impacts, adolescent cannabis users have shown greater psychotic-like symptoms and more severe cannabis use problems than adult cannabis users, noting that the relationship is likely associated with a number of other factors in adolescence, such as a developing brain and endocannabinoid system, evolving sense of identity and changing social relationships. There was no evidence of an amplified vulnerability to cannabis-related increases in subclinical depression, anxiety or psychotic-like symptoms in adolescence.
In terms of regulatory examples that seek to mitigate the potential health impacts of cannabis building on the scientific evidence, the Canadian legalization model was presented. After 5 years of implementation, Professor Rebecca Haines-Saah talked about her observation regarding drug and cannabis consumption in adolescence. She highlighted that the main outcome of legalization for young people was a strong, 87% decrease in youth arrests related to drugs. However, legalization has not led to a decrease in youth consumption, while also no increase in youth cannabis use either. The government has invested funding for an extensive education plan for young people, but drug consumption in general hasn’t decreased significantly. The country is currently grappling with an epidemic of overdoses, also significantly affecting young people, The leading cause of deathages Canada between the age 10-18 years old is overdose from fentanyl, and more young people are dying from drug overdose than car accidents.
However, The Professor stressed that the experience showed which problems were underlying after legalization, so it is crucial to assist adolescents in the most effective correct way. One of the most significant observations is the harm that is done by stigma. Cannabis and drug users fear and avoid getting health care or communicating about their issues. Moreover, there is also a racial stigma and people from marginalized communities still face harsher treatment when using or being arrested by the authorities. The government’s educational project is difficult because one approach doesn’t work for everyone some kids will follow the recommendations, some won’t. The key is to promote a non-judgmental approach and support kids in making safer and better choices.
Perhaps the most important conclusion from Canada’s experience on how to prevent harms from teen use has been that the best drug education doesn’t have anything to do with drugs but with family, community, and environment surrounding the kids. Investing in initiatives that support youth, families, communities, and mental health is therefore crucial, she explained, adding that legal regulation of cannabis brings transparency and destigmatization, which are also necessary factors.
From a Public Health point of view, how can we reduce the potential negative health impact of cannabis?
Experts argued that legalization seems to be the way forward, as it gives back control on the products to the state and legal entities. The main goals of regulation are to prioritize public health through product quality control, and to reduce or ideally disappear the illicit market.
Through a roundtable discussion of Parliamentarians representing all parties in the Portuguese parliament, the conference also showed that there is a general consensus in the legislature in support of the legalization of cannabis in Portugal. It has recently been announced that there’s plans to establish a Cannabis Working Group in the Health Committee of Parliament in the coming weeks, aiming to develop a proposal by the end of the year.
In addition to the parliamentarians’, other high-level representatives expressed their support and recommendations. The State Secretary of Health of Portugal stressed that there is a need to destigmatize cannabis, define public policy and create regional structures, in order to protect individuals and public health. Dr João Goulão, Portugal’s General-Director for Intervention on Addictive Behaviours and Dependencies highlighted the market and economic possibilities for Portugal in exploring a legal cannabis market, which would also be safer for users.
The conference also highlighted that there is an openness for European initiative, which would make legalization easier at the country level.
The discussion was important in providing scientific evidence and experiences from countries to inform upcoming policymaking processes. The considerations highlighted will be key in the process of building a regulation of Cannabis legislation.
In conclusion, the question remaining at the end of the conference was not whether to legalize cannabis or not but how to regulate Cannabis in the best interest of Public Health and the protection of young people.
