Looking for a relationship between cannabis use and penalties
Looking for a relationship between cannabis use and penalties
Corresponding author: Brendan Hughes
European Monitoring Centre for Drugs and Drug Addiction, Cais do Sodré, 1249-289 Lisbon, Portugal.
Telephone +351 211 210 211
Fax +351 213 584 441
Names, addresses and positions of all authors:
Brendan Hughes, Senior Scientific Analyst
Paul Griffiths, Scientific Director
Roland Simon, Head of Unit Interventions, Best Practice and Scientific Partners
João Matias, Scientific Assistant
All authors work for the European Monitoring Centre for Drugs and Drug Addiction, Cais do Sodré, 1249-289 Lisbon, Portugal.
Summary box
What is already known on this subject?An international literature review of cannabis policy (longitudinal or cohort) studies in 2003 found “the weight of the evidence leans towards a lack of connection” between formal policy and prevalence. However, many single-country studies lack controls, while cohort studies lack before-after measurements; both struggle with regional context. This longitudinal study provides a multi-country context using comparable data,and removes any suspicion of intentionto support or discredit a particular legal change.
What does this study add?We now know that, within a defined region and limited time period, countries’ cannabis use rates may change in ANY direction following a change to the penalties established in law. Therefore it would not be correct to attribute any change in prevalence to the law without other evidence. Policymakers considering changing penaltiesfor cannabis use or possessionshould not be overly concerned with the subsequent changes in prevalence (“sending a message”) when discussing the costs and benefits of the various options available.
Abstract:
Background: It is widely claimed that the threat of punishment deters cannabis use, and that a reduction of penalties in the law can send the wrong message to the general public. Thus, penalties are implicitly assumed to have a direct causal association with drug use rates.
Methods: Cannabis prevalence was used to conduct simple before-after studies on those European countries who had varied their drug use or possession penalties in the period 2000-2008. Eight countries were identified with legal changes, whether increasing or decreasing penalties, together with general population surveys providing estimates of drug use.
Results:No association could be observed between the legal changes and the drug prevalence estimates of the countries examined before and after the changes. Across the eight countries we see all possible permutations; increases in penalty are followed by increases and decreases in use, and decreases in penalty are followed by increases and decreases in use.
Conclusion: As the UNODC calls for public health rather than law enforcement responses to drug users, legislators may consider a wider range of policy options for managing cannabis consumption, and reduce the current emphasis on considering how consumption may be affected by changing penalties in the law.
Introduction
The level of cannabisuse in the population is a perennial topic of public health concern.In 2008 and 2009, the International Narcotics Control Board expressed concern that decriminalisation of cannabis for personal use “would send the wrong message to the general public”.[1], [2]Drug control laws and penalties, as one of the main tools of policymakers to control drug use, are implicitly assumed to be causally related to prevalence rates; a “harsher” law would deter and result in lower prevalence, while a “softer” law would result in, or even encourage, increased drug-taking, thus limiting policy options. Yet those who argue for policy change claim there is no such link.[3] We decided to test this hypothesis by examiningnational cannabis use rates before and after penalty changes in different countries.
Methods
The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has been monitoring drug laws and drug use prevalence for over ten years across Europe.[4],[5] During that time, legal changes have taken place inmany of these countries regarding the laws prohibiting personal use of drugs, and so Europe is a natural laboratory for this study; where these countries have also reported cannabis use prevalence estimates from general population surveysbefore and after the legal changes, we overlaid the two types of data to see if the associationhypothesised above is observable.This is a standard technique. A review of methodologies of evaluations of drug law changes worldwide found that 14 out of 18 evaluations of laws changing the penalty for personal use chose before-after prevalence data as an indicator to measure outcomes,[6] and the authors of a cohort studynoted that “further studies that examine prevalence before and after policy shifts would be illuminating”.[7] The added advantage of using the EMCDDA figures for our study is that they provide a set of examples of change occurring within a broadly similar geographical and temporal context.
This overview considers last year prevalence of cannabis use as the most appropriate temporal measure available.Lifetime prevalence would not show a noticeable change in the general adult population in the short term, and last-month prevalence ratesmay disproportionately reflect consumption patterns of the regularusers, who may beless amenable to legal changes. The age range of 15-34 was chosen as drug use prevalence rates are higher in this age group than in groups of older adults.
Results
In the period 2000-2008, eightcountries changed their legal sanctions for illegal drug possession/use and had corresponding before-after cannabis use prevalence estimates. We chose to include one country (Portugal) even though the first estimate was collected during, not before, the year of the legal change.
Six of the eight countries reduced the maximum sanction or severity of the offence. In Finland, in 2001 an amendment to the Penal Code reduced the maximum penalty for a minor narcotics offence from two years in prison to six months, allowing the prosecutor to deal with the majority of cases with a fine.[8] In Hungary, in 2003 the criminalisation of drug consumption per se was removed from the Penal Code.[9] In Greece in 2003, the maximum penalty for drug use was reduced from five years to one year for a first offence.[10] In the UK, in 2004 cannabis was reclassified from Class B to Class C,lowering maximum penalties for simple possessionfrom five to two years’ imprisonment, and national police guidelines were issued not to arrest but to give an informal warning if there were no aggravating circumstances.[11] A change of the Criminal Code in Slovakia in 2005 widened the definitionof “possession for personal use” from one tothree doses of any illicit substance, while leaving the maximum punishment (three years) unchanged.[12] In Portugal, decriminalisation of all drug use-related offences took place in 2001.[13]
Two of the eight selected countries increased the severity of the sanction. In Denmark, a legal change inMay 2004 set outthat the normal response for minor drug possession offences should be a fine, rather than a warning.[14] In Italy at the end of 2006, the maximum duration of the administrative sanction was increased from four months for the “harder”illicit drugs to one year for any illicit drug.[15]
We then looked at the corresponding last year prevalence estimates for cannabis in surveys conducted before and after the legal changes. These showed increases in Finland, from 4.9% in 2000 to 7.1% in 2002; in Slovakia, from 12.1% in 2004to 14.7% in 2006; and in Italy, from 16.5% in 2005 to 20.3% in 2008. In Portugal, only a very small change was seen, from 6.3% in 2001, the year of change, to 6.7% in 2007. Survey data showed decreases in last year prevalence in Hungary, from 7.7% in 2003 (the year of change) to 5.7% in 2007; in Greece, from 8.8% in 1998 to 3.2% in 2004; in the UK (England and Wales), from 20% in 2003 to 17.9% in 2005; and in Denmark, from 13.1% in 2000 to 12.5% in 2005.
This initial before-after comparison between two data points did not yield any firm support for the hypothesis of impact of the legal changes on subsequent cannabis last year prevalence rates. We then investigatedfurther by taking into accounttrends in national prevalence figures over a longer period.To aid interpretation, the trends in last year cannabis use prevalence rates pre/post change are plotted over time (see Figure 1). Countries that reduced penalties are represented by a solidline, while countries that increased penalties are represented by adottedline, and last year cannabis use trend lines are re-alignedaround the year of legal change.
[Figure 1 about here]
The legal impact hypothesis wouldpredict that the dotted lines would fall and the solid lines would rise after the change. However, no suchassociationcan be observedwithin the data. Across the eight countries we see all possible permutations; increases in penalty are followed by increases and decreases in use, and decreases in penalty are followed by increases and decreases in use. Therefore, changes in legal penalties for drug use or possession, whether increasing or decreasing the penalties available, do not seem to be associated with observable changes in cannabis prevalence within the time period.
Discussion
These findings are in line with other available studies that suggest changes in legal sanctions do not directly impact on prevalence levels.[16] The findings alsohighlight the importance of multi-country analysis; it might be suggested that the legal change influenced users in Slovakia and Finland, and possibly in Denmark and Portugal, but taken as a group, there is no association.
This analysis has many limitations. The confidence intervals of the surveys are not included, and therefore minor increases or decreases may not constitute a statistically significant change. The small number of data points available in some of the countries prevented any further meaningful statistical analysis.Data is lacking to control for the penalties most likely to be given to users;a change of law may not affect the most likely choice of disposal by the judicial system.[17] We cannot measure public perception of the change (“mixed messages”). InEurope, cannabis is primarily smoked as resin mixed with tobacco, and public smoking bans were implemented from 2004 onwards in many European countries.[18] Finally, a fully comprehensive analysis would consider the results in all permutations of age groups, substance types and patterns of use. Nevertheless, given that arguments made to support changes in drug legislation often rely on the interpretation of prevalence data, these results have important implications.
Our findings are particularly relevant in light of the observation by the UN’s Office on Drugs and Crime (UNODC)in the World Drug Report 2009 that “resources that could have been focused on [traffickers] are often wasted on the opportunistic arrest and incarceration of large volumes of petty offenders”; a timely comment given the expense of criminal justice systems and the current pressure on public finances. Such resources could also have been focused on the health sector. The report goes on to illustrate the Portuguese decriminalisation model of drug control that falls within the 1988 UN drugs convention parameters but ismanaged by the Ministry of Health.[19]In September 2010, the new UNODC Executive Director has repeated that “drug users need humane and effective treatment - not punishment”.[20]
The policy debate in this area sometimes appears to revolve almost exclusively around concern that lowering penalties may result in increased use, which may thenlimit the policy options - and associated resource allocation -under consideration. Yet the data presented here suggest that neither moderate increases or decreases in penalties appear to result in observable changes in prevalence levels, at least in the medium term.We would hope that thefindings of this study might encourage legislators to consider a wider range of policy options for managing cannabis consumption, and to reduce the current emphasis on considering how consumptionmay be affected by changing penalties in the law.
Competing interest: None declared.
[Provenance:]
Brendan Hughes, Paul Griffiths, Roland Simonand João Matias all work for the European Monitoring Centre for Drugs and Drug Addiction ( the EU’s drug agency tasked to provide objective and reliable information on the topic. BH has monitored national drug laws for 9 years, PG is the Scientific Director, RS is the Head of the Interventions Unit, andJM has monitored drug population surveys for 6 years. BH designed the concept and drafted the article, which was then finalised by all authors. The data is taken from the official national reports of the drug situation that EU Member States must send to EMCDDA annually. BH is the guarantor.
Figure 1. Last year cannabis use prevalence rates, re-aligned around year of penalty change.
Note: Legal changes took place 2001-2006
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