Doctors Nova Scotia recommendations on cannabis legalization

Today, Doctors Nova Scotia released six recommendations to encourage the province to take a population health approach to cannabis legalization. The recommendations aim to minimize the harms associated with cannabis use.

“Our recommendations are heavily influenced by organizations and leading experts on the topic,” said Dr. Tim Holland, chair of the association’s Policy and Health Issues Committee. “It’s clear that cannabis availability and use must be carefully considered.” 

Health Canada data from 2012 indicates cannabis is the most commonly used illegal drug in Nova Scotia. Lifetime use of cannabis by Nova Scotians is 42.4 percent, the highest provincial usage in Atlantic Canada and the fourth highest in Canada.

According to the Nova Scotia Student Drug Use Survey 2012: Technical Report (Dalhousie University), the percentage of junior and senior high school students who have used cannabis has remained relatively unchanged since 1996, hovering between 32.1 and 37.7 percent. Students in grades 7, 9, 10 and 12 in Nova Scotia reported past year usage at 34.7 percent. In this population, cannabis use more than once per month was reported by 16.2 percent of males and 12.4 percent of females. 

Doctors Nova Scotia believes it will be important to restrict cannabis use in public places and restrict its availability, similar to the approach taken with tobacco, yet not to the degree that it triggers underground sales. 

“Our province has made great strides to protect youth from tobacco use; the result has been decreased rates of tobacco use among youth and adults alike. We don’t want cannabis to normalize the act of smoking, which would likely have the negative result of increased rates of cannabis and tobacco use,” said Dr. Holland.

Following are the association’s six recommendations, which were informed by physicians from across the province.

Recommendation #1: Cannabis should be distributed and sold through government monopolies where the primary objective is protecting public health and safety, not revenue generation. This distinction should be recognized in legislation. 

Recommendation #2: Establish and invest in the necessary infrastructure to appropriately administer a government monopoly system and enforce restrictions.

Recommendation #3: Establish a pricing and taxation structure designed to curb demand for cannabis. Initially, pricing should maximize purchase from the legal market, but over time pricing should be adjusted. Base price on Delta-9-tetrahdrocannibonal (THC) concentration and/or set maximum THC concentrations. Finally, develop a taxation system that supports prevention strategies, and prohibit discount pricing, happy hour pricing, bulk purchasing, coupons and giveaways.

Recommendation #4: Protect youth from cannabis use by means such as establishing the minimum legal age of 21 to enter a cannabis shop, purchase cannabis and/or use cannabis.

Recommendation #5: Implement a comprehensive public education and awareness program aimed at promoting responsible use and preventing cannabis-related morbidity and mortality, such as harms to children and youth exposed to or using cannabis, and cannabis-impaired driving.

Recommendation #6: The initial regulatory approaches put forward by the federal and provincial governments should be cautious. Adjustments can be made as time progresses based on comprehensive monitoring and research. 

The full position paper is available here.