EDITORIAL The Government’s proposal to legalise cannabis in New Zealand: 10 key questions Chris Wilkins, Marta Rychert national referendum on the legal information (eg, price, product range) and status of recreational cannabis use “advice and recommendations” about A and supply in New Zealand will be products from within retail outlets. There held at the next general election in Sep- will be a home cultivation limit of two tember 2020.1 The referendum will involve cannabis plants per person or four plants voting to support or oppose the Coalition per household. Social sharing of up to 14 Government’s recently released fi nal draft grams of cannabis will be permitted. The of the Cannabis Legalisation and Control Bill CLCB will prohibit the public consumption (CLCB).2,3 The Government has indicated that of cannabis; the sale of cannabis products they will conduct a public education cam- with alcohol and tobacco; and any impor- paign in the months leading up to the refer- tation of cannabis. endum to inform voters about the details of 1. What will be the price of legal the proposal.2,3 The aim of this editorial is to highlight a number of key questions arising cannabis? Alcohol and tobacco research has shown from the fi nal CLCB release, and to raise that price is a particularly strong infl uence wider issues relating to the regulation and on level of consumption and related harm, enforcement of the proposed legal cannabis and, contrary to popular belief, heavy and market that go beyond the Bill. Our purpose younger users are particularly sensitive is to stimulate public discussion and inform to price.4–6 Cannabis is essentially a basic the upcoming public education campaign. agricultural crop, and drug policy analysts We believe the questions raised will be of have suggested that under legal production interest to readers regardless of whether conditions its price could conceivably fall they currently support or oppose cannabis to a fraction of the current black market legalisation. price.7 The price of legal cannabis in US Overview of the Cannabis states has declined by as much as 50% Legalisation and Control Bill since legalisation, refl ecting economies As proposed by the CLCB, the purchase of scale of legal production and growing and use of cannabis will be restricted to market competition.7–9 The CLCB includes those 20 years or older (two years older a provision to set an excise tax on different than the alcohol purchase age). There will cannabis products based on weight and THC be a daily purchase and possession limit content, but no indication of the level of the of 14 grams of cannabis per user. Sales respective product excise rate (cl269(2)). of cannabis will be restricted to licensed The key question is will the cannabis excise physical stores only (ie, no mail order be similar to beer (approx. 10% retail price) or internet sales), and there will also be and wine (15%), or more like the excise rate separate licensed public consumption on spirits (38%) or tobacco (76%)? A high premises for those who cannot consume at legal price for cannabis will reduce legal home (eg, people in shared living arrange- consumption and harm, and may make ments or renters). Advertising will be non-commercial legal home growing more banned except for the provision of objective attractive. Conversely, high legal prices NZMJ 22 May 2020, Vol 133 No 1515 ISSN 1175-8716 © NZMA 9 www.nzma.org.nz/journal EDITORIAL may encourage purchasing from the black types. Furthermore, given the evidence of market. Yet, the legal cannabis market cannabis concentrates overseas, are these will provide a range of advantages beyond products consistent with the harm reduction strictly price, including convenience, safety objectives of the CLCB? and the absence of legal risk. Legal cannabis 3. How strictly will retail outlets be regimes that place too high a priority on reducing the black market will encourage regulated? Alcohol and tobacco research has shown weak regulatory regimes that generate high that higher outlet density and longer health costs.10 opening hours are associated with higher One way to address declining prices in levels of consumption and harm.5,15,16 Similar legal cannabis markets is to mandate a set results have been found for proximity to minimum price per unit, as has been imple- medicinal cannabis dispensaries.15,17,18 New mented in some countries for alcohol. The Zealand’s recent attempt to establish a CLCB includes a provision to raise the excise regulated commercial market for so-called for cannabis for a maximum period of 12 “legal highs” under the Psychoactive months if the price falls too much (cl263(2)). Substances Act 2013 (PSA) highlighted a However, the power is discretionary, time number of issues with retail outlets.19 The limited, and has no set minimum price for PSA required the development of Local when it would be activated. Approved Products Policies (LAPP) that set 2. What will be the maximum minimum physical distances between stores potency of products? and sensitive sites such as schools (often Historically, the THC level of cannabis 500 metres), but the PSA did not include any plant material from the black market has limits on the number of outlets or opening 19 been around 5–10%, but enhanced hydro- hours. As a consequence, some central ponic cultivation techniques have produced Auckland legal high stores operated on a 20 potencies as high as 15–20%.11,12 In US legal near 24-hour basis. cannabis markets, new cannabis concentrate Under the CLCB, the central government products with THC levels of over 50–60% Cannabis Regulatory Authority is tasked with have become increasingly popular.9,14 developing local license premise policies for Studies of higher potency cannabis, every district and city council in the country including concentrates, have found higher (ie, 67 territorial authorities in total). These risk of psychosis, psychosis relapse and policies will provide guidance with respect dependency.13,14 The CLCB includes a to the location and opening hours of retail maximum THC potency of cannabis plant of outlets (cl16(2)) and must take into account 15% THC (Schedule 8). This cap appears to the characteristics of the territory, location of be at the higher end of the levels currently sensitive sites (eg, schools, churches, sports found in the black market. The CLCB also facilities) and whether a retail outlet will includes provision for the sale of cannabis reduce the “amenity and good order” of the edibles and extracts (concentrates), but territory (cl16(3)). The Authority is required indicates these products will initially not be to “consult” with “local persons and groups approved (Schedule 7). The CLCB includes who may be affected” and local government potency levels for these products (Schedule authorities (cl16(6)(7)), but it is not clear 8), but they are expressed as milligrams “per what role local government will play and unit” and “per package”, and these terms the infl uence these local groups will have. are not defi ned. Furthermore, the potency During the PSA, there were a number of caps outlined in the CLCB do not appear to instances where there was a clear disconnect apply to home grown cannabis, creating between central government licensing of the potential for social sharing of higher legal high outlets and local government and potency products and leakage to the black community concerns about these outlets, market. The possibility of future concentrate indicating the need for early engagement and edible sales raises the question of what and communication of policy aims between will be the cap on potency on these product central and local government.19,21,22 NZMJ 22 May 2020, Vol 133 No 1515 ISSN 1175-8716 © NZMA 10 www.nzma.org.nz/journal EDITORIAL 4. Which government agency will to issue an infringement notice than administer the new sector? proceed with an arrest under the previous approach.25 Cannabis users were also The CLCB establishes the Cannabis Regu- continued to be convicted and imprisoned latory Authority to regulate the new regime for non-payment of infringement notices.26,27 but does not state which government agency One way the CLCB could improve the like- will administer the new legal recreational lihood of payment of infringement fees is cannabis sector. This will be key to how to lower the fees set for infringements and/ the sector is perceived and regulated.23 or provide non-fi nancial resolution options, Government agencies with any kind of such as attending a cannabis education economic development mission (ie, business, session or completing community work. innovation or tourism agencies) will place greater emphasis on facilitating cannabis 6. How will purchase and business growth and jobs. For example, the possession limits be enforced? gaming machine regime is regulated by the The CLCB proposes a daily cannabis Ministry of Internal Affairs and they have purchase limit of 14 grams per day shown a willingness to respond to the needs (considered by offi cials to be suffi cient for of the gaming industry.24 Alternatively, a a week of regular use) (cl29). It is not clear health agency is more likely to focus on the how such a daily purchasing limit will be adverse health outcomes from cannabis use. enforced in practice without a real-time 5. How will the cannabis retail system that includes all retail outlets infringement scheme be operated? and collects personal identifying infor- mation from buyers to prevent them The CLCB includes provisions for civil purchasing the maximum daily quantity infringement fees of $200–$500 (NZD) for from multiple retail outlets. In Uruguay, a exceeding the 14-gram personal possession biometric system requires registered buyers or purchase limit, exceeding the personal to submit a thumbprint before making a plant cultivation limit, and for public use purchase.28,29 In New Zealand, police already and public cultivation (Part 3).