Health and Medicine

Why WHO needs a radical rethink of its draconian approach to cannabis

The ConversationCannabis is hugely popular. 182m people use cannabis across the world and, with this level of exposure, the way cannabis is regulated matters. As does the evidence of risks and benefits to health which underpins regulation.

Sometimes saying nothing is as telling as saying something. Silence can suggest retaining the status quo. The World Health Organisation (WHO) has been silent about the international regulatory controls on cannabis since its inception in 1935. The past 80 years have brought dramatic advances in scientific knowledge about cannabis, so it is odd that it has not provided updated advice about its legal status.

Indeed, cannabis continues to be scheduled in the same legal category as morphine – despite opiates such as morphine being more harmful, as recent drug fatality data reveals.

Non-compliance with drug treaties

It is not surprising that many countries such as Uruguay, Portugal and many states in America now don’t comply with the international treaties underpinned by this outdated scheduling and have adopted more tolerant policies which allow regulated access to cannabis for non-medical use. California recently approved recreational use of cannabis, a significant step as the state has overtaken the UK to become the world’s fifth largest economy.

The United Nations drug control system relies on WHO to provide evidence about drugs which in turn should inform international policy and treaties. But WHO’s stance on drugs appears increasingly adrift from the evidence. The UN drug agencies, for example, continue to promote the idea that cannabis acts as a gateway to the use of harder drugs – despite the gateway theory having been discredited.

Although cannabis use has been declining in the United Kingdom in the past decade, this trend is not reflected across Europe or in other countries across the world. A survey of teenagers from 25 countries found that while their use of alcohol and cigarettes was declining, cannabis use was rising. So cannabis matters – and the approach taken to regulation for the current cohort of teenagers is key to the credibility of cannabis control.

Cannabis use by gender.

WHO starved of cash

There is much speculation as to why policy change in supranational institutions proceeds cautiously almost to the point of inertia. Undoubtedly, different countries need to be appeased in the search for consensus. What is often downplayed is that organisations such as WHO have a seemingly permanent budgetary crisis. They are resource-light and consequently make very pragmatic decisions concerning what to fund. WHO’s leadership priorities include the promotion of universal health coverage, reducing shocks from the microbial world and widening access to the most up-to-date health technologies.

Engaging in advocacy for change to the current global regulatory frameworks controlling substances is nowhere near the top of WHO’s priorities. Several organisations are trying to change this and have submitted evidence to a recent meeting of an expert group at WHO. A detailed report put together by the Beckley Foundation and the Independent Scientific Committee on Drugs concluded that WHO should conduct a critical review of the scheduling of cannabis. They argue that the current scheduling of cannabis is not only out of step with the available evidence but is restricting its potential use as a medicine.

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