WHO Cannabis Rescheduling and Its Relevance for the Caribbean
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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,