The ‘war on drugs’ has very little to do with safeguarding the health of citizens, argues James Linney
The cannabis sativa plant has been harvested for medical and recreational reasons for well over 3,000 years; along with alcohol and opium, it is one of the oldest psychoactive drugs used by humans - yet, unlike these other two substances during the era of late capitalism, cannabis has remained illegal in most countries.
The two exceptions are Canada, which legalised recreational use in 2018; and Uruguay (Portugal and the Netherlands have decriminalised its use). Both the US and UK still classify cannabis among the most dangerous of drugs and claim the threat of misuse is so great that its potential for therapeutic use should not even be considered. However, ever since its prohibition, doctors and researchers have been clear: the dangers of cannabis have been enormously exaggerated. It is, for example, far less harmful than alcohol and has none of the potent addictive properties of, say, tobacco or opioids. Additionally, there is growing body of evidence setting out the benefits of cannabis for certain medical conditions. Below I will look in more depth at the potential harms and benefits, and will also attempt to explain that it is ultimately a political agenda, not scientific evidence, which drives drug policies.
There has been some change in the tide in regard to cannabis in the past two decades. In the USA 10 states have now legalised its commercial sale for recreational purposes and in total 30 now allow it to be prescribed for certain medical conditions - the first was California back in 1996. Despite this though, federal law still classifies it as illegal for both uses; meaning that sellers and users remain vulnerable to lengthy jail sentences. The UK has been even more resistant to any change in the legal status of cannabis. Although it was temporarily reduced to a class C drug between 2004 and 2009, it was then reinstated as class B, contrary to the recommendations of the Advisory Council. Recently there has been a minor shift, caused largely by overwhelming public pressure to allow some forms of cannabis to be prescribed for a few, very strictly defined medical conditions. We will come to examine these changes in more detail - but first a brief look at the history of the drug’s legal status in the US and UK will help explain how we got into this mess in the first place.
Like opium and cocaine, cannabis was widely available throughout the US and UK up until the fist half of the 19th century, in the form of tinctures - tonics marketed and sold in general stores, promising to be a ‘wonder cure’ for a wide range of conditions: tetanus, joint pains, menstrual symptoms and nausea. The idea of prohibition developed in the US, motivated largely by anti-Mexican xenophobia. The Mexican Revolution (1910-20) resulted in large numbers of Mexicans entering the US in order to escape the violence. Anti-immigrant US politicians weaponised the use of cannabis within this population as a way of demonising them, inventing wild stories of cannabis-fuelled violence and debauchery. The term ‘marijuana’ (then ‘marihuana’) was used and still prevails to highlight the drug’s foreignness.
This manufactured fear soon led to the Marihuana Tax Act (1937), and was effectively the beginning of the end for cannabis in the US. It was replaced by the Controlled Substances Act in 1970, which classified cannabis as a schedule 1 drug - it was specified as one of the most dangerous, which allegedly had no medical benefits. Richard Nixon made its prohibition the main aim of his infamous ‘war on drugs’ - a war that benefited only the reactionary, fear-mongering politicians, together with the powerful drug cartels, whose huge profits are secured precisely because illegality allows them to charge extortionate prices. Caught in between are the communities who are terrorised by the violence of the cartels and the corrupt politicians they bribe; and the workers forced to toil in an illicit industry without the most basic union protection.
The drug laws were also a useful tool for the US state - they were wielded to weaken any political threat from within: namely the Black Panther Party and the increasingly radical anti-Vietnam war movement. The targeting of their leaders, through the use of long prison sentences for cannabis possession, often went hand in hand with the same racist propaganda that had been employed against the influx of Mexican migrants 60 years earlier. This time it was largely the poorer African-American urban population that was worst affected. Ronald Reagan fully embraced and expanded the ‘war on drugs’ and since the 1980s we have seen the legacy of this: mass imprisonment, largely of the poor blacks. Between 2001 and 2010 there were 8.2 million arrests relating to cannabis1 - 88% of which being minor possession charges - equating to 52% of all arrests. Despite the changes in its legal status, arrests relating to possession continue to increase - 659,700 in 2017, compared to 653,249 in 2016.2 And, although the use of cannabis by whites and blacks is about equal, black people are nearly four times more likely to be arrested for possession.
The legal status of cannabis in the UK has largely been determined by US lobbying for it to banned internationally - hence the 1961 UN Convention on Narcotic Drugs, classifying it as a schedule 1 (fully prohibited) drug, which was consolidated into UK law in the Misuse of Drugs Act (1971).
Unlike in some US states, the UK has continued to resist medicinal use of cannabis until very recently - let us take a brief look at how cannabis is used therapeutically and how these changes in UK law came about.
The cannabis sativa plant contains more than a hundred biologically active compounds, called cannabinoids, but the two most active and important in both recreational use and in medicines are tetrahydrocannabinol (THC) and cannabidiol (CBD). In the central nervous system these bind with receptors within the body’s own endocannabinoid system - a binding which triggers a cascade of chemical reactions and physiological effects. THC is the psychoactive component of cannabis and mostly binds to receptors in the brain - with multiple effects that, among other things, influence cognition, memory, appetite, pain perception, proprioception and mood; essentially it makes you feel stoned. CBD in contrast does not - it causes no psychoactive actions, and actually has more of an inhibiting, regulatory effect on THC. But it can have some potentially therapeutic uses - for example, in producing anti-inflammatory effects (similar to ibuprofen) and in treating some forms of rare childhood epilepsy.
Both THC and CBD have been developed as medicines, and there is still potential for utilising some of the other cannabinoids in the sativa plant. However, due to the severe restrictions on research in both the US and Europe, the evidence for their effectiveness is sparse and fragmented. There is evidence that cannabinoids produce benefits in some conditions. As anti-sickness medications they have been shown to be more effective than placebo and as useful as many others. In multiple sclerosis a THC-CBD mix has been proven to provide some benefits in muscle spasticity and pain. This medication called Sativex has until recently been the only medication available, albeit in a very restricted way, in the UK. In chronic pain cannabinoids have again shown some benefit above placebo - although the studies have featured high drop-out rates due to side effects. CBD oils have been shown to have significant benefit for some patients with rare childhood epilepsy conditions, when used alongside other anti-epileptic medications. These medications are different from the CBD oils on sale legally in the UK in herbal shops, which essentially are only allowed to contain sub-therapeutic traces of CBD.
The case of Billy Caldwell, a 12-year-old boy with Dravet syndrome, recently forced the government to make a small shift in its cannabis policy. Dravet syndrome can cause hundreds of seizures a month, and the child responded remarkably well to CBD treatments while he was in Canada, where he was being treated. When his mother tried to bring his medication back to the UK, it was confiscated at the airport, resulting in him relapsing into severely uncontrolled, potentially fatal, seizures. The resulting public outcry forced a quick change in the law, allowing the prescribing of CBD in some exceptional cases. However, it is still severely restricted and only available in some specialist centres, meaning that many sufferers who could benefit are still being denied it.
So, there is a clear role for cannabis in some medical conditions and further research would surely confirm this, as well as finding new cannabinoids of therapeutic use. Like any medicine though, that use needs to be based on empirical evidence of benefits outweighing harms - ideally through carrying out large-scale, randomised trials, which are impossible under the current law.
Let us also be clear though: cannabis is not, as some say, a ‘miracle drug’. Claims that it cures cancer or depression have no basis in evidence and are on par with the quackery of the ‘wonder drug’ label favoured by the sellers of the 19th century tinctures. There are also some adverse effects arising from cannabis use, although these continue to be overblown for political reasons. Regularly smoking any chemical increases the risk of respiratory disease and cancer, although the risk is much less than with tobacco. There is also a continuing debate around the link between heavy cannabis use and psychotic illnesses, such as schizophrenia.
A recent peer-reviewed study published in The Lancet found that there was a fivefold increase in the risk of a single episode of psychosis following heavy use of skunk.3 Skunk is a very potent strain of cannabis that has been manufactured by illicit growers due to the banning of traditional herbal cannabis. Historically cannabis contained no more than 10% THC, but skunk contains up to 67% and, of course, when bought on the street illegally, there is no way of telling what quality or concentration it is, or what impurities have been added. So, although there does appear to be a small increased risk of psychosis with heavy skunk use - particularly when taken from an early age - this risk is a direct result of cannabis’s illegality in the first place.
As we have seen - from mass incarceration and criminalisation to the denying of valuable medical research and treatments - cannabis prohibition has never been deployed for the benefit of the general population, but for political ends, largely by demonising certain components of the working class. But capitalism’s longevity is partly due to its adaptability and, as seen in the US, there is a lot of money that could be made through the legalisation of cannabis - legal sales exceeded $10 billion in 2018 alone. If the US federal law is changed to allow medical or recreational cannabis use, it will be because of pressure from the likes of Walmart and Pfizer, which have so far missed out on the ‘green rush’ currently taking place in an increasing number of US states.
We obviously have no interest in creating new markets for transnational corporations and calls for the legalising of cannabis here in the UK should be made alongside the demand for its medical forms to be developed by a nationalised pharmaceutical service and prescribed for free, where proven to be beneficial. Growing should be allowed for individual use and should not be the privilege of large companies, thanks to huge licence fees. Any cannabis sold should clearly be subject to strict quality control and have its THC and CBD concentrations labelled - ending the sale on the street of harmful ‘super-skunk’.
Above all else, though, is the need to put an end to the handing down of drug policies by a state that pretends to do so in the interest of its citizens, acting like a parent caring for a naive child. Rational, evidence-based debate and democratic decision-making must be the driving force behind drug legalisation - both recreational and medicinal.