WHO Cannabis Rescheduling and Its Relevance for the Caribbean

Briefing paper

August 2020

WHO cannabis rescheduling and its relevance for the Caribbean

By Vicki J. Hanson, Pien Metaal and Dania Putri*

Executive Summary • Actively engage with CND members, in particular Jamaica, the only English-speaking Following its first-ever critical review of Caribbean member of CND, emphasising cannabis, in January 2019 the World Health the urgent nature of recommendations 5.1 Organization (WHO) issued a collection of formal and 5.4. recommendations to reschedule cannabis and • Actively engage in relevant meetings and cannabis-related substances. 53 member states processes at the CND level, as well as of the Commission on Narcotic Drugs (CND), two emphasising the need for further follow- of which are Caribbean states, are set to vote on these recommendations in December 2020. ups to the critical review. • Actively engage and encourage support from Among the WHO’s recommendations, two other Caribbean governments and other key in particular appear to be the most urgent stakeholders such as CARICOM and OECS, and relevant for Caribbean countries: as well relevant civil society organisations, namely recommendation 5.1 (concerning experts, and affected communities. the acknowledgment of cannabis’ medicinal usefulness) and recommendation 5.4 (concerning Background: Cannabis and the the need to remove the term ‘extracts and UN drug scheduling system tinctures of cannabis’ from the 1961 Convention). Supporting these two recommendations Around the world, most national legislations presents an opportunity for Caribbean relating to the consumption, production, and governments and civil society to decolonise distribution of cannabis and cannabis-related drug control approaches in the region, as well substances are rooted in the current global drug as to strengthen the international legal basis for control system as institutionalised by the three 1 emerging medicinal cannabis programmes in main UN drug conventions. Over 300 substances several Caribbean countries. Also, it provides the listed under these conventions are subject to historical opportunity to gain global recognition varying degrees of control depending on the for two deeply rooted and unique traditions: categories in which they have been scheduled, the use of cannabis as sacrament in religious ‘defined according to the dependence potential, Rastafarian practise, and its use as traditional abuse liability and therapeutic usefulness of the 2 medicine, particularly but not exclusively by the drugs included in them’. It is thus crucial to note Maroon community. that these UN drug conventions exist to ensure the global (legal) trade in, production, and use of In this regard, the recommended principle ‘asks’ controlled substances for medical and scientific for Caribbean advocates and policy makers are to: purposes, while aiming to prevent diversion to • Support the most urgent recommendations the illegal market which typically caters to non- 5.1 and 5.4. medical and non-scientific needs.

* An adapted version of the TNI- IDPC briefing paper note for Africa by Dania Putri. 1 From the moment that the 1961 Convention As reflected in global trends,9 cannabis remains was first negotiated, cannabis has been included the most widely used illegal substance in in the most restrictive sections – Schedule I the Caribbean region, and especially but not and IV – along with drugs such as heroin and exclusively in Jamaica, where cannabis is grown fentanyl. Schedule IV in particular is designated – by rural communities with few other viable incorrectly, in the case of cannabis – for substances alternative livelihoods.10 In most Caribbean with limited ‘therapeutic advantages’.3 However, countries, the (restricted) status of cannabis one of the essential chemical components of corresponds to that prescribed by the UN drug cannabis, dronabinol/Δ9-tetrahydrocannabinol conventions, and hence the continued punitive (THC), is listed separately in the less restrictive approach to cannabis consumption, trade, and Schedule II of the 1971 Convention.4 cultivation. In recent years, however, a number of Caribbean countries have adopted different As reiterated by experts of various backgrounds, forms of legislative changes to regulate cannabis the manner in which substances are categorised cultivation, with Jamaica leading the way as the and controlled at the UN level is largely based first Caribbean country to decriminalise small- on cultural and political ideologies, rather than scale cultivation for personal use and ceremonial on impartial scientific assessment5 of each usage. Other countries have taken, or are taking, substance’s potential harm for its users and their steps to allow cannabis production for medical, surroundings. In fact, the level of health and industrial, and/or research purposes, most social harms of cannabis (as well as other strictly controlled drugs such as LSD and MDMA) is notably St. Vincent and the Grenadines, which proven to be lower than others currently placed granted an amnesty to cannabis growers and in the same category (cocaine, heroin), and also designed a cannabis licencing system seeking the 11 lower than legally regulated substances like inclusion of traditional cannabis farmers. 6 tobacco and alcohol (Figure 1). The WHO’s first ever critical Figure 1: Relative harms of selected psychoactive review of cannabis 7 substances (source: Wikimedia Commons) As mandated by the UN drug conventions, the World Health Organization (WHO) Expert Committee on Drug Dependence (ECDD)12 serves as a body whose task is to assess a substance’s potential harm and medicinal usefulness, primarily from a public health perspective, and to provide scheduling-related recommendations for member states at the UN Commission on Narcotic Drugs (CND). Being one of the first substances (together with coca and opium) scheduled under international control, cannabis was not subject to a WHO critical review until 2018. The results of this first- ever critical review of cannabis were published in 0 10 20 30 40 50 60 70 January 2019, along with a list of recommendations Furthermore, as articulated by the WHO, for the rescheduling of cannabis and cannabis- ‘preparations of cannabis have shown therapeutic related substances (Figures 2 and 3). potential for treatment of pain and other medical conditions such as epilepsy and spasticity associated with multiple sclerosis’8 – to name only a few. By early 2020, over 30 countries have developed some kind of legal framework for the legal use of medicinal cannabis. 2 Figure 2: WHO recommendations on cannabis and cannabis-related substances (source: UNODC)13

WHO recommendations on cannabis and cannabis-related substances 5.1 Delete cannabis and cannabis resin from Schedule IV 5.4 Delete extracts and tinctures of cannabis from of the 1961 Convention Schedule I of the 1961 Convention

5.2.1 Add dronabinol and its stereoisomers (delta-9-THC) to 5.5 Add a footnote on cannabidiol preparations to Schedule I of the 1961 Convention Schedule I of the 1961 Convention to read: 5.2.2 If 5.2.1 is adopted: “Preparations containing predominantly cannabidiol and Delete dronabinol and its stereoisomers (delta-9-THC) not more than 0.2 per cent of delta-9- from Schedule II of the 1971 Convention tetrahydrocannabidiol are not under international control”

5.3.1 If 5.2.1 is adopted: 5.6 Add preparations containing dronabinol, produced Add tetrahydrocannabinol to Schedule I of the 1961 either by chemical synthesis or as preparations of cannabis that are compounded as pharmaceutical Convention preparations with one or more other ingredients and in such a way that dronabinol cannot be recovered by 5.3.2 If 5.3.1 is adopted: readily available means or in a yield which would Delete tetrahydrocannabinol from Schedule I of the constitute a risk to public health, to Schedule III of the 1971 Convention 1961 Convention

Figure 3: Implications of WHO recommendations on cannabis and cannabis-related substances (source: TNI)

WHO recommendations cannabis-related substances 1961 Single Convention on Narcotic Drugs

Schedule I Schedule II Schedule III Schedule IV

Substances that are highly Substances that are Preparations with low Drugs also listed in Sched- addictive and liable to less addictive and liable amounts of narcotic drugs ule I with “particularly abuse or easily converti- to abuse than those in that are exempted from dangerous properties” ble into those (e.g. opium, Schedule I (e.g. codeine, most control measures and little or no thera- heroin, cocaine, coca leaf, dextropropoxyphene) placed upon the drugs peutic value (e.g. heroin, oxycodone) they contain (e.g. <2.5% carfentanil) codeine, <0.1% cocaine) Cannabis and resin Cannabis and resin Extracts and tinctures Certain ‘pharmaceutical + Tetrahydrocannabinol preparations’ containing + Dronabinol (Δ9-THC) dronabinol from which the Δ9-THC cannot be * CBD preparations with easily recovered <0.2% THC not under control

1971 Convention on Psychotropic Substances

Schedule I Schedule II Schedule III Schedule IV

Drugs with a high risk of Drugs with a risk of abuse Drugs with a risk of abuse Drugs with a risk of abuse abuse posing a particular- posing a serious threat to posing a serious threat to posing a minor threat to ly serious threat to public public health, with low or public health, with mod- public health, with a high health, with little or no moderate therapeutic val- erate or high therapeutic therapeutic therapeutic value (e.g. ue (e.g. amphetamines) value value (e.g. tranquillizers, LSD, MDMA, cathinone) (e.g. barbiturates, bu- diazepam) Dronabinol (Δ9-THC) prenorphine) Tetrahydrocannabinol (Moved to Schedule 1 (Moved to Schedule 1 1961) 1961)

3 Main implications of the WHO and the isomers should be deleted from the 1971 recommendations Convention (recommendations 5.2.2 and 5.3.2).19 Acknowledgement of cannabis’ Exempting preparations containing medicinal usefulness (recommendation cannabidiol (CBD)20 with <0.2% THC from 5.1) international control (Recommendations The current status of cannabis in Schedule I of 5.4 and 5.5) the 1961 Convention means that cannabis is Following recommendations to keep cannabis in 14 considered ‘highly addictive and liable to abuse’. and add dronabinol/Δ9-THC into Schedule I of The additional mention of cannabis in Schedule the 1961 Convention, the WHO also recommends IV of the 1961 Convention implies that cannabis (5.4) deleting the term ‘extracts and tinctures of 15 contains ‘particularly dangerous properties’ cannabis’ from Schedule I of the 1961 Convention. with little or no therapeutic value. The WHO In this regard, the WHO recommends (5.5) recommends (5.1) the removal of cannabis including a footnote stating that non-psychoactive from Schedule IV, which, if adopted, would CBD-containing preparations (which technically mean that the medicinal usefulness of cannabis cover ‘extracts and tinctures’) with not more than would be implicitly acknowledged under the 0.2% THC21 are not under international control.22 UN drug control system. However, even if this Such CBD-containing preparations23 could range recommendation is not followed by the CND, from medicinal oil to food and wellness products. Caribbean countries could still move ahead with However, psychoactive ‘extracts and tinctures’ allowing medical cannabis, as the imposition of which typically contain higher levels of THC, such full prohibition for medical purposes has always as butane hash oil and edibles, would still be 16 been optional. In this regard, it is important subject to the same control as other substances to note that the WHO recommends keeping listed in Schedule I of the 1961 Convention. cannabis in Schedule I of the 1961 Convention, even though the WHO’s assessment shows that Less control and restrictions for cannabis does not pose ‘the same level of risk to ‘pharmaceutical preparations containing health of most of the other drugs that have been THC’ (Recommendations 5.4 and 5.6) placed in Schedule I’.17 The WHO’s last recommendation is based on the Moving THC into the 1961 Convention growing legitimacy of approved pharmaceutical (recommendations 5.2.1, 5.2.2, 5.3.1 and products such as Sativex and Marinol, which 5.3.2) ‘are not associated with problems of abuse and At present, dronabinol/Δ9-THC – either natural- dependence and they are not diverted for the 24 ly obtained from plant materials or synthetically purpose of non-medical use.’ According to produced – is placed under Schedule II of the 1971 the WHO, these pharmaceutical preparations Convention. Following their critical review, the – which may contain naturally obtained or WHO now recommends (5.2.1) that dronabinol/ chemically synthesised THC – should be moved Δ9-THC (and six other isomers of THC) is added into Schedule III of the 1961 Convention, though to the stricter Schedule I of the 1961 Convention. it remains unclear what the implications of this This is one of the main consequences of the deci- recommendation (5.6) would be for other ‘natural 25 sion to recommend keeping cannabis in Schedule cannabis extracts with medicinal properties’ I: because of the ‘similarity principle’, THC should – many of which may not necessarily qualify as 26 be included in the same schedule as cannabis, ‘pharmaceutical preparations’ as mentioned by despite the fact that the ECDD in previous critical the WHO. reviews of dronabinol/Δ9-THC recommended it to be scheduled in Schedule II and even III of the 1971 Convention that require substantially less strict controls.18 Only if these recommendations (5.2.1 and 5.3.1) are adopted would CND members then vote on whether dronabinol/Δ9-THC 4 The relevance of these discourse that has long undermined the medicinal recommendations for Caribbean potential of cannabis and reclaim the cultural and countries traditional use of the plant. Out of the 193 UN member states, 53 are selected In most Caribbean small island states, cannabis at any one time to be ‘members’ of the CND;two has a long history of restriction and prohibition. of them are currently from the Caribbean region. It is argued by some scholars that the prohibition At the moment, these countries are Jamaica of cannabis is mainly due to social factors and and Cuba.27 Although all governments are able historical and racial prejudices. A study by Rubin to participate in CND meetings and discussions, and Comitas on ganja (cannabis) in Jamaica only these 53 member states are able to vote highlighted that the Evangelical Churches in on the WHO recommendations on scheduling. 1912 raised the concern that ganja smoking was In December 2020, the CND is set to vote on the resulting in serious social upheaval, because it aforementioned recommendations on cannabis made people behave immorally and without and cannabis-related substances – having already any mental control.29 It was argued then that delayed a vote in both March 2019 and March this type of behaviour was mainly from East 2020 to allow for further consideration. The Indians who had been brought to the island as vote outcomes would be legally binding for all indentured labourers. The study showed that the signatories of the 1961 and the 1971 Conventions laws relating to cannabis became severely and (including Jamaica and all other Caribbean increasingly prohibition-oriented between 1913 states28), requiring states to amend relevant and 1961. The severity of the laws outlawing national drug laws and scheduling accordingly. ganja in Jamaica was also influenced by legislative However, it should be made clear that adopting changes and the global social and economic these recommendations would not necessarily challenges experienced because of the Great obligate national governments to initiate legal Depression of 1938. In 1937 the Marihuana Tax medical cannabis programmes in their respective Act was adopted in the USA, bringing with it an countries. increased public campaign against ganja, which as stated before was already associated with Nevertheless, as we move forward, several deviant behaviour.30 questions arise. How relevant are the WHO’s recommendations for Caribbean countries? What Literature shows that historically cannabis laws would rescheduling cannabis at the UN level mean in the Caribbean sought to discuss how cannabis for Caribbean countries, especially considering regulations impacted the lives of persons in the the origins, historical use and transformation of region, by highlighting the number of cases that cannabis-related policies in the Caribbean? And were brought before the courts in the various could they in the future offer benefits and legal countries.31 It is also notes that the societies alternatives for the thousands of traditional small in the Caribbean did not view the use of ganja farmers in countries like Jamaica, Saint Vincent as a major social problem, and it was not until and the Grenadines, Antigua and Barbuda, after the Opium Conference at The Hague in Saint Lucia and other Caribbean states, who are 1912, that colonial governments in the region currently still dependent on the unregulated decided to prohibit the cultivation and use of the market for cultivating cannabis? plant. Countries that had a strong East Indian culture, such as Guyana and Trinidad and Tobago, Decolonisation of drug control regulated the cultivation, sale and possession The WHO recommendation to remove cannabis of ganja under a licensing system. In the case from Schedule IV of the 1961 Convention (5.1) of Trinidad and Tobago, the “Ganja Ordinance”, may serve as an opportunity for Caribbean civil which was in place until 1928, allowed for the society and governments to further decolonise cultivation, possession and selling of ganja by drug control approaches in the region and granting a licence to those who paid an annual fee recognize the cultural right of groups such as the to the colonial authority.32 The “Ganja Ordinance” Maroons and Rastafarians, which has not been also required the premises from which the claimed at a global level yet, by challenging the ganja would be traded to be registered with the 5 authorities, and outlined several parameters which are more herbal and traditional in nature,36 under which the product could be traded. This such as the Maroons in Jamaica and Guyana. This signalled an existing legal structure within the seems to contradict the renewed importance the cultural fabric of these Caribbean societies with WHO is giving to promoting traditional medicines a strong East Indian component. However, in general.37 continued debate at the international level caused a number of Caribbean countries, such Inevitably, the establishment of legal medicinal as Guyana, Trinidad and Tobago, and Jamaica to cannabis programmes in the Caribbean would change their approach to ganja, even though it yield considerable impact on thousands of rural was culturally accepted.33 working people currently dependent on illegal cannabis cultivation.38 Such communities have so Medicinal cannabis programmes far been largely excluded from the emerging legal Indeed, the colonially rooted discourse that dis- market, and would likely continue to be so should regards cannabis’ medicinal usefulness has slowly the UN drug control regime evolve into an insti- faded in the Caribbean, as more and more coun- tution that increasingly favours large corporations, tries are eyeing the socioeconomic prospect of le- many of which have enjoyed preferential treat- gally regulating cannabis for medicinal, industrial ment in licensing systems of medical cannabis pro- and scientific purposes. Even though the current duction around the world,39 including in Jamaica institutional framework of the UN drug control re- and Saint Vincent and the Grenadines. Given that, gime does not serve as a barrier for such efforts,34 some recommendations of the WHO, particularly transforming the status of cannabis within the UN the transfer of THC from the 1971 to the 1961 Con- drug scheduling system would strengthen the in- vention and 5.5 and 5.6, should be approached ternational legal basis for these emerging medici- with caution. Approving them in their current form nal cannabis programmes. In accordance with this with the extremely low threshold of 0.2% and the development, the CARICOM report ‘Waiting to phrasing ‘pharmaceutical preparations’ appears to Exhale – Safeguarding our Future through Respon- give preferential treatment to big companies over sible Socio-Legal Policy on Marijuana’, completed more traditional cultivation techniques and herbal and presented in 2018, advocates for not only a medicines. On the other hand, support for Recom- medicinal framework, but has also noted in its rec- mendation 5.1 and 5.4 appears more urgent and ommendations that cannabis policies in the region potentially more fruitful, particularly in thecon- should likewise focus on ‘human rights, social jus- text of scientific and policy development on me- tice and development perspectives’.35 dicinal cannabis that is based on public health and The WHO’s recommendation (5.1) to delete can- human rights principles. In support of this, Article nabis from Schedule IV of the 1961 Convention 28 of the 1961 Convention requires countries to appears relevant as its adoption would further establish specialised government agencies respon- legitimatise the international status of cannabis sible for maintaining control over production of as (a source of) medicine. Meanwhile, the WHO’s and trade in medicinal cannabis. recommendation to loosen control measures for certain medicinal preparations (5.4, 5.5, and 5.6) Next steps: timelines and the could in principle constitute another opportunity ‘advocacy asks’ for Cariobbean for Caribbean countries interested in developing governments a domestic (and potentially export-oriented) le- Given the early inclusion of cannabis in the gal cannabis industry. However, governments and international drug control regime, the WHO’s civil society need to remain cautious and ensure critical review of cannabis had long been that the door for the more natural herbal prepa- overdue. While fully respecting the independent rations is not closed via these developments. Fur- and critically important role that the WHO ECDD thermore, the explicit reference to ‘pharmaceuti- plays, many feel that the recommendations cal preparations’ and underlining of products like could have been more far-reaching in nature. Sativex and Marinol in Recommendation 5.6 may Critics have questioned the WHO’s decision not pose challenges for countries with a long histo- to recommend deleting cannabis from Schedule ry of therapeutic use of cannabis preparations I of the 1961 Convention, especially since the 6 WHO’s own risk assessment shows that cannabis society. Member states have also been invited to does not belong there.40 Considering the rapidly make written submissions. advancing scientific research in cannabis, a more This series of ‘Topical Meetings’ will then regular review of the plant would be advisable be followed by a formal CND intersessional to update scheduling considerations with new meeting on 18 September 2020, which should scientific insights about the plant in order to be possible for civil society to attend and request preserve the integrity of the international to intervene. On 12-16 October the WHO Expert scheduling system. Notwithstanding this, the Committee will hold its next meeting, opening political significance of the WHO’s critical review the possibility that they could reconsider some of cannabis is not to be underestimated, nor are of the recommendations if the CND discussions its’ resulting recommendations, which represent have given them convincing arguments of a an opportunity towards the modernisation of social, legal or administrative nature to do so the UN drug control system (and, by extension, (the CND does not have a mandate to challenge of national drug control policies in Africa and the WHO’s medical/scientific assessment). worldwide). In this regard, active engagement from civil society and governments is needed to The 63rd Reconvened CND is then scheduled encourage a positive outcome at the CND. for the 3rd and 4th December 2020 in Vienna,43 where the 53 CND members should finally vote Timeline for advocacy on the WHO’s recommendations. It is possible At the CND in early March 2020, member states for CND members to vote only on certain agreed by consensus to delay a vote and ‘continue… recommendations, and not on others. In this the consideration of the recommendations of regard, priority should be given to the more the World Health Organization on cannabis obvious and urgent recommendations 5.1 (to and cannabis-related substances, bearing in remove cannabis from Schedule IV) and 5.4 mind their complexity, in order to clarify the (to remove the term ‘extracts and tinctures of implications and consequences of, as well as cannabis’ from the 1961 Convention). the reasoning for, these recommendations, and Now it is therefore a key time for civil society ad- decides to vote at its reconvened sixty-third vocacy across the continent to raise awareness of session in December 2020, in order to preserve this ‘live’ process and its importance for Caribbean the integrity of the international scheduling countries. It is important that as many Caribbean 41 system’. governments as possible are engaged in these dis- Member states have continued discussions since cussions, and not just the two CND members from March via informal (closed and unrecorded) con- the region who are able to actually vote. Below we sultations being held online (due to the global propose some of the ‘advocacy asks’ which NGOs 44 COVID-19 pandemic that has taken hold since can bring to their government representatives: the CND was held in March). A series of three so- called ‘Topical Meetings’ have also been sched- Substantive asks: uled to take place on 24-25 June (online again - • Support the more obvious and urgent with a focus on ‘extracts and tinctures’ and CBD), recommendations: 5.1 (to remove cannabis 24-25 August (on THC and preparations) and 16- from Schedule IV, thereby acknowledging 17 September 2020 (on deletion from Schedule its medical usefulness) and 5.4 (to remove IV). These ‘Topical Meetings’ are a new structure, the term ‘extracts and tinctures of cannabis’ but disappointingly appear to remain informal from the 1961 Convention). in nature with no translation, no web-casting or • Question the potential implications of recording, and no invitation for civil society ob- the other recommendations for the servers (as would have been the case for a for- recognition and regulation of traditional mal meeting, according to UN rules).42 However, and herbal cannabis-based medicines, and member states have been encouraged to include request the WHO to amend some details ‘experts’ on their delegations for the ‘Topical accordingly in the upcoming ECDD meeting Meetings’, which can include experts from civil or to reconsider them at a later stage. 7 Process asks: References and endnotes • Emphasise the need for follow ups to 1. The three main UN drug conventions guiding today’s global the critical review, as scientific research drug control system include the UN Single Convention on continues to shed new light on the risks Narcotic Drugs (1961) as amended by the 1972 Protocol, the UN Convention on Psychotropic Substances (1971), and the and benefits of cannabis, especially in UN Convention Against Illicit Traffic in Narcotic Drugs and response to the WHO recommendation Psychotropic Substances (1988). The different categories of to keep cannabis in Schedule I of the 1961 controlled drugs are defined under the 1961 and the 1971 Convention. Convention. 2. United Nations Office on Drugs and Crime (2016), Terminol- • Participate and engage at the CND meetings ogy and Information on Drugs: Third Edition, https://www. related to the WHO’s recommendations unodc.org/documents/scientific/Terminology_and_Informa- tion_on_Drugs-E_3rd_edition.pdf on cannabis and cannabis-related 3. United Nations (1961), Single Convention on Narcotic Drugs, substances, especially in order to support as amended by the 1972 Protocol amending the Single recommendations 5.1 and 5.4, to ensure Convention on Narcotic Drugs, 1961, https://www.unodc. clear voting mechanisms, and to improve org/pdf/convention_1961_en.pdf 4. Six isomers of Δ9-THC are currently placed under Schedule clarity about the WHO’s recommendations I of the 1971 Convention, which is more restrictive than and their implications. Schedule IV of the 1961 Convention. However, in the 41st meeting, the WHO’s Expert Committee on Drug Dependence • Facilitate the participation of civil society, stated: ‘While these six isomers are chemically similar to and in particular of ECOSOC-accredited Δ9-THC, there is very limited to no evidence concerning NGOs, in the forthcoming ‘topical meetings’ the abuse potential and acute intoxicating effects of these on the WHO’s recommendations. isomers. There are no reports that the THC isomers listed in Schedule I of the 1971 Convention induce physical de- • Engage with other governments to discuss pendence or that they are being abused or are likely to be these issues, particularly with the two abused so as to constitute a public health or social problem. There are no reported medical or veterinary uses of these Caribbean CND members: Jamaica and isomers’. Source of citation: World Health Organization Cuba (2019), Annex 1: Extract from the Report of the 41st Expert Committee on Drug Dependence: Cannabis and cannabis-re- • Engage with CARICOM on this issue lated substances, p. 4, https://www.who.int/medicines/ac- to encourage their involvement and cess/controlled-substances/Annex_1_41_ECDD_recommen- coordination, in line with the 2018 report dations_cannabis_22Jan19.pdf on the Cannabis Commission. 5. Government of India (1895), Report of the Indian Hemp Drugs Commission. Finance and Commerce Department, • Actively consult and engage with relevant https://digital.nls.uk/indiapapers/browse/archive/74908458. civil society organisations, experts, and See also: Bewley-Taylor, D., Blickman, T. & Jelsma, M. (2014), The Rise and Decline of Cannabis Prohibition: The History representatives of affected communities in of Cannabis in the UN Drug Control System and Options for Caribbean countries. Reform (Amsterdam: Transnational Institute). https://www. tni.org/files/download/rise_and_decline_web.pdf 6. Global Commission on Drug Policy (2019), Classification of Psychoactive Substances: When Science Was Left Behind. https://www.globalcommissionondrugs.org/reports/classification-psychoactive-substances 7. Wikimedia website, File:HarmCausedByDrugsTable. svg, https://commons.wikimedia.org/wiki/ File:HarmCausedByDrugsTable.svg (Accessed: 22nd June 2020). Data sourced from: Nutt, D., King & L., Phillips, L., ‘Drug harms in the UK: a multi-criteria decision analysis’, The Lancet, 376:9752, DOI: https://doi.org/10.1016/S0140- 6736(10)61462-6 8. World Health Organization (2019), Annex 1: Extract from the Report of the 41st Expert Committee on Drug Depen- dence: Cannabis and cannabis-related substances, https:// www.who.int/medicines/access/controlled-substances/An- nex_1_41_ECDD_recommendations_cannabis_22Jan19.pdf 9. United Nations Office on Drugs and Crime (2019), World Drug Report 2019, https://wdr.unodc.org/wdr2019/ 10. The Jamaica Gleaner (2018), Cannabis Cultivation And Consumption Pattern In Jamaica 2017 – 2018, http://jamaica-gleaner.com/article/news/20180926/briefing-cannabis-cultivation-and-consumption-pattern-jamaica-2017-2018 8 11. Jamaica Observer (2018), St Vincent Parliament approves be chemically synthesised. In its 41st meeting, the WHO legislation decriminalising marijuana, http://www.jamai- ECDD stated that ‘Cannabidiol is found in cannabis and caobserver.com/news/st-vincent-parliament-approves-leg- cannabis resin but does not have psychoactive properties islation-decriminalising-marijuana_152072?profile=1373; and has no potential for abuse and no potential to produce Loops News (2018), Antigua & Barbuda moves to decrimi- dependence’. Source of citation: World Health Organization nalise marijuana for personal use, https://www.looptt.com/ (2019), Annex 1: Extract from the Report of the 41st Expert content/antigua-decriminalises-marijuana-personal-use Committee on Drug Dependence: Cannabis and cannabis- related substances, p. 4, https://www.who.int/medicines/ 12. The ECDD is ‘an independent group of experts in the field access/controlled-substances/Annex_1_41_ECDD_ of drugs and medicines. The ECDD assesses the health risks recommendations_cannabis_22Jan19.pdf and benefits of the use of psychoactive substances accord- 21. Critics have questioned the WHO’s decision to limit the THC ing to a set of fixed criteria. These criteria are: evidence of quantity threshold to only 0.2%, which may pose issues for dependence potential of the substance, actual abuse and/ countries who have set higher THC quantity thresholds for or evidence of likelihood of abuse, therapeutic applications CBD and/or hemp products, including Ghana (0.3%) and of the substance’. Each year in December, ‘[t]he ECDD rec- many European countries such as Switzerland (1%). ommendations are presented by the Director General of the WHO to the UN Secretary General and the United Nations 22. World Health Organization (2019), Annex 1: Extract from st Control Narcotic Board (CND)’ for consideration by the CND the Report of the 41 Expert Committee on Drug Depen- every March. See: World Health Organization website,WHO dence: Cannabis and cannabis-related substances, https:// Expert Committee on Drug Dependence, https://www.who. www.who.int/medicines/access/controlled-substances/An- int/medicines/access/controlled-substances/ecdd/en/ (Ac- nex_1_41_ECDD_recommendations_cannabis_22Jan19.pdf cessed: 22nd June 2020). 23. At its 40th meeting, the ECDD stressed that, ‘[t]here are no 13. United Nations Commission on Narcotic Drugs & United -Na case reports of abuse or dependence relating to the use of tions Office on Drugs and Crime (2020), WHO recommenda- pure CBD. No public health problems have been associated tions on cannabis and cannabis-related substances, https:// with CBD use’ and that ‘CBD has demonstrated effectiveness www.unodc.org/documents/commissions/CND/Scheduling_ for treating at least some forms of epilepsy, with one pure Resource_Material/Cannabis/Backdrop_status_16_January. CBD product (Epidiolex®) found effective in clinical studies pdf of Lennox-Gastaut syndrome (a severe form of epileptic encephalopathy that produces various types of seizures) and 14. Bewley-Taylor, D., Blickman, T. & Jelsma, M. (2014), The Rise Dravet syndrome (a complex childhood epilepsy disorder and Decline of Cannabis Prohibition: The History of Canna- that has a high mortality rate), which are often resistant to bis in the UN Drug Control System and Options for Reform other forms of medication’. See: World Health Organization (Amsterdam: Transnational Institute), p. 23,https://www. (2018), ‘WHO Expert Committee on Drug Dependence: For- tni.org/files/download/rise_and_decline_web.pdf. tieth report’,WHO Technical Report Series 1013, pp. 15-17, 15. United Nations (1961), Single Convention on Narcotic Drugs, https://apps.who.int/iris/bitstream/handle/10665/279948/ 1961: As amended by the 1972 Protocol amending the Single 9789241210225-eng.pdf?ua=1 Convention on Narcotic Drugs 1961 , p. 3. 24. World Health Organization (2019), Annex 1: Extract from the 16. A Party to the Convention is only required to follow the rec- Report of the 41st Expert Committee on Drug Dependence: ommendation ‘if in its opinion the prevailing conditions in Cannabis and cannabis-related substances, p. 7, https:// its country render it the most appropriate means of protect- www.who.int/medicines/access/controlled-substances/An- ing the public health and welfare’. (United Nations (1961), nex_1_41_ECDD_recommendations_cannabis_22Jan19.pdf Single Convention on Narcotic Drugs, 1961: As amended by 25. Walsh, J., Jelsma, M., Blickman, T. & Bewley-Taylor, D. the 1972 Protocol amending the Single Convention on Nar- (2019), The WHO’s First-Ever Critical Review of Cannabis: A cotic Drugs 1961, p. 3.) In other words, if a Party was of the Mixture of Obvious Recommendations Deserving Support opinion that this was not the most appropriate way, it could and Dubious Methods and Outcomes Requiring Scrutiny still decide to permit the cultivation and use of cannabis for (Amsterdam: Transnational Institute),https://www.tni.org/ medical purposes, as many countries indeed have done in en/publication/the-whos-first-ever-critical-review-of-canna- spite of its Schedule-IV status. bis, p. 11. 17. Walsh, J., Jelsma, M., Blickman, T. & Bewley-Taylor, D. 26. The term ‘pharmaceutical preparations’ (with regard to (2019), The WHO’s First-Ever Critical Review of Cannabis: A cannabis) is not mentioned or explained in the UN drug Mixture of Obvious Recommendations Deserving Support conventions, which mainly use the term ‘preparations’. and Dubious Methods and Outcomes Requiring Scrutiny 27. This year, 2 Caribbean States are included and they are Cuba (Amsterdam: Transnational Institute), pp. 7-9, https://www. and Jamaica. ‘In accordance with Council resolution 845 tni.org/en/publication/the-whos-first-ever-critical-review-of- (XXXII), and 1147 (XLI), members are elected (a) from among cannabis, the States Members of the United Nations and members 18. Ibid, pp. 9-10. of the specialized agencies and the Parties to the Single 19. Meanwhile, questions have been raised with regard to the Convention on Narcotic Drugs, 1961, (b) with due regard to possible repercussions of having dronabinol/Δ9-THC and its the adequate representation of countries that are important six isomers in both the 1961 and the 1971 Convention. See: producers of opium or coca leaves, of countries that are United Nations Office on Drugs and Crime website,Decision important in the field of the manufacture of narcotic drugs, tree depicting the conditionalities of the WHO recommenda- and of countries in which drug addiction or the illicit traffic tion on cannabis and cannabis-related substances, https:// in narcotic drugs constitutes an important problem and (c) www.unodc.org/documents/commissions/CND/Scheduling_ taking into account the principle of equitable geographical Resource_Material/Cannabis/Decision_tree_depicting_the_ distribution’. See: United Nations Office on Drugs and Crime conditionalities_of_the_WHO_recommendation_on_canna- website, CND: Membership and Bureau, https://www.unodc. bis_and_cannabis.pdf (Accessed: 22nd June 2020). org/unodc/en/commissions/CND/Membership/Member- nd 20. CBD or cannabidiol is one of the principal chemical ship.html (Accessed: 22 June 2020). compounds found in the cannabis plant. CBD can also 28. International Narcotics Control Board, (2020),Report of 9 the International Narcotics Control Board for 2019, https:// cultivation and alternative development, (Amsterdam: Trans- www.incb.org/documents/Publications/AnnualReports/ national Institute). https://www.tni.org/en/publication/ AR2019/Annual_Report_Chapters/English_ebook_AR2019. connecting-the-dots pdf 39. Jelsma, M., Kay, S. & Bewley-Taylor, D. (2019), Fair(er) Trade 29. Rubin, V., and Lambros C. (1975). Ganja in Jamaica: A Med- Options for the Cannabis Market. Cannabis Innovate, (Am- ical Anthropological Study of Chronic Marihuana Use (The sterdam: Transnational Institute)https://www.tni.org/en/ Hague: New Babylon). publication/fairer-trade-cannabis 30. Ibid. 40. In its 41st report, the WHO Expert Committee on Drug 31. Fraser, H. A. (1974). ‘The Law and Cannabis in the West Dependence states that ‘[w]hile the Committee did not con- Indies’, Social and Economic Studies 23(3):361-385 sider that cannabis is associated with the same level of risk to health as that posed by most of the other drugs placed in 32. Ibid Schedule I, it noted the high rates of public health problems 33. Ibid. arising from cannabis use and the global extent of such 34. The overarching goal of the UN drug conventions is to help problems. For these reasons, it recommended that cannabis regulate the licit trade in, production, and use of controlled and cannabis resin continue to be included in Schedule I of substances (including cannabis) for medical and scientific the 1961 Single Convention on Narcotic Drugs’. See: World uses only. Governments must create and implement regu- Health Organization (2018), ‘WHO Expert Committee on latory policies in compliance with specific articles of each of Drug Dependence: Fortieth report’,WHO Technical Report the three drug conventions, as mapped in this table: United Series 1013, p. 41, https://apps.who.int/iris/bitstream/handl Nations Commission on Narcotic Drugs (2019),Questions e/10665/279948/9789241210225-eng.pdf?ua=1, p. 41. and answers relating to WHO’s recommendations on can- 41. United Nations Commission on Narcotic Drugs (2020),Draft nabis and cannabis-related substances, pp. 96-100, https:// decision submitted by the Chair: Changes in the scope of www.unodc.org/documents/commissions/CND/Schedul- control of substances: proposed scheduling recommenda- ing_Resource_Material/Cannabis/Consultations_with_WHO tions by the World Health Organisation on cannabis and Questions_and_Answers_26_November_2019.pdf cannabis-related substances, UN Doc. E/CN.7/2020/L.8, 35. See: CARICOM Regional Commission On Marijuana (2018), https://undocs.org/E/CN.7/2020/L.8 Waiting To Exhale – Safeguarding Our Future Through Re- 42. For more information on the ‘Topical Meeting’ format, sponsible Socio-Legal Policy On Marijuana, https://caricom. see: International Drug Policy Consortium (2020), Closing org/documents/report-of-the-caricom-regional-commis- doors: the exclusion of civil society at the ‘topical meetings’ sion-on-marijuana-2018-waiting-to-exhale-safeguard- of the UN Commission on Narcotic Drugs. https://idpc.net/ ing-our-future-through-responsible-socio-legal-policy-on-m- publications/2020/08/closing-doors-the-exclusion-of-civil- arijuana/ society-at-the-topical-meetings-of-the-un-commission-on- 36. ‘Cannabis as an herbal medicine poses serious challenges to narcotic-drugs modern medicine, which operates according to the “single 43. United Nations Office on Drugs and Crime (Website),Events , compound, single target” paradigm of pharmacology’. See: https://www.unodc.org/unodc/en/commissions/CND/CND_ Hazekamp, A. & Fischedick, J. T. (2012), ‘Cannabis - from Meetings-Current-Year.html (Accessed: 22nd June 2020). cultivar to chemovar’, Drug Test. Analysis (New Jersey: 44. If you want to learn which government officials and agencies John Wiley & Sons), https://bedrocan.com/wp-content/up- are already engaged in CND discussions from your coun- loads/2012-cannabis-from-cultivar-to-chemovar_hazekamp. try, you can view the official list of participants from the pdf March 2020 meeting here: United Nations Commission on 37. World Health Organization (2013), WHO Traditional Med- Narcotic Drugs (2020),List of Participants: Members of the icine Strategy 2014–2023, https://apps.who.int/iris/bit- Commission on Narcotic Drugs, UN Doc. E/CN.7/2020/INF/2, stream/handle/10665/92455/9789241506090_eng.pdf https://www.unodc.org/documents/commissions/CND/ 38. Jelsma, M. (2018), Connecting the dots… Human rights, illicit CND_Sessions/CND_63/LoP_63_CND_Final_V2001716.pdf

10 About this Briefing Paper About IDPC This Briefing Paper provides an analysis of The International Drug Policy Consortium is a global the recommendations on the rescheduling network of non-government organisations that of cannabis issued by the World Health specialise in issues related to illegal drug production Organisation in January 2019, highlighting and use. The Consortium aims to promote objective their historical context and their and open debate on the effectiveness, direction and implications for Caribbean countries. The content of drug policies at national and international recommendations will be put up for a vote level, and supports evidence-based policies that are at the UN Commission on Narcotic Drugs in effective in reducing drug-related harm. It produces December 2020. briefing papers, disseminates the reports of its member organisations, and offers expert advice to International Drug Policy Consortium policy makers and officials around the world. 61 Mansell Street London E1 8AN, United Kingdom © International Drug Policy Consortium Publication 2020 Tel: +44 (0)20 7324 2975 Email: [email protected] Report design by Mathew Birch - [email protected] Website: www.idpc.net

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