 Welcome everybody to our new webinar on cannabis approaches to control across Europe. I will leave the floor to Brendan Hew for chairing this session. Our director Alexis Gosdil is travelling, so he will try to connect with us for concluding remarks. His flight was delayed, so he had some problem joining us, but he's always with us, at least in the spirit. Brendan, the floor is yours. Thank you very much, Marika. Hello to everybody watching this webinar, and thank you very much to our guests for joining us here with this chat about different cannabis control policies. And we're joined in the order that I can see on the screen by Tom Blickman, who's a senior project officer at TNI, Transnational Institute. He's been working for well over 20 years looking at national and international cannabis policies. And that includes not only different countries views, but also the UN conventions, the different UN systems for control. And how they might have been changing and the proposals to change them recently. We're joined by Sabrina Molinaro, who's working in Italy at the National Research Council. She's particularly got the position of the coordinator of ESPAD, the European School Survey Project on alcohol and other drugs. And so her expertise here will be the impact, if any, or how to track the impact of cannabis policies against teenage use, the 15 and 16 year olds who complete the ESPAD survey. And that clearly is reflecting a very, very common concern of those who wish to change cannabis policies that particularly interested in use by young people. And finally, Karen Marmel joining us from Malta. Karen's been a researcher, if I'm right, with the Maltese Parliament for about five years, which gives her a very good picture of the recent changes that have been happening in Malta over that time. And right now she's a researcher as master of science in addictions. So very well placed to join this discussion. And I'd like to say thank you to all three of you for joining us today. If I can just start with a few words really to sum up why we're here. So for 50 years, cannabis has been classified as a controlled drug, more than 50 years. And the default response to this to use and supply of cannabis for non medical purposes has been punishment. And it's usually been criminal punishment with either the threat of prison or the reality of prison in several countries. They have done this they've passed these laws in order to protect their populations from the public health consequences and social consequences of use, and of the illicit supply chains. They've been trying to block the illegal supply chains from traditionally in Europe it's been from North Africa from the Middle East and Asia coming to Europe. But while those laws have been in place, we've seen organized crime groups have gained money, they've gained power. Consequently the state responses to the use and supply got tougher they resulted in the 1988 United Nations Convention, which was the first to explicitly address use related offenses, even though it was titled as a convention against trafficking. Since then, in the 20 years when I personally have been working at this monitoring center and looking at drug laws around Europe. The policy responses have changed, and this direction of getting tougher has in in several cases been reversed. So we've seen prison sentences either reduced or removed. We've seen monetary fines have got smaller and sometimes replaced by warnings. Even punishment itself the whole idea of punishment might have been changed or supplemented with brief interventions with over more rehabilitative nature, such as counseling. In terms of these policy responses and the changes of the policy responses, unfortunately the message, whether it's to other policymakers or to the public, the message is often mixed, and it's misunderstood. So, in order to try and bring some kind of clarity. EMCDA released a short video nearly 10 years ago now on our own website on YouTube, which describes the differences between decriminalization, depenalization, legalization. These are not absolute, they are not agreed by everybody. But at least if we can agree that some basic terminology, then we could have a more constructive conversation and that was the initial idea. This came about as a result as the Portuguese policy of decriminalization, where many people seem to interpret that as legalization and that you travel to Portugal and you were permitted to possess drugs, you were permitted to use drugs. That's not true at all. And eventually we had to do a very simple video to explain the difference. Nothing is easy across Europe and across international boundaries. We're talking about different languages being used, different legal systems and different gradations of the legal system, but we've tried to put forward these very simple ideas which should be able to translate to each country's legal system. So we would propose the terms for decriminalization means reducing the size or the significance of the penalty, changing the status, changing the consequences of the penalty. Different from the penalization where we see some countries in Europe, having systems that remove the application of the penalty, the penalty is still there in law. But the police or the prosecutor or the judge has the option to close the case if they somehow consider the offense as minor or not significant. We also should not confuse these with diversion. Many people are saying that decriminalization is the model look at Portugal. And I think what they're really thinking of is they're thinking of diversion. The idea of diverting an offender from a criminal justice system aiming primarily at punishment to a health or social system that aims more at some kind of rehabilitative response or treatment. And finally, legalization, for which we usually talk about regulation because it's certainly not a free legalization, which in our understanding allows some form of supply and use, and that would include self supply, self cultivation. The main thing is that here the authorities have no power, no authority to confiscate or to intervene. And there are blends of these, there are mixtures of these, there are variations of these. And as I say, they are addressed by different terminology in different countries which can make this a very tough subject for comparative discussion. But let's try to start off with that. So I've said that over the last 20 years there was a, there was a trend generally in reducing penalties, but I want to emphasize that this is not a universal trend. Some countries have insisted on increasing their penalties, they felt that they were too low. Other countries may have reduced penalties and then decided after a few years to increase them once again. But nevertheless, I think it is a general trend. And different people have different views as to why these changes have happened. They could be due to internal factors just within a country, they could be due to external factors outside. And so therein we have this question, why is this trend only in some countries in Europe and not in all of them? Why is it that different countries choose different responses? So I'm going to share three questions on a PowerPoint and I'm going to ask the three of our panelists please just to give two, three minutes viewpoint on each question, their opinions. And then maybe we'll take five minutes afterwards to discuss between the group before we move on to the next question. So if I can share this screen, and we'll look at the first question. Is that displaying correctly? Can I check? It is, but it is not in full screen. Is that better? Yeah. Okay. So there's question one. So here we're looking at the events that have brought us to this point to this year to the evolution of cannabis policies. And I'd like to ask from your particular perspective, what are the developments that have led us to this current debate about how much cannabis should be prohibited or regulated in Europe? And to start off, I'd really like to direct this question to Karen, who I think has quite some experience with the changes in Malta. Thank you very much, Karen. Thank you. Hi, Brendan and thank you for inviting me. Yes, I think before we ask the question how it should be regulated or if it should be prohibited, I think it would be better to look at the question before that, because in Malta, let's say, 10 years ago, no one would have thought of discussing cannabis as a decriminalized or as a regulated market. I think the shift happened along other civil liberties too, especially from our perspective. Just recently Malta legalized the divorce. We are the top when it comes to LGBTIQ rights. So as a country, we're moving a bit closer to human rights and better civil liberties for all members of society. I think, although with the effect of cannabis and drug policy, a lot of cases that were making it to the media of people incarcerated for years or long years and maybe others who have been waiting for their court cases for even longer years and now have adjusted lives and have to be sent to prison. I think those were cases that started to crumble a bit the status quo and how the country addresses people who use drugs and in this case, people who use cannabis. That's great. Thank you very much. I think that's certainly something to look at and indeed the development of civil liberties around Europe and around the world. We've seen from some of the judgments of superior courts where they've considered that this is no longer the preserve of the state. Tom, what are your views on this historical development up to now? Well, I think you could say that the fence of authentic winds of change that have been blowing in the Americas for a while has now reached the shores of Europe. And I think the common denominator is more or less that this is an increasing understanding that the prohibition of cannabis has failed or at least it doesn't work that well or there are too many negative consequences. And usually also it's not fit for purpose anymore. And I think that in several countries in Europe there is a movement to legal or tolerated regulation of cannabis and basically you could say well it's about taking back control. I know that is within the European Union that's a little bit taboo after Brexit, but basically that is what it boils down to take back control of an illicit and criminal market that in fact is out of control in terms of protecting public health, public safety, it doesn't respect age limits, there are no quality controls on the cannabis, etc. And if you look at Europe, you could say that I think the whole process is a little bit like the process, you know, after not a small town in Luxembourg where you go three steps forward and two steps back. In the 1970s, the Netherlands already made three giant steps forward by decriminalizing and allowing sales of cannabis in the coffee shops. They also had to take two steps back because the initial intention was to further regulate cannabis at the time in the 1970s, but they had to take back two steps back because of international pressure and you see that that is a repetitious thing happening in Europe. In Spain there was cannabis, the explosion of cannabis clubs, and now you can see that the Supreme Court and the Constitutional Court have limited the room of maneuver of cannabis clubs. You can also see it in Luxembourg, where the original proposals of the government coalition were more ambitious, let's say. They wanted to establish a whole chain of regulated cannabis from cultivation distribution to sales, and now it's basically back to home cultivation and a form of decriminalization, which fits within what has become the EU rule and regulation of the 2004 framework position, which allows some cannabis use and some cooperation for personal use, but that's about the limit. If you go beyond that, then there will be problems with EU rules and regulations, but we'll probably get to that later on in the debate. Okay, thank you. So there's the idea that there may be internal drivers for it, but there are also external limitations and that a country can't really operate just by itself anymore. So Sabrina, what's the view from Italy or what are your own personal understandings of this question and these developments? So let me give you not my personal view, but the ASPAD view of this topic, because we have a big scenario from the ASPAD data regarding the 16 years old that used to be one of the age class much more interested in the cannabis use. And based on the 2019 ASPAD results, the average lifetime prevalence of cannabis use among adolescents in all the participant countries remains stable since 2015, but increased a lot from the first wave of ASPAD in 1995. And the level of the lifetime prevalence is 16% with the high cross-country variability. Of course, from my point of view, the most important thing is to push the governor to organize policy in order to evidence-based results. And let me tell you that the countries with the highest prevalence of cannabis use in the 2019 were Czechia, Italy and Latvia. So our countries with very different policy about the legalization of the provision of the possession of cannabis. And we also observed a strong decrease in the lifetime use up of 10% point in Czechia as well in Bulgaria and France and in Monaco. And this developer wanted further investigation to gain insight into possible factor that can influence all the decreases. The low lifetime prevalence rate were also found in four of the Nordic countries like Faroe Highland, Norway, Sweden and several Balkan states. And with respect to the last wave, the 2015 wave, the average prevalence of the last year use that the other indicator because in the lifetime use we look at the only the general experience when we look at the last year prevalence. It's something much more concrete and that prevalence remains stable at 13% is not so far from the lifetime one. But what is also important is that the average of the current use amount the last month prevalence remains stable with a significant increase observed in six countries and significant decrease observed only two countries, Bulgaria and France. But what is important is that the high prevalence of current user 13% of Iger is in Italy and in France and in Netherlands that are countries with very different cannabis regulation in place. And that meant that probably we need to look deeply inside this kind of data to have the necessary information in order to understand what is going on. And what I also want to tell you is that we have in the as per the study scale for the measure of the high risk use of cannabis, the name of the scale is cast cannabis abuse screening test. And this scale suggests that on average of 4% of students in the total of the as per the population can be considered to be a risk of developing cannabis related problem. And these correspond to the negligence of 35% among last year users. So the 35% of the students who use cannabis one more time during the one year may have some may have a high risk cannabis use. But what is interesting is that costable cycles Montenegro, Serbia, Sweden, which were the countries where I guess proportion of user that I risk of developing cannabis related problem, the prevalence of cannabis use in the last month was among the lowest in Europe. That means that there is not a straight relationship between the prevalence of use of the people who use the cannabis and the prevalence of people who develop a problem related to the use of cannabis. In fact, in the in the countries like Netherlands, Latvia and Czechia, where the rate of the prevalence last year prevalence is higher are very lowest percentage proportion of students with problematic use of cannabis. This suggests that there is not a simple direct relation between the cannabis use and the risk use with the potential in front of other factors such for example the quantitative actually user as well as a broader social or cultural factor or the quality of the cannabis use. And this factor may include how different societies react to cannabis use which may influence the self assessment of excessive use on the willingness to stop using all the recommendation by other for example parents and teacher to stop using and the development of the conflicting in relation to use. I'm sorry it was a little longer, but I think it was important to have this general overview about among the adolescents. It shows that the issue is not is not as simple as many people believe. At EMCDA, at least we tracked cannabis use amongst young adults in those countries which changed their penalties in law and found that it was not a very simple relationship like many people expected that if you increase the penalty the use falls or if you reduce the penalty, the use increases. I think your work in SBAT is particularly interested when it comes to cannabis policies as in legal status, because when we talk about the law normally the law only refers to adults it is only adults who would be punished. And yet what you're looking at is 15 to 16 year olds. So once again it's a it's an extra consideration about how these different factors may be linked or how there may be breaks in the links that we all expect. Thank you everybody for your views. Can I ask if anybody if any three of you have any questions to the other panelists about what they said. If I may add something please. I find it very interesting that when we speak about cannabis and problematic cannabis use we tend to forget that there are different methods of consumption and unfortunately in Europe. There is a prevalence of mixing cannabis with tobacco in the same in the same cigarette practically and I'm curious if any of you maybe encountered any studies which take this into consideration. And I find it very interesting that when experts in Mualta were speaking about and discussing what do we mean by the criminalized and and the amounts that should be allowed. All experts used to speak only about joints. And that is cannabis mixed with tobacco and when sometimes there are discussions about edibles or other forms of cannabis. Unfortunately, this is not given enough space. And and I'm curious a bit how maybe research could also look into different methods of consumption different risks linked with with methods of consumption also maybe prevalence and problems later on in life. Thank you. Thank you. I mean I think that's a great point and if we look at the question the developments which have led up to the current debate. What we know and what Sabrina may be telling us is that the level of tobacco consumption has really dropped across Europe in about the last 20 years amongst young people. So then one one questions how much young people still interested in smoking joints. This is something that we'll be coming on to in in the next questions also are the different formats of cannabis consumption. But it's true that consumption trends are changing beliefs in the harms in cannabis and tobacco are changing and they may have led us to where we are at the moment. Other colleagues. Any questions. I think Tom's got a problem with his internet. If I if yeah I also encourage more research into the different forms of cannabis and I mean we can talk about tobacco and cannabis we can there's cannabis can have many different forms so we should look into the THC CBD ratios and even yeah use that also in prevention measures towards younger people that it would actually be better to smoke cannabis with with with low THC levels and or maybe even better somewhat higher CBD level so the kind of cannabis that is smoked can be very different at many levels and I think that would that is something that future research look into you could even imagine that you if cannabis would be regulated that up to a certain age limit people are not allowed to buy cannabis above a certain THC level or below a certain CBD level as that is usually considered a more safe form of cannabis to use and that these are things you can do when you regulate you can try to no regulation is 100% perfect and it's always difficult to control but at least then you have a clear clear message on what I would call a responsible cannabis use. Tom in your work following the developments at the United Nations. Would you like to take this moment to explain really briefly what's been happening in the last year because I think that I saw some headlines about a year ago about about the UN is now declaring that cannabis is not so harmful and that there are steps towards legalization. I think that's once again a bit of a mixed message. Are you able to give our viewers a really brief summary about what happened there. Yes, cannabis was placed on the 1960. Well, if you if you look at the conventions. There's a lot of substances that are on the different levels of control. And there is a mechanism to put these substances there. However, at the beginning when the 61 convention was negotiated, a lot of substances like cannabis, opium, cocoa were just put on that list and there was never ever a review or critical review if cannabis was a dangerous deal. And cannabis was placed in two schedules. One, which is schedule one, which is the most strict one. And additionally in schedule four, which is all substances of schedule four also in schedule one. And schedule four was a special but optional schedule that said that these look for particularly dangerous and there should not be allowed for even for medical use but that was optional countries were not obliged to to to go that far. And the way the WHO expert committee on dangerous drugs who proposes where to put the drugs in the schedule did have a finally after 15 years or so, a critical review of cannabis and decided that cannabis does not belong in schedule four. So, and that means that countries or that that is a signal towards countries that indeed there is medical use and that researching into medical use would be useful but like I said, but that was always optional so the changes actually quite small, because there still remains in schedule one, which basically calls for the strictest controls possible of substances. I hope that the short and open. Let's get something really short, please interesting that multi is law had listed cannabis as Indian hemp. And it's still listed as Indian hemp. It's only now that is going to be changed with the new law proposed to to decriminalize partially decriminalized cannabis and that is interesting because for all these years. And the multi slow was criminalizing Indian hemp, including seeds and branches and all that is composed of Indian hemp. Let me show how they get the conventions are my personal. There are, you know, there are there are some countries in Europe which haven't changed the basis of their cannabis control for 20 or 30 years and there are others which are making quite significant changes just in the last few years and there you've you've seen. What I know also is that in these developments that have led up to this up to now that there have been scientific advances in cannabis for medicinal uses, and we'll be making that the subject of a future webinar so I don't want to go into that too much. There have been now as a result of the World Health Organization's expert committee on drug dependence critical review that Tom mentioned. We have more accurate and agreed statement of the current risks of harms from consuming cannabis. Yes, we have whether it's referred to as Indian hemp or whether it's hemp generally, we have the confusion that the cannabis plant without its intoxicating THC has been used for 100 years for hundreds of years for purposes of fiber. Even the word canvas comes from cannabis it's it's an old French variation of cannabis. So there is this idea of prohibition of the psychoactive substance, but at the same time, not everybody can prohibit the whole plant because there's a very well existing trade in it. And increasingly there has been a bit more confusion between the two about where do you draw the line one stops and the other starts. Okay, thank you very much. If I just share again to move on to the second question. Ask each of you in turn, moving on from the developments what are the most pressing challenges right now. I think, Sabrina, would you like to have a look at that and the second half of the question is the current cannabis policy debate, having an impact I think you're you're looking there at the different use statistics around Europe between the different age groups and you may be able to contribute. Yes, thank you for the question. I think that right now the greatest challenge of the country is to push our governance to develop a truly evidence based policy. This is what I think. And regarding that I want to show you some results always from the as per the data. I want to talk about the paper from Elisa Benedictine. The name of the paper is cannabis policy change and hardcore kind of an adolescent cannabis user story evidence from Europe. I want to share with you some results from this paper because I think that this is an example of what we can do with the data that we collect. Of course it's only something partial because we also need some other indicator in order to drive the policy from our governance, but it's something that is necessary to consider to start. In this paper we examine the association between the changes in cannabis control policies and changes in adolescent perceived the viability and self reported the use of cannabis in 20 European countries. We look at 13 countries where laws were changed in this time frame and seven countries which served as a control group because and we look at over a period of more than 15 years science 1995 to 2015. Specifically, we reviewed all the existing literature to characterize the type of cannabis control policy and we categorize from the much more restrictive to the much more much more liberalized and we look at the changes in each country and apply the difference and difference model. That is a popular statistical technique that attempts to meaning mimic the experimental research design. What we did is we analyze the starting from the analyzing from the perceived availability. We found that we found that there are not non criminalization and the depenalization reforms seems to be linked to an increase in the perception of the easy access to the substance by students. And this finding suggests that the common assumption of the cannabis availability will increase with the relaxation of prohibition might not be applied to the European cases. This means that in the countries like for example, Portugal, where the personal possession of cannabis was the criminalized in 2001, the perceived availability of cannabis did not increase as a result of the reform compared for example to a country like France where the possibility of incarceration for the possession of cannabis for personal use is still foreseen. And concerning, for example, the cannabis use outcomes, our results show that only some cannabis policy reforms were associated to significant change in the prevalence. This can be considered a very important findings itself as it confirms that there is not an automatic link between cannabis policy and the use and the other factor might play an important role and that's important to underline because we need many other indicators to understand what we needed to do. Among these we can mention information and prevention programs but also actual level of implementation and enforcement of reforms that they can affect both the perception of risk and the knowledge in the adolescent. And as highlighted by previous study conducted in Europe, we look also at the comparison and when we consider all types of users, two categories of policies show an effect among the more restrictive ones. So only if we look at the occasional user, the more restrictive kind of policies seems to impact with the prevalence of users. In the meantime, only when we look at the occasional user also the much more liberalized policy seems to be related. But when we look at the frequent users, no relationship we found between the cannabis use and the kind of reform. That's what we think is very, very important because some reform reducing the penalty for cannabis possession are associated to an increase in some measure of the adolescent cannabis use. Signal that the reformer might have someone reduce the stigma of the perception of the risk associated with cannabis use. So we are not really sure that the results can be only associated to only the change in the occasional use. And this is in line with the fact that the non-increase was observed concerning the adolescent to perceive the easy access to substance that indicated that there are other main factors which the policy reformer may have acted and did not change significantly. And shifting social norm regarding cannabis use may have increased cannabis use among experimental and non-frequent use. And on the contrary, in those countries where the city penalties for cannabis possession were increased, the reduction in the share of experimental and non-frequent use was coped by reduction in their perception of cannabis aviabilities. And this may indicate that this kind of policy was effective in reducing access to informal channel, sorry, or increasing the price of these substances on the black market for the other city population of users. And our results at the end confirm that some of these reforms have linked to a reduction in the share of students approaching this substance, which is in line with this object. However, the fact that non-reduction was observed in the share of frequent users who were the kind of students who cannot have a higher risk related to their user, we think is really, really important to underline. So that's a really important response to the second question then, which is the policy debate having an impact. And what you're highlighting there is impact on whom. There's many different groups of society where there are groups of drug users, groups of young people who are expected to be impacted by policies, but they are receiving the messages in very different ways. And this can be because of the level or the quality of the policy debate. This can be because of the implementation of the policies themselves, not just how they're framed in legislation and the beliefs of those people looking at them. Thank you so much for that. Tom, what are your views on the challenges that we have and the impact of the debate? Yeah, I want to highlight a completely different issue and that is related to international law. If you see what is happening now that current and also future legal regulations practices are violating international law. But it's happening in Canada, Uruguay, the US, and possibly also in the European countries in the future is not only violating the three UN drug conventions, but also challenging the EU law and notably the 2004 framework decision. And I think that is a problem because international law is already a fragile system, but it's indispensable for a more secure and humane and environmentally safe world order. So ignoring or violating international law is undermining that system. And I think really we should start looking into that, how we can figure out a way that we can change because conventions are very difficult to change, specifically the drug control convention are difficult to change because of the growing tensions between countries on the issue and of course a very emotional issue, rational arguments tend to disappear. And yeah, I think we should really start looking at that and find ways to deal with that. Of course, as T&I we have done have some proposals to do so. Countries who do want to regulate cannabis can make a late reservation to the conventions like Bolivia has done with the coca leaf and that has been accepted by the system. You can also do that with a group of countries so collectively have late reservations and what we also propose is an interstate treaty modification where in which a group of like-minded countries for instance on cannabis say well we don't agree with what is in the conventions anymore. Among us we will have a different system but we respect our obligations towards other states and that might be a legally international that is all according to international law so that would be a controversial but a way out and probably the most elegant way out. We see the same problem with EU law but has happened in like I mentioned before that Luxembourg had initially a more let's say radical proposal which would have violated the framework decision but I'm now reading in the newspapers is not to put it bluntly is that Luxembourg has been bullied back by its neighbors. Luxembourg is sandwiched, a small state sandwiched between the two important European powers like France and Germany and also Belgium. We're going into what fits in that framework decision but I expect that limited framework decision will eventually be violated because Luxembourg has announced that it will enable another more far reaching proposal and what Germany is going to do, we see now that the new government coalition in Germany is also thinking about regulating cannabis, will they remain within the limits of the framework decision, what is happening in the Netherlands right now, the experiment with ten municipalities that can now, well I wouldn't say legally but can in a regulated way supply coffee shops but there is currently also a law proposal going through the Senate which would extend that possibility to all municipalities in the Netherlands but that would also create tensions with the framework decision so yeah I think we can see the problems coming and with the already a little bit toxic atmosphere in the European Union I think it would be wise that we start discussing what would be the best ways to deal with that before we start going into infringement procedures by member state or even by the commission maybe and try to avoid that and have a rational and evidence based discussion on how, yeah what could be needed and how the framework decision should be adapted to that. If you look at the United States, we have now 15 or 16, I'm losing track, states within the Federation that have legally regulated cannabis and other states have not and apparently that isn't causing many problems, there might be some smaller problems but the country continues to exist and even within these states you have an opt out for municipalities or counties as they fall in the United States to not allow regulation of cannabis so you can see and that is something we also researched in Europe you can see that there is more and more a tendency to go to local customization of cannabis regulations where, yeah, where there can be differences, you can also, there are already many differences in European drug policy, we have the coffee shops in the Netherlands and while there is more or less a zero tolerance policy in Sweden, often in France, there are cannabis social clubs in Spain, so there is a wide diversity and even in the Netherlands itself there is only one third of the municipalities actually do allow coffee shops and some coffee shops have extra rules some municipalities have extra rules for coffee shops so you already see there is a lot of that version customization towards what fits best the local circumstances or national circumstances and I think that is a model that we should go to in Europe as well, it's okay if Sweden or France doesn't want to regulate cannabis, fine, that's their decision, they're democratic right but they should not impede other countries to do so and I think we should find some kind of agreement there and better start that debate now before it gets out of hand and all kinds of nasty measures at the European level So quite a challenge in international relations then and particularly with the treaties so well established the last one in 1988 and there doesn't seem to be much international enthusiasm for a uniform change in any direction You spoke earlier about the reclassification of cannabis which eventually happened last year and I think even there where we understand that the WHO put forward six proposals to adjust the classification of cannabis and its related substances as an illicit drug and they only just managed to get one proposal approved only just according to the number of votes from the 55 countries voting so we saw even there when even the most basic change was proposed it got very heated, very emotional, a lot of countries really really really questioning the evidence behind the change and ultimately preferring not to take the risk and not to make the change and we could certainly see that being reflected in any broader change Karen if I turn to you, I mean we discussed a little bit here about legalization of cannabis but many countries are a long long way from legalization and many haven't even considered decriminalization If there are countries considering just moving very slightly to decriminalize to reduce the size or the significance of the penalty but still to keep it What would your experience show from Malta because Malta made a change in 2015 before its current proposal and that was from a very strict drug law and it must have taken quite some change to convince whether the people or the government just to make that step towards decriminalization which other countries still haven't managed to do What do you see as challenges there? Yes, well in reality in 2015 the country moved to a depenalized system although it was promoted as a decriminalized when you look at the details of how certain substances, small amounts of certain substances were being treated You see it's a depenalized system therefore although a person for example when it comes to cannabis found with amounts not more than 3.5 grams The police still arrest the person, take the person for interrogation and if they have a suspect of trafficking the person is still arrested and kept in lock up until further investigations So I think the challenge now is to move even a bit further away from the criminal and the prohibitionist approach which unfortunately not only in Malta but everywhere around the world created the so called unintended consequences of the war on drugs which is a higher level of people incarcerated for a nonviolent crime and an increase in criminal and mafia dealings related to substances So I think now the challenges will also be linked to the fact of finding the right balance between preserving personal rights and freedoms and public health and also in a way trying to better understand who is the user and who is the trafficker because unfortunately as laws have been interpreted and used a person found with a substantial amount of cannabis or plants is considered immediately a trafficker and there were also cases where the act of sharing simply the act of sharing was considered as trafficking and people ended up in prison as traffickers So I think one of the challenges for countries moving towards the criminalized system is also to try and understand who is the criminal and therefore the high level trafficker involved also maybe in other criminal operations and who is the user and the grower and that also needs to be balanced out in the sense that it needs also to reflect different realities in different countries I am sure that the reality of cannabis use in the Netherlands I'm not talking here about prevalence but about the way cannabis is used and perceived in the Netherlands is completely different from how it is perceived and understood in Malta I think another challenge is linked to the education for a long time we have always here that cannabis is bad, no cannabis should be used and no other information was made available and now we're seeing that not only in Malta but a lot of countries are regulating or diminishing the negative effects and a lot of criticism is being leveled out in the sense that how are we going to explain to our children that what was wrong two years ago or all of a sudden is less wrong and I think that is one of the main challenges that we are forgetting that most of the changes are being brought forward to push persons who are nonviolent and not present a problem to society away from potentially becoming criminals because they are being criminalized for their use, consumption, sharing or cultivation and I think even when I was observing local discussions especially how certain experts were analyzing the proposed white paper and now the proposed bill is the fact that there continues to be a missing link in our understanding about cannabis education and why changes are being pushed forward although there are a lot of talking about a liberalized market I think it's important to also highlight that essentially changes are coming about because of the negative effects created by policy in the first place and I go back to education and harm reduction which is completely inexistent when it comes to cannabis it's only applied for heroin and cocaine used intravenously and I think most countries that are now moving towards a less criminal approach should also look at education and provide young people but also adults who maybe might be using particular substance and not in a positive or in a less harmful way and try to reach out to these people and speak with them in an open and without the risk of being labeled as criminals or being labeled by society as being I don't like to use these words but a pot head or a stone and these are the things that within the community are accepted but when they're used from outside the community the only aim is to humanize the person and unfortunately silence the person up I think two other challenges which will probably be faced by countries is how the authorities will adapt to the new legislative approach and how they will deal with these new changes and also the potential of a commercial takeover as we have seen in medicinal cannabis there has been a great lobby by the pharmaceutical industry who practically also influenced a lot how the law would be drafted and at the end patients I'm talking here from Malta from this perspective ended up not being given enough space and recognition for why they need and how they should access medicinal cannabis and I fear that if there is a corporate takeover also on this side of from the recreational side of cannabis we could end up with a sec with another alcohol and tobacco industry creating much more even bigger challenges than than the actual cannabis or a decriminalized system person so I think these overarching issues should be taken into consideration especially but important most importantly the fact that this is most decriminalized systems try to keep the person especially heavy users away from the criminal component and if needed they can be diverted to health services or others services but importantly to keep away the person from the horrible process of going through courts and the delays and the potential being end up imprisoned once more statistics maybe if I may add if I can give a number for example this year in Malta between January and July a total of 209 cannabis seeds were confiscated by the police so the persons being found with seeds will be prosecuted in front of the court and cannabis plants there were confiscated 39 plants however interestingly enough only five cannabis joints were retrieved by the police and this is interesting because obviously we're in a lockdown so no events were taking place so obviously it's much more difficult to find people consuming cannabis in public however the amount of plants confiscated and seeds and in my opinion are indicative of a still criminalized and the prohibitory perspective apart from the law. Okay great. So I hear there particularly the challenge of for those countries that wish to continue some form of prohibition they recognize that there should be a very different response to users and traffickers and certainly in my work the question of quantity thresholds is an absolute perennial debate but also this idea that giving a message to society that now our values are changing what what used to be prohibited is now maybe less prohibited or perhaps even allowed and certainly that's one of the questions that many states have had over the years. How can we say that we're reducing the penalty and yet we don't want to say that we're fully condoning the behavior and there's a lot of difficulties with that. So let's move on now to question three because I'm aware that we're running late. So we've talked about the past the present now we'll talk about the future, just really quickly pleased from all of you so that we can manage to get in a few questions from our audience but just generally. And what do you see is the possible future scenarios and the implications for policy practice and research. Yeah, I already started to answer the question in the previous question I see a, I hope to see a scenario of of increasing regulation with a harm reduction approach I should add to it. This discuss I mean, it's obvious that psychoactive substances have potential risks and harms and we should be aware of that especially towards younger people. But yeah, so I would say that we have reached the point of no return. More and more countries will start to regulate cannabis and hopefully with a harm reduction approach interesting point Karen was making about the corporate capture of the industry I think that is something that should be avoided and that's also part of a harm reduction approach. We have to learn from from tobacco and alcohol in that sense. So yeah I would also be in favor of not to have a huge cannabis companies and if they reach a certain level they should be split up and they should be space for small producers. There should be no advertising and blah blah blah you know all the kind of rules. And like I said, yeah. Europe is a very diverse place. We should recognize that and we should also look at yeah and Europe has all kinds of mechanisms in place to respect that in fact so this is the rules of subsidiarity proportionality. We should apply to cannabis and there should be some countries will regulate others won't. And I think we have to find a common some common scenario there and have a rational discussion how we can best solve that that issue amongst each others and not start all kinds of cruelty or wars around cannabis, or start infringement procedures with that countries are not obeying European law. And to prevent that I really think that in the European Parliament but also in in the Council of Ministers there should be a debate and in the horizontal group for how can we best manage this process so that yeah. That is the wide diversity of Europe is respected. Thank you. Great points. Karen. Where do you see the future. And what us currently is going through a transition so I hope I really hope that to see a more coordinated future in the sense that as members of the European Union, we share beliefs we share principles. However, when it comes to cannabis, even from a medicinal perspective. People with medicines cannot access equally medicine cannabis, for example, but also recreational cannabis so I hope that in the future there will be more considerations for for the rights also people who use drugs in this case. People who use cannabis and therefore balance between personal rights and freedoms and the well being of society, especially from a public health perspective. I also hope that there is better research in the sense that sometimes we tend to assume that cannabis is just one thing. We tend to assume that people use cannabis only in one form, when in reality it's very much different. I hope that research is much more focused and giving giving us better, better picture of why and how people use cannabis. Thank you. That's great. Thank you and talking of research Sabrina, that's your expertise. Speaking of research, as I said, in Europe right now there is a real scarcity of comparable data. And for this reason little work has been performed and mainly focused on a single country perspective. What is necessary is because despite the scarcity of previous studies in Europe because it was an interesting case for conducting this type of research, particularly because the cannabis law reform faced over 20 years in many countries generated a significant variation in the intensity and the trajectory of policy say changes toward and decrease on increase of penalties, which offer an optimal ground for research. Although data access to the implementation and the evolution of policy on the ground are very limited, the recent studies have highlighted the importance of paying attention to the variability of specific policy in provision when trying to evaluate the effect. Instead of using a simple categorization, for example, binary variable to classify legalization and not legalization. And so the challenges in Europe can offer an optimal setting for this kind of study. And in order to be able to really use studies and research to build evidence based policies is necessary to keep the data repository active and reinforce the monitoring work carried out by MCDGA because this is the only home of all the very real comparable data about cannabis, all the cannabis indicators. And we need to ensure the integration of different data sources in order to re-understand what is going on and how policy can affect in order to use of cannabis. Thank you so much. I'm going to stop sharing. So there's a lot of points raised there definitely the need to move forwards to some regulation that works at least for individual countries and those countries will have to come to agreements with their neighbors or not to bother their neighbors certainly all neighbors are concerned about about cross-border leakage. The idea of corporate capture we're aware that there are several Canadian companies now listed on the New York Stock Exchange worth quite several billion dollars at the moment and those numbers have gone up and down over the years but they're worth a lot of money they can afford to pay a lot of lobbyists. There is the risk very much of corporate capture, particularly coming from those wealthy North American countries. But also I'm aware from EMCDA the need for new data the monitoring and illicit behavior is not the same as monitoring a legal behavior and that some of the data formats that we used would not be used to monitor the consumption of alcohol or the consumption of cigarettes because once something is legally available then behaviors can completely change. But still also I wonder the idea for example you know can a country change its mind later it's there will we know that some of these are experiments that they're moving forward with experiments. And there's a big caution. So some have used the expression putting the genie back in the bottle which the films I watched you could do with a simple command. Whereas other people use the expression putting the toothpaste back in the tube and I haven't seen any films where people have managed to do that. So there's a lot of concern about if a country does make a change and it eventually evaluates that change and comes to the conclusion it didn't work. Is it possible to change back again. And there's a lot of hesitance there amongst policymakers as to how they might either move back or change different aspects of their policy. But certainly at least now partly through EMCDA and general the scientific discussion of addictions and addictions policy. We're seeing more and more countries trying to measure their policies trying to monitor their policies and understand if as was earlier mentioned if the implementation of the policy actually matches the initial desires. I'm going to say thank you very much to my colleagues there for answering those questions that we set you and I'm now going to try and open and excuse me if I don't get this completely right open the questions in the chat. And, and have a look to see some of the different ideas that are coming up here. Certainly there's a there's a nice point there made about mental health services are mental health services prepared for any increase of use of cannabis for recreational purposes. And that's something which is traditionally not been very well funded by public health systems. Another question is looking at the measurement of harms that we talk about the harms from drug use but at the same time, is there any acknowledgement of the harms from enforcement against drug use. And certainly these were questions raised more famously in North America, where some of the more recent states who've been legalizing have stated that they're doing it specifically for reasons of social justice. And the, the other, another one that I see here is the different forms of regulation that we can talk about regulation we can talk about legalization. And I think this was touched on as well in the recent discussions that there are many things to be adjusted. Even at EMCBA when we look at national level. We know, for example, as, as Tom mentioned in the Netherlands, it's not all of the, all of the municipalities in the in the Netherlands that have the coffee shops. There's only if I remember correctly, it's something like 100 out of 350 municipalities. So when we're comparing the some municipalities which do have coffee shops against national statistics on drug use, is this the correct comparison to make. And it was stated again that in the US states again, each an individual state may have a law saying that it's possible. But we know that several counties and cities within the states opt out to not allow cannabis consumption or cannabis sales in those areas. So how are we going to understand with our different data sets, what is really working, what is not. But from the different points raised, do my colleagues here have anything extra to add. If I may, please. I do also address the issue of what we see now. It's all domestic regulations out in the Netherlands does this Germany does that. It's all domestic so as not to bother neighboring countries and try to defend cross border leakage. The effect is that while countries are regulating you see the particularly in the Netherlands, where the government is even obliging producers in the experiment to produce hashish, which was never produced in in the Netherlands was always imported from and you see now that basically that market, it will be closed down. Although it's an illicit market, it's still 20 to 25% of that market, and that will have devastating consequences for the tradition of cannabis cultivators in Morocco and Lebanon. So I would also, if there is regulation and that is also a reason why regulation should be not only domestic or national but in a broader context, these communities that have supplied the market for decade and have suffered the consequences are not left out. They should also benefit from the emerging markets, whether medical or recreational and they should have their fair share in those in those new markets. I fully agree with Tom, especially if you look at how other commodities or substances have been taken over by leading countries are leading companies and unfortunately the the producers who have been traditionally cultivating and manufacturing cannabis in this case will be left out. This has already happened in the Caribbean. In Jamaica, I think other islands have experienced a similar structural violence in a way because people who have been so negatively affected by policy now have been left out of policy that should be correcting the wrongdoings of the past. And from a Mediterranean perspective, I think to risk having thousands of households not having their work continued because their market is closed, in this case Europe will also create other problems related to social and internal displacement of people who will have to leave to find other means of survival. And I think this consideration should also be taken on board when we discuss cannabis from a regional perspective. Great, thank you. I've got another point raised in the questions here, which is that there are claims that the legalization is a means to curb the black market. Yet certainly we've seen from different US states and Canada, I think also Uruguay, whose system has been running now for five or six years, that there is no magical disappearance of the black market. Is it correct that we then have a system of legal supply and illegal supply running in parallel? Or should we forget this idea of reducing or removing the black market? What do you think? I think it will be very difficult to completely eliminate the black market because there is always a parallel economy and a parallel market for most commodities in life. However, when countries regulate, they reduce the market for this particular lose, but also the potential of risks for users. And I think apart from looking at the bigger picture, how to attack these criminal organizations, it's also important to look at the end results of why we should try to disrupt criminal organizations, but also what could be the consequence when they provide a substance or a particular crop, in this case cannabis. Yeah, maybe also to add to that, it's also how we design the transition from the illicit market towards the illicit market. And with the benefit of hindsight, you could maybe say that in Canada, not enough effort has been made to include the already existing growers for the illicit market. And that has been done better, instead of all these new corporations that started, maybe that transition would have been faster than it now is. It's still, it is this transition, it's slowly the legal market is taking over the illicit market, but it's also how you design that transition period. The Europe should learn from that. There are a lot of influences, one of the companies who is now allowed into the experiment used to be an illicit grow. I think that is a good example. And of course, there are some conditions that should not be involved in violent crime and whatever, but most cannabis parties are not. So yeah, I think an important lesson. That's why I said it's important to understand who is a trafficker, and who is a criminal, and who is a user who is a grower. Because as the law stands right now, every consumer, if above 3.5 grams in Malta, for example, is a criminal. So if the transition and the law is not does not reflect this reality, there is a risk that yes, it will not really be well, well designed. Okay. Thank you colleagues. I'm going to have to draw this to a close now because I think we're we're running out of time. We're all I think very well aware that we could talk for hours if not days on this topic because many experts have for many years. And we certainly wouldn't come to a universal solution, but this is the point of emcda at least to discuss to come to common understandings, and also probably to recognize that different people different countries have different values, and they will judge them accordingly and reach their own solutions accordingly. As we do in Europe already, if I remember correctly the motto. And we cannot hear you. There is some issues with the with Brandon connection right on the end. So while we wait for Brandon being able to connect again I inform you that unfortunately the director hasn't make in time for concluding this webinar. In a few minutes I will launch a poll to ask the opinion of our audience. And in the meanwhile, I can already says what Brandon was saying, we were not able to answer all the questions we had in the questions and answers. What we do in general is that we collect the question and then we let them have to our including Alexis is here. I'm trying to make him a panelist so that he can give some here it is. And here he can speak to us now. Can you read me. Yes, we can. Yes, I don't know if you can see me but at least you can hear. We see a nice picture anyway. Wait a minute. Go ahead. Yes, one second. I'll try to find how to connect. In fact, I am in Paris airport. So it's a bit. Now we cannot hear you any longer. Alexis. So what we do with the questions that remain unanswered is that we let them have to the speakers so that you can. Through emails go on with this discussion, we will have more webinars on cannabis. Shirley one about the low THC products that we can find already in the market and the next one on the medical cannabis. I hope Alexis is connecting to audio. Yes, now we can hear you. Sorry. What I was saying I'm just in Paris airport so apparently my connection is not fantastic. But still I managed to follow most of the webinar. And as I said, I want to thank and to congratulate all the speakers Sabrina Karen and Tom. I want to thank and congratulate also Brandon Marica and all the MCD colleagues. Let's make a summary of the summary, but I would like to do I like a few points. The first is as Sabrina said, we need more research. And certainly on two areas related to cannabis policy, not only but certainly to one is the evaluation of the policies. I think one of the biggest difficulties is when when you attend some international conferences. Almost any setting. The speakers or most of the speakers they come to tell you a success story. And it's like everything is perfect. And of course there is like in Colorado eight billions dollars invested by the private industry. But officially there is no impact on us. But it cannot be true. I cannot imagine that the private sector private companies invest the total of eight billion dollars in the new industry and pretend to lose money to lose customers and to reduce consumption. So this means that we need to facilitate and that's one of the roles of the MCD we need to facilitate the debate, but also to help clarify situation clarify position. To really allow a better understanding. And for that we need research, not only about prevalence or impact. We need much and better research on evaluation. And also we need more and better research for the make medical use of cannabis. I don't enter into detail here, but you probably know that at MCD we we tend to avoid to speak about medical cannabis because we don't speak about medical Bob up or whatever we use when we speak about medicine. It's about one specific substance or a group of substances like the use of morphine to treat pain caused by cancer among children. And I think we have a big lack of data and information about existing or potential therapeutic opportunities. Actually, not only with cannabis, but with the MDMA ketamine and many other substances as as they are new and recent research showing the the other point that I found very interesting in the in the discussion today is that basically found very interesting that we we all understand and agree that whatever is being decided at policy level. I think there is a growing awareness, not everywhere, not at the same speed diversity like Tom said is very big, but I think it is the wealth of Europe or diversity. So we should learn from that is the fact that they are they are really the different options, different opinions, different ways to do the things and and but still there is a growing awareness in Europe, at least that we want to reduce the risks for the users, because one of the negative assessment for some only repressive policies is exactly about what is the impact for the users who, by the way, are all citizens too. So that's that's an important point and and probably in some of the debates for legalizing or decriminalizing or not of cannabis, for instance, the notion of the risk for the users is sometimes forgotten. And and honestly, I already expressed including at the European Parliament that I would find very worrying if the move if there is one day or they will certainly be a move towards changes for for cannabis policy, including among the you member states. I think that this would not be a good sign. If this moved was completely based only on the pressure of the cannabis industry. And as it was said by some of you, there is already in the US, a very strong lobby industry lobby and referring to to what Tom was saying about the importance to whoever to maintain or keep the access for small producers. If you remember, for those of you who attended the last least born addiction conference, there was a specific session on that. And from the the evaluation that was made by colleagues working in California, for instance, in California there was a component in the policy that was aiming at just ensuring the diversity of the market. And it has been the total failure. And at the end, it's the big cannabis bit like big tobacco that that was prevailing. I don't know what is the situation today so so all of that to say that the webinar today and the next webinars and activities. We are going we are going to continue to work on this. We are preparing the publication of futures report a report on the, what are the the future trends. What's 2013 the drugs field, and you will not be surprised if we have identified and we will present in that report and in the toolkit among the emerging trends in the drugs field to specific trends that are related to our discussion today, evolving policies and changing regulatory framework so this meeting is not the end of the story is just the beginning. Once, once again I want to congratulate and thank the three speakers. This was extremely useful, extremely interesting. One of you and Brandon with the challenging task to summarize and move forward the discussion. You helped us to clarify for all the audience, some of the key issues the key challenges the key concepts without entering into to ideological debate immediately. More and better evidence and more critical reflection. That's our mission and we will continue to do that with you and I hope to be able to visit you when I will be able to visit again your country in the near future. Thank you. Thank you Alexis. Thank you very much Alexis. I'm sorry I had. That's what we usually call technical difficulties, but thank you very much to everybody who has attended and listen. Thank you so much to our panelists for giving us all your different views your different perspectives. Thank you so much for giving us an evidence that we have on these questions. For me what I was starting to say before my own computer cut me off is that whatever it is, we really need to watch this to monitor and to encourage some kind of neutral countries to understand that whatever was the purpose of their change, whether it's decriminalization whether it's criminalization, stopping youth taking drugs, allowing money to be earned as in North America, or allowing police to concentrate on what they think is serious crime. Always, these have to be monitored they have to be checked, and progress has to be made in the right direction. We can't continue simply talking about ideas, and then not checking that we're getting towards our ideas. Thank you so much to everybody. We really appreciate it.