1) Canada is taking a sensible approach to legalizing cannabis by planning in advance, articulating specific goals, developing an evaluation process, and coordinating federal and provincial governments. 2) A report from CAMH advocates for a government monopoly over supply to allow for adjustments to product mix as understanding of harms increases, and argues this approach promotes health equity by reducing arrests of minorities and poor people under prohibition. 3) However, the report is criticized for not adequately recognizing potential benefits of cannabis use or considering whether pleasure should count in policymaking, and relying too much on a health model without considering other social harms.

1. Comments on Canada panel
Peter Reuter
School of Public Policy and Department
of Criminology
University of Maryland
1

2. Introduction
• Canada as a US politics litmus test
• Importance of Canada as first rich nation (OECD
member) to legalize
• As usual Canada more sensible
– “correct, beneficial, rational”?
• Avoiding major trap of for-profit industry
– Irreversibility
– Foolishness of “regulate like alcohol”
• But overly sober
– No recognition of benefits of marijuana use
– Does pleasure count?
2

3. What Canada is doing right
• Planning well in advance
• Articulating specific goals
• Developing an evaluation process
• Co-ordinating provincial and federal govt
• Paying attention to experiences in regulating
alcohol and tobacco
3

4. CAMH Report
• Note that RAND missed the Report for its Vermont study
– Our provincialism
• Advocates for state monopoly
– Inefficiency welcome
– Can adjust product mix as understanding of mairjuana
harms become better understood
• E.g. THC/CBD ratio
• Uses notions of “health equity” in policy choices
– Prohibition generates more arrests of minorities and
poor people
– But the health model is strained
• Other harms: employment, dignity etc.
4

5. Projected outcomes for options
46
Alternative Production
costs
without fees,
taxes or
regulations
Product
quality
assurance
and labeling
Incentive for
legal suppliers
to promote
use harmful to
public health
Retain
prohibition but
decrease the
expected
sanction
Highest Bad Status quo
Allow
distribution only
within small co-
ops or buyers’
clubs
Have the
government
operate the
supply chain
Implement an
alcohol-style
commercial
model

6. Projected outcomes for options
46
Alternative Production
costs
without fees,
taxes or
regulations
Product
quality
assurance
and labeling
Incentive for
legal supplies
to promote
use harmful to
public health
Gov. ability
to restrain
suppliers’
promotion
of harmful
use
Likelihood
to promote
harmful use
Cost or
effort of
gov.
control
efforts
Ability to
generate
state
revenue
Retain
prohibition but
decrease the
expected
sanction
Highest Bad Status quo Debated but
probably
high
None High Very low;
depends
on seizure
and fines
Allow
distribution only
within small co-
ops or buyers’
clubs
Have the
government
operate the
supply chain
Implement an
alcohol-style
commercial
model

7. Projected outcomes for options
46
Alternative Production
costs
without fees,
taxes or
regulations
Product
quality
assurance
and labeling
Incentive for
legal supplies
to promote
use harmful to
public health
Gov. ability
to restrain
suppliers’
promotion
of harmful
use
Likelihood
to promote
harmful use
Cost or
effort of
gov.
control
efforts
Ability to
generate
state
revenue
Retain
prohibition but
decrease the
expected
sanction
Highest Bad Status quo Debated but
probably
high
None High Very low;
depends
on seizure
and fines
Allow
distribution only
within small co-
ops or buyers’
clubs
Highest Okay None Low or not
applicable
None High on
remaining
market
Very low;
depends
on
seizures
and fines
Have the
government
operate the
supply chain
Low or
medium
Very good Low Best Low or
medium
(see
lotteries)
High Best
Implement an
alcohol-style
commercial
model
Very low Good Very high Low Very high Low Fair

8. What is missing? Benefits
• “The overarching purpose should be health promotion
and health protection. This means maximizing benefits
and minimize harms, promoting health and wellness, and
reducing inequities for individuals, families, communities,
and society.”
• Only mention of benefits
– Is there any basis for judging marijuana high as less
legitimate than other risky sources of pleasure?
– Should access be more restricted than for alcohol?
• More of the harms of alcohol are borne by others
• Key to making policy choices
8

9. Wildcard: Legalization’s effect on use
of other substances
48

10. Legalization could be major public health
gain…
• If marijuana consumption is a substitute
for heavy drinking by young males
– Possibly large reductions in violence, crime,
motor vehicle accidents
– Caulkins et al. (2012) estimate 10%
reduction in drinking would offset doubling
of marijuana use in terms of social costs
– Relationship could differ between short-run
and long-run

11. Legalization could be major public health
gain…or loss
• If marijuana consumption is a substitute for
heavy drinking by young males
• If marijuana is complement to heavy
drinking by young males
– Possibly large increases in ….
• Marijuana and smoking highly correlated
– A 1% increase in cigarette smoking might
generate 4,000 excess deaths annually
• It will take a long time till these behaviors
have fully adjusted
– 3 years is surely a minimum
– 10 years might be necessary for prediction

12. Recommendation:
Ban short-term evaluations
• Early and late results may be very
different
– When will parents start to include
responsible marijuana use in parental
duties?
– no-longer forbidden fruit effects
• Possibly large distributional changes
– Across ages (Rosanna Smart findings)
– Across SES (shift downwards w/ lower
prices)