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Cannabis Rescheduling: a Global Introduction by Dania Putri

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Cannabis Rescheduling: a Global Introduction by Dania Putri Briefing paper October 2020 Cannabis rescheduling: A global introduction By Dania Putri Executive Summary Background: Cannabis and the UN Following its first-ever critical review of cannabis, in Jan- drug scheduling system uary 2019 the World Health Organization issued a collec- Around the world, most national legislations relating to tion of formal recommendations to reschedule cannabis the consumption, production, and distribution of can- and cannabis-related substances. 53 member states of nabis and cannabis-related substances are rooted in the the Commission on Narcotic Drugs (CND) are set to vote current global drug control system as institutionalised on these recommendations in December 2020. by the three main UN drug conventions.1 Over 300 sub- stances listed under these conventions are subject to Among the WHO’s recommendations, two in particular varying degrees of control depending on the categories appear to be the most urgent: namely recommendation in which they have been scheduled, ‘defined according 5.1 (concerning the acknowledgment of cannabis’ me- to the dependence potential, abuse liability and thera- dicinal usefulness) and recommendation 5.4 (concerning peutic usefulness of the drugs included in them’.2 It is the need to remove the term ‘extracts and tinctures of thus crucial to note that these UN drug conventions ex- cannabis’ from the 1961 Convention). Supporting these ist to ensure the global (legal) trade in, production, and two recommendations presents an opportunity for gov- use of controlled substances for medical and scientific ernments and civil society to further reform and decol- purposes, while aiming to prevent diversion to the il- onise drug control approaches across the globe, as well legal market which typically caters to non-medical and as to strengthen the international legal basis for existing non-scientific or recreational needs. and emerging medicinal cannabis programmes in differ- ent parts of the world. From the moment that the 1961 Convention was first negotiated, cannabis has been included in the most re- In this regard, the recommended principle ‘asks’ for advo- strictive sections – Schedule I and IV – along with drugs cates and policy makers are to: such as heroin and fentanyl. Schedule IV in particular is • Support the most urgent recommendations 5.1 and designated –incorrectly, in the case of cannabis– for sub- 3 5.4. stances with limited ‘therapeutic advantages’. However, one of the essential chemical components of cannabis, • Actively engage with CND members, emphasising the dronabinol/Δ9-tetrahydrocannabinol (THC), is listed sep- urgent nature of recommendations 5.1 and 5.4. arately in the less restrictive Schedule II of the 1971 Con- vention.4 • Actively engage in relevant meetings and processes at the CND level, as well as emphasising the need for fur- As reiterated by experts of various backgrounds, the ther follow-ups to the critical review. manner in which substances are categorised and con- • Actively engage and encourage support from other trolled at the UN level is largely based on cultural and governments and key regional stakeholders, as well political ideologies, rather than on impartial scientific 5 relevant civil society organisations, experts, and affect- assessment of each substance’s potential harm for its ed communities. users and their surroundings. In fact, the level of health and social harms of cannabis (as well as other strictly controlled drugs such as LSD and MDMA) is proven to be NGOs attending the opening ceremony of the UNGASS on drugs, 19th April 2016, New York 1 lower than others currently placed in the same cate- The WHO’s first ever critical review gory (cocaine, heroin), and also lower than legally reg- of cannabis ulated substances like tobacco and alcohol (Figure 1).6 As mandated by the UN drug conventions, the World Health Organization (WHO) Expert Committee on Drug Dependence (ECDD)13 serves as a body whose task is to assess a substance’s potential harm and me- dicinal usefulness, primarily from a public health per- spective, and to provide scheduling-related recom- mendations for member states at the UN Commission on Narcotic Drugs (CND). Being among the first substances (together with coca and opium) scheduled under international control, cannabis has never been subjected to a WHO critical review until 2018. The results of this first-ever critical review of cannabis were published in January 2019, along with a list of recommendations for the resched- uling of cannabis and cannabis-related substances (Figures 2 and 3). Figure 1: Relative harms of selected psychoactive substances (source: Wikimedia Commons)78 Main implications of the WHO’s Furthermore, as articulated by the WHO, ‘prepara- recommendations tions of cannabis have shown therapeutic potential for treatment of pain and other medical conditions Cannabis remains in Schedule I of the such as epilepsy and spasticity associated with mul- 1961 Convention tiple sclerosis’9 – to name only a few. By early 2020, over 30 countries have developed some kind of legal The WHO’s assessment shows that cannabis does not framework for the legal use of medicinal cannabis. pose ‘the same level of risk to health of most of the other drugs that have been placed in Schedule I’.14 As reflected in global trends,10 cannabis remains the However, the WHO recommends keeping cannabis in most widely used illegal substance on the planet, Schedule I of the 1961 Convention, on the basis of ‘the while cannabis is also illegally grown by millions of high rates of public health problems arising from can- people in rural areas with few other viable alternative nabis use and the global extent of such problems’.15 livelihoods.11 In most countries, the (restricted) status This is not a robust argument for keeping cannabis in of cannabis corresponds to that prescribed by the UN Schedule I, as the basic test for recommending the in- drug conventions, and hence the continued punitive clusion of a substance in either Schedule I or Schedule approach to cannabis consumption, trade, and pro- II of the Convention is the ´similarity principle´, that duction. In recent years, however, a growing number is, whether the substance is ´liable to similar abuse of countries, from Uruguay and Canada to South Afri- and productive of similar ill effects as the drugs in ca and Thailand, have adopted different forms of leg- Schedule I or Schedule II’ or is ´convertible´ into one islative changes to regulate cannabis cultivation and of those drugs.16 use, for either medical or adult non-medical purpos- es.12 Credit: Jasper Hamann Credit: 2 Figure 2: WHO recommendations on cannabis and cannabis-related substances (source: UNODC) 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) 1961 Single Convention on Narcotic Drugs Schedule I Schedule II Schedule III Schedule IV Substances that are highly Substances that are less ad- Preparations with low Drugs also listed in Sched- addictive and liable to dictive and liable to abuse amounts of narcotic drugs ule I with “particularly abuse or easily convertible than those in Schedule I that are exempted from dangerous properties” and into those (e.g. opium, (e.g. codeine, dextropro- most control measures little or no therapeutic val- heroin, cocaine, coca leaf, poxyphene) placed upon the drugs ue (e.g. heroin, carfentanil) oxycodone) they contain (e.g. <2.5% 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 easily * CBD preparations with 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 particularly posing a serious threat to posing a serious threat to posing a minor threat to 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. LSD, ue (e.g. amphetamines) value value (e.g. tranquillizers, MDMA, cathinone) (e.g. barbiturates, bu- diazepam) Dronabinol (Δ9-THC) prenorphine) Tetrahydrocannabinol (Moved to Schedule 1 (Moved to Schedule 1 1961) 1961) 3 Having recognised explicitly that this is not the case, However, this recommendation goes contrary to the it is hard to understand why the WHO would still rec- WHO‘s previous critical reviews of dronabinol/Δ9- ommend the inclusion in Schedule I.
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