LC LSIC Inquiry into Use of Cannabis in Victoria Submission 1347 Inquiry into the use of Cannabis in Victoria

Dr Vendula Belackova

Organisation Name:Drug Policy Modelling Program, Social Policy Research Centre, University of New South Wales Faculty of Arts and Sciences Your position or role: Adjunct Senior Lecturer

SURVEY QUESTIONS Drag the statements below to reorder them. In order of priority, please rank the themes you believe are most important for this Inquiry into the use of Cannabis in Victoria to consider:: Public health,Young people and children,Mental health,Social impacts,Public safety,Accessing and using cannabis,Education,Criminal activity

What best describes your interest in our Inquiry? (select all that apply) : Academic and research

Are there any additional themes we should consider? Reduction of harms from cannabis use

Select all that apply. Do you think there should be restrictions on the use of cannabis? : Personal use of cannabis should be legal. ,Sale of cannabis should be legal and regulated. ,Cultivation of cannabis for personal use should be legal.,Other – please explain. We argue that neither full prohibition nor full legalisation seem fit for purpose, nor address the concerns around public health. In this submission we advocate for a middle ground option – Cannabis Social Clubs.

YOUR SUBMISSION Submission: The Legislative Council Legal and Social Issues Committee Inquiry into the use of Cannabis in Victoria Parliament House, Spring St EAST MELBOURNE VIC 3002

30th August 2020

Thank you for the opportunity to provide a submission to the Legislative Council Legal and Social Issues Committee Inquiry into the use of Cannabis in Victoria.

Our submission is provided in the attached PDF document.

We would be pleased to expand on any of the points raised in our submission. Please feel free to get in touch if you have any further questions or points of clarification.

Kind regards,

Dr Vendula Belackova Adjunct Senior Lecturer, Drug Policy Modelling Program Social Policy Research Centre UNSW FASS ? UNSW ? Sydney ? NSW 2052 ? Australia

1 of 10 LC LSIC Inquiry into Use of Cannabis in Victoria Submission 1347 E:

Liz Barrett Research Officer, Drug Policy Modelling Program Social Policy Research Centre UNSW FASS ? UNSW ? Sydney ? NSW 2052 ? Australia T: E:

Professor Alison Ritter Director, Drug Policy Modelling Program NHMRC Senior Research Fellow Social Policy Research Centre UNSW FASS ? UNSW ? Sydney ? NSW 2052 ? Australia T: E:

Do you have any additional comments or suggestions?: In case the committee would like to hear our witness to ask further questions or points of clarification, perhaps an online participation would be suitable for Dr Vendula Belackova given that DPMP is located inter-state and pending the situation around the pandemic at the time of the hearing.

FILE ATTACHMENTS File1: 5f4b9836a1ea2-SUBMISSION_Inquiry_into_the_use_of_Cannabis_in_Victoria_DPMP_UNSW.pdf File2: File3:

Signature: Dr Vendula Belackova

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The Legislative Council Legal and Social Issues Committee Inquiry into the use of Cannabis in Victoria Parliament House, Spring St EAST MELBOURNE VIC 3002

30th August 2020

Thank you for the opportunity to provide a submission to the Legislative Council Legal and Social Issues Committee Inquiry into the use of Cannabis in Victoria. The Drug Policy Modelling Program (DPMP) is the leading drug policy research and practice program in Australia. Our mission is to improve government decision-making on drugs. We have been conducting research into drug policy, including cannabis policy, for the last 14 years. In addition, Dr Vendula Belackova who is an adjunct Senior Lecturer with DPMP and co-author to this submission has undertaken extensive research on the harm reduction potential of Cannabis Social Clubs – the focus of our submission. She would be a valuable expert witness to the Inquiry. We understand the Inquiry to be exploring ways in which the harmful consequences from cannabis use can be reduced, how young people can be protected from accessing and using cannabis, and how criminal activity surrounding cannabis can be curtailed. The regulatory solutions are usually cast as either full prohibition, or full legalisation. The former, full prohibition, has been superseded as an option in Victoria, with its successful implementation of de facto decriminalisation of the personal use of cannabis among first time offenders, a significant positive step with no evidence of unintended negative consequences (McLeod Nelson and Associates Pty Ltd, McLeod, Stewart, Meade, & Munro, 1999). The latter, full legalisation, looks appealing as it seems to offer better tools to control the cannabis market when compared to prohibition. Yet, it is still too early to draw conclusions about the actual impacts of cannabis legalisation given the mixed results in terms of its potential harms and impact on cannabis use (Anderson, Hansen, Rees, & Sabia, 2019; Fischer, Daldegan-Bueno, & Boden, 2020; Hall & Lynskey, 2016, 2020; Melchior et al., 2019; Smart & Pacula, 2019). We argue that neither full prohibition nor full legalisation seem fit for purpose, nor address the concerns around public health. In this submission we advocate for a middle ground option – Cannabis Social Clubs. Cannabis Social Clubs are a model of restricted cannabis supply and regulation that have the potential to undermine the black-market supply of cannabis and also to promote the health of people who use cannabis. As such, it is a model that offers a possible solution in terms of:  Preventing young people and children from accessing and using cannabis in Victoria;  Protecting public health and public safety in relation to the use of cannabis in Victoria; and  Preventing criminal activity relating to the illegal cannabis trade in Victoria. We are not alone in thinking that non-profit approaches to cannabis supply should be explored when considering cannabis law reform (Belackova, Roubalova, & van de Ven, 2019; Pacula, 2017; Rolles & Murkin, 2016; Room & Örnberg, 2019; Rychert & Wilkins, 2019; Wilkins, 2018), including Cannabis Social Clubs (Belackova, Tomkova, & Zabransky, 2016a; Decorte, 2018). Cannabis Social Clubs are non-profit, private organisations that organize the collective cultivation and distribution of cannabis in order to meet their members personal cannabis needs (Arana & Sánchez, 2011; Barriuso, 2011; Decorte, 2015; Gartner, Bromberg, Musgrove, & Luong, 2018). Internationally there is great variety among the different models of Cannabis Social Clubs, with some clubs/cooperatives also offering information on safer practices of cannabis use and promotion of harm reduction, advocacy on behalf of members, or provision of private consumption venues (Belackova et al., 2016a; Pardal, Decorte, Bone, Parés, & Johansson, 2020).

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As a closed, non-profit system of cannabis supply and consumption (Pardal, 2018), Cannabis Social Clubs lack commercial incentives to increase consumption and so avoid the excesses of profit-driven systems seen elsewhere. For example, it has been argued that cannabis legalisation as seen in the U.S. states and in Canada has manifested important contradictions with public health policies including that commercial cultivators tend to use unsafe cultivation practices which are hard to regulate (Stone, 2014; Subritzky, Pettigrew, & Lenton, 2017). Additionally the cannabis industry in those countries has been adopting practices similar to the tobacco industry in the past by marketing their products to regular (dependent) users and attempting to circumvent public health policy (Hall et al., 2019; Subritzky, Lenton, & Pettigrew, 2016). Cannabis Social Clubs have therefore been identified as having an outstanding role by occupying important middle ground between prohibition and legalisation (Arana, 2019; Belackova et al., 2016a; Caulkins et al., 2015; Decorte, 2018; Decorte & Pardal, 2017; Wilkins, 2016). Like other models of cannabis regulation, they provide an alternative site for the acquisition of cannabis away from the black market and therefore challenge the dominance of organised crime in cannabis supply (Arana & Sánchez, 2011). Different international models of Cannabis Social Clubs and their regulation The first Cannabis Social Clubs emerged in Spain in 2002 (Barriuso, 2011). There are now reported Cannabis Social Clubs to be present in twelve other European countries - Austria, Belgium, Czech Republic, Germany, Italy, Slovenia, Hungary, Ireland, the Netherlands, Poland, Romania, and United Kingdom (Pardal et al., 2020) as well as in Uruguay, Argentina, Colombia, Chile and Mexico (Bewley- Taylor, Blickman, & Jelsma, 2014; Decorte et al., 2017; Pardal, 2016). Each of these countries has a different history, and a specific legal and regulatory context which influences the forms of Cannabis Social Clubs in operation, leading to a multiplicity of models for any new system to draw from. Uruguay was the first sovereign country in the world to formally legalise cannabis supply, and Cannabis Social Clubs are one of three options for adults there to obtain their cannabis legally (the other two being non-medicinal pharmacy sales produced by a government monopoly and home cultivation) (Queirolo, Boidi, & Cruz, 2016). This makes Uruguay the only country in the world which has fully legalised the operation of Cannabis Social Clubs. Elsewhere the development of Cannabis Social Clubs has mainly relied on decriminalisation policies for personal use, possession and/or cultivation (or legal interpretations of these decriminalisation regimes). In the latter localities where Cannabis Social Clubs have been tolerated rather than legalized, their development has been characterised by a strong presence of self-driven, auto-regulatory processes, resulting in codes of good practices developed by individual clubs or by Cannabis Social Club federations (Belackova & Wilkins, 2018; Jansseune, Pardal, Decorte, & Parés Franquero, 2019; Pardal, 2016). An important step in promoting the model among people who use cannabis has been the adoption of Cannabis Social Club guidelines by a European advocacy group European Coalition for Just and Effective Drug Policies (ENCOD) that aims to assure certain requirements concerning public health and safety are fulfilled by the clubs (ENCOD, 2011). ENCOD regulation includes protocols for Cannabis Social Clubs to recognise problematic consumption (e.g. through initiating conversations with potential members on their cannabis use) and respond appropriately (ENCOD, 2011). Additionally, the regulations require that clubs apply an ‘active policy of prevention of harms and risks, and promotion of safer methods of consumption of cannabis by its members’ (ENCOD, 2011). Internationally, Cannabis Social Clubs have been found to impose self-regulation that reduces risks to public health and safety. This includes strict membership requirements, including limiting membership to adults only (with minimum ages ranging from 18 to 21 years) (Decorte et al., 2017), to nationals or residents (an initiative which is seen to discourage potential ‘cannabis tourism’) (Decorte, 2015; Jansseune, Pardal, Decorte, & Parés Franquero, 2019), and for new members to be endorsed by existing members (Pardal et al., 2020). In many countries there is an expectation that Cannabis Social Club membership is restricted to one club at a time (in order to limit the amount of

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cannabis that can be acquired by one person). While this can be easily ascertained in Uruguay where there is a national agency regulating Cannabis Social Club membership (Decorte et al., 2017), in other countries like Belgium, there is no way for clubs to check this as there is no centralised agency or other formal monitoring body (Decorte, 2015). The amount of cannabis that can be produced and distributed to members is determined by regulation but can also be influenced by member demand (where consumption may be less than the legal limit). In Belgium where personal cultivation is restricted to one plant per person, clubs are limited on the numbers of plants they can grow by the number of their members (Decorte, 2015). Legislation in Uruguay allows up to 480 g cannabis to be grown per member/year and also lets the clubs grow a maximum of 99 plants, with most Cannabis Social Clubs reporting to cultivate between 28 and 99 per cycle (Pardal, Queirolo, Álvarez, & Repetto, 2019). As such, growers in Uruguay were found to produce enough cannabis to supply 40 g per month to each member (Decorte et al., 2017). In Spain, the quantity of cannabis cultivated is determined by the amount consumed by each member per month, with new members predicting their consumption rates upon registration (Decorte et al., 2017). There are a variety of means of cannabis distribution among the clubs, although which system results in the best harm reduction has not been tested. Some clubs dispense in bulk at harvest, via monthly delivery or via delivery on demand (Decorte & Pardal, 2017; Decorte et al., 2017). Other clubs set a maximum daily and maximum monthly amount that can be retrieved by members (e.g. 10 g and 60 g respectively) (Belackova & Wilkins, 2018). One study found that for some people in Uruguay, Cannabis Social Clubs offered a preferential model over other forms of legal cannabis acquisition (pharmacies), due to the clubs offering increased privacy and more stable supply (Pardal et al., 2019). Cannabis Social Clubs and harm reduction Research on Cannabis Social Clubs has highlighted how this model contributes to harm reduction through formal and informal structures. Formally, the presence of guidelines, regulations, or club rules can mandate the provision of harm reduction activities. The ENCOD guidelines have already been mentioned but other guidelines include those produced by CSC Federations in Barcelona who require federated clubs to organise at least two harm reduction events per year such as lectures or talks on the use of cannabis (Jansseune, Pardal, Decorte, & Parés Franquero, 2019). These activities may also take place in the absence of regulation, with the majority of self-identified Cannabis Social Clubs in the EU reportedly sharing information materials with members and holding informative events such as workshops and talks (Pardal et al., 2020). There are other harm reduction aspects to Cannabis Social Clubs as reported in the burgeoning literature:  harmful adulterants (e.g. pesticides) are avoided in the cultivation process because those cultivating are potentially consumers and members of the club/cooperative can hold the cultivation processes to account (Belackova & Wilkins, 2018; Pardal et al., 2019);  adult members can access a range of varieties of cannabis with varying content of THC and CBD and accompanying peer-led education about their effects and safer use (e.g. ability distinguish between sedating and stimulating properties of the different strains which can help to manage impact on mental health) (Belackova et al., 2016a; Belackova, Tomkova, & Zabransky, 2016b; Jansseune, Pardal, Decorte, & Parés, 2019; Pardal et al., 2019);  adult members can access information from the dispensing staff about safer modes of cannabis administration (e.g. medicinal-grade vaporisers, tobacco-free administration) (Belackova et al., 2016b; Jansseune, Pardal, Decorte, & Parés, 2019);  clubs can screen members for health and social issues when people come to acquire cannabis (Belackova et al., 2016a; Pardal et al., 2019).

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One study used a survey among 155 Cannabis social club members in Spain and found that since joining a Cannabis Social Club, the majority of participants did not increase their cannabis use (Parés et al., 2019). Only a small proportion increased (5%) or decreased (6%) their use over time or fluctuated between higher and lower levels of use (14%) (Parés et al., 2019). Finally the very structure of Cannabis Social Clubs is argued to be one that supports harm reduction. Many Cannabis Social Clubs are based on cooperative structures of organisation, with members participating in choices about the varieties of cannabis grown and cultivation practices (Decorte, 2015; Decorte & Pardal, 2017; Pardal et al., 2019, Pardal, 2018). The literature shows that people who use drugs try to obtain the least harmful substances for themselves and their peers (Bancroft, 2017; Belackova, 2020; Belackova & Wilkins, 2018; Southwell, 2010), so models that afford members a degree of choice and control over the product will likely have greater harm reduction effects than those that do not. Additional regulatory considerations Aside from Uruguay, Cannabis Social Clubs are often in a legally precarious situation, being located on the margins of the law where their existence is threatened by attempts to criminalise the model. The clubs can be therefore vulnerable to, and constantly adapting to, changing responses from the authorities (Bewley-Taylor et al., 2014; Decorte, 2015). This uncertain legal situation can trigger deviations from the stated good practice such as when larger volume of cannabis are sought on the black market (instead of cultivated), in order to cater for any cannabis seized by the authorities (Arana, 2019; Jansseune, Pardal, Decorte, & Parés Franquero, 2019). This suggests that Victoria has an opportunity to implement Cannabis Social Clubs that are not legally precarious, ensuring the positive harm reduction activities arising from these cooperatives. Yet experiences from Uruguay also show that in a completely legal setting, well-aimed regulations might be hard to comply with and subject the clubs to financial hardship (Queirolo et al., 2016). For example, some clubs have argued that limiting membership numbers to 45 have made them financially unviable (Queirolo et al., 2016). Previous research has shown that people who use cannabis seem to be willing to work hand in hand with the authorities in developing regulations (Belackova & Wilkins, 2018; Lenton, Frank, Barratt, Dahl, & Potter, 2015; Sánchez & Collins, 2018); this might indeed be the best way to develop a balanced and locally-relevant regulatory framework for Cannabis Social Clubs. Another element lacking across clubs’ harm reduction activities is a coherent quality control and testing system (Decorte et al., 2017). Even in Uruguay where Cannabis Social Clubs and cannabis are legal, formal testing or quality control systems are lacking (Pardal et al., 2019). It is easy to see how regulation could add additional harm reduction value here – for instance through mandating and facilitating the THC levels in cannabis to be checked and requiring that mechanisms for quality control are in place. Much of this could also be self-driven, given the right circumstances. As noted by Belackova & Wilkins (2018), simply giving access to affordable cannabis testing and providing safe cultivating guidance could bind well with the existing objective that the clubs have – to provide a safer supply of cannabis to their peers. A final caveat of Cannabis Social Clubs seems to be the risk of disguised entrepreneurial practices (Belackova & Wilkins, 2018; Pardal et al., 2019). These can compromise the private nature of Cannabis Social Clubs and take advantage from cannabis tourism; to mitigate this problem, non-advertising policies, enhanced transparency to facilitate participation of the members in club matters, and waiting periods between registration of new members and the time when cannabis is first dispensed to them have been suggested (Belackova & Wilkins, 2018; Parés & Bouso, 2015). Conclusion In summary, any potential changes to the current system of cannabis regulation should be considered an experimental policy at this stage and subjected to rigorous evaluation.

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Cannabis Social Clubs have demonstrated themselves as a credible ‘middle ground’ alternative to systems of prohibition and legalisation. This model has the potential to shift cannabis supply away from the black market to private venues with member-only access for adults who use cannabis and as such, decrease cannabis availability for young people and children. Additionally, with the correct legal and regulatory support, Cannabis Social Clubs can enhance harm reduction and limit cannabis supply, therefore protecting public health and safety in relation to the use of cannabis. This is a model worthy of further exploration for Victoria. We would be pleased to expand on any of the points raised in our submission. Please feel free to get in touch if you have any further questions or points of clarification.

Kind regards,

Dr Vendula Belackova Adjunct Senior Lecturer, Drug Policy Modelling Program Social Policy Research Centre UNSW FASS │ UNSW │ Sydney │ NSW 2052 │ Australia T: +61 0401 802 625 E: [email protected]

Liz Barrett Research Officer, Drug Policy Modelling Program Social Policy Research Centre UNSW FASS │ UNSW │ Sydney │ NSW 2052 │ Australia T: +61 (2) 9065 8350 E: [email protected]

Professor Alison Ritter Director, Drug Policy Modelling Program NHMRC Senior Research Fellow Social Policy Research Centre UNSW FASS │ UNSW │ Sydney │ NSW 2052 │ Australia T: +61 (2) 9385 0236 E: [email protected]

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REFERENCES

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Gartner, C., Bromberg, M., Musgrove, T., & Luong, K. (2018). Vape Club: Exploring Non-Profit Regulatory Models for the Supply of Vaporised Nicotine Products. International Journal of Environment Research and Public Health, 15(8). doi:10.3390/ijerph15081744 Hall, W., & Lynskey, M. (2016). Why it is probably too soon to assess the public health effects of legalisation of recreational cannabis use in the USA. The Lancet Psychiatry, 3(9), 900-906. Hall, W., & Lynskey, M. (2020). Assessing the public health impacts of legalizing recreational cannabis use: the US experience. World psychiatry, 19(2), 179-186. Hall, W., Stjepanović, D., Caulkins, J., Lynskey, M., Leung, J., Campbell, G., & Degenhardt, L. (2019). Public health implications of legalising the production and sale of cannabis for medicinal and recreational use. The Lancet, 394(10208), 1580-1590. doi:https://doi.org/10.1016/S0140- 6736(19)31789-1 Jansseune, L., Pardal, M., Decorte, T., & Parés Franquero, Ò. (2019). Revisiting the Birthplace of the Cannabis Social Club Model and the Role Played by Cannabis Social Club Federations. Journal of Drug Issues, 49(2), 338-354. doi:10.1177/0022042618815690 Jansseune, L., Pardal, M., Decorte, T., & Parés, Ó. F. (2019). Revisiting the birthplace of the Cannabis Social Club model and the role played by Cannabis Social Club federations. Journal of drug issues, 49(2), 338-354. Lenton, S., Frank, V. A., Barratt, M. J., Dahl, H. V., & Potter, G. R. (2015). Attitudes of cannabis growers to regulation of cannabis cultivation under a non-prohibition cannabis model. International Journal of Drug Policy, 26(3), 257-266. McLeod Nelson and Associates Pty Ltd, McLeod, J., Stewart, G., Meade, J., & Munro, G. (1999). Evaluation of the Drug Diversion Pilot Program (Vol. A Report prepared for the Drugs and Health Protection Services Branch, Public Health Division, Department of Human Services). Melbourne: State of Victoria. Melchior, M., Nakamura, A., Bolze, C., Hausfater, F., El Khoury, F., Mary-Krause, M., & Da Silva, M. A. (2019). Does liberalisation of cannabis policy influence levels of use in adolescents and young adults? A systematic review and meta-analysis. BMJ Open, 9(7), e025880. Pacula, R. L. (2017). Regulating Medical Mariuana Markets: Insights from Scientific Evaluations of State Experiments Testimony presented before the Florida House of Representatives Health & Human Services Committee, Subcommittee on Health Quality on January 25, 2017. Santa Monica, California: RAND Corporation. Pardal, M. (2016). Cannabis Social Clubs through the lens of the drug user movement. Tijdschrift over Cultuur & Criminaliteit, 6, 47-58. doi:10.5553/TCC/221195072016006002003 Pardal, M. (2018). An analysis of Belgian Cannabis Social Clubs’ supply practices: A shapeshifting model? International Journal of Drug Policy, 57, 32-41. doi:https://doi.org/10.1016/j.drugpo.2018.03.027 Pardal, M., Decorte, T., Bone, M., Parés, Ó. F., & Johansson, J. (2020). Mapping Cannabis Social Clubs in Europe. European Journal of Criminology, 1477370820941392. Pardal, M., Queirolo, R., Álvarez, E., & Repetto, L. (2019). Uruguayan cannabis social clubs: from activism to dispensaries? International Journal of Drug Policy, 73, 49-57. Parés, Ó. F., & Bouso, J. C. S. (2015). Innovation Born of Necessity: Pioneering Drug Policy in Catalonia Lessons for Drug Policy Series (pp. 66). New York: Open Society Foundation. Parés, Ó. F., Jubert-Cortiella, X., Olivares-Gálvez, S., Díaz-Castellano, A., Jiménez-Garrido, D. F., & Bouso, J. C. (2019). Use and Habits of the Protagonists of the Story: Cannabis Social Clubs in Barcelona. Journal of drug issues, 49(4), 607-624. Queirolo, R., Boidi, M. F., & Cruz, J. M. (2016). Cannabis clubs in Uruguay: The challenges of regulation. International Journal of Drug Policy, 34, 41-48. doi:https://doi.org/10.1016/j.drugpo.2016.05.015 Rolles, S., & Murkin, G. (2016). The commercial focus of US cannabis regulation models should not close our eyes to other options. Addiction, 111(12), 2092-2094.

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Room, R., & Örnberg, J. C. (2019). Government monopoly as an instrument for public health and welfare: Lessons for cannabis from experience with alcohol monopolies. International Journal of Drug Policy, 74, 223-228. Rychert, M., & Wilkins, C. (2019). A ‘community enterprise’model for recreational cannabis: Lessons from alcohol licensing trusts in New Zealand. International Journal of Drug Policy, 67, 72-78. Sánchez, C., & Collins, M. (2018). Better to ask forgiveness than permission: Spain’s sub-national approach to drug policy. Policy Brief, 12. Smart, R., & Pacula, R. L. (2019). Early evidence of the impact of cannabis legalization on cannabis use, cannabis use disorder, and the use of other substances: findings from state policy evaluations. The American journal of drug and alcohol abuse, 45(6), 644-663. Southwell, M. (2010). People who use drugs and their role in harm reduction. In T. Rhodes & D. Hedrich (Eds.), Harm reduction: Evidence, impacts and challenges (pp. 101 - 104). Lisbon: EMCDDA. Stone, D. (2014). Cannabis, pesticides and conflicting laws: the dilemma for legalized States and implications for public health. Regulatory Toxicology and Pharmacology, 69(3), 284-288. Subritzky, T., Lenton, S., & Pettigrew, S. (2016). Legal cannabis industry adopting strategies of the tobacco industry. Drug and Alcohol Review, 35(5), 511-513. Subritzky, T., Pettigrew, S., & Lenton, S. (2017). Into the void: Regulating pesticide use in Colorado’s commercial cannabis markets. International Journal of Drug Policy, 42, 86-96. Wilkins, C. (2016). After the legalisation of cannabis: the Cannabis Incorporated Society (CIS) regulatory model for recreational cannabis in New Zealand. NZ Medical Journal, 129(1433), 74-77. Wilkins, C. (2018). A “not-for-profit” regulatory model for legal recreational cannabis: Insights from the regulation of gaming machine gambling in New Zealand. International Journal of Drug Policy, 53, 115-122. doi:https://doi.org/10.1016/j.drugpo.2017.12.002

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