Schools of Population Health and Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Department of Psychiatry, University of Toronto, Toronto, Canada.
Drug Alcohol Rev. 2020 Jul;39(5):555-567. doi: 10.1111/dar.13087. Epub 2020 May 20.
Non-medical cannabis policies are changing, including towards legalisation-with-regulation frameworks. New Zealand will hold a public referendum on cannabis legalisation in 2020. We reviewed data on cannabis use and health/social harms; policy reform options; experiences with and outcomes of reforms elsewhere; and other relevant considerations towards informing policy choices in the upcoming referendum.
Relevant epidemiological, health, social, criminal justice and policy studies and data were identified and comprehensively reviewed.
Cannabis use is common (including in New Zealand) and associated with risks for health and social harms, mainly concentrated in young users; key harms are attributable to criminalisation. 'Decriminalisation' reforms have produced ambivalent results. Existing cannabis legalisation frameworks vary considerably in main parameters. Legalisation offers some distinct advantages, for example regulated use, products and user education, yet outcomes depend on essential regulation parameters, including commercialisation, and policy ecologies. While major changes in use are not observed, legalisation experiences are inconclusive to date, including mixed health and social outcomes, with select harms increasing and resilient illegal markets. It is unclear whether legalisation reduces cannabis exposure or social harms (e.g. from enforcement) for youth.
IMPLICATIONS/CONCLUSIONS: No conclusive overall evidence on the outcomes of legalisation elsewhere exists, nor is evidence easily transferable to other settings. Legalisation offers direct social justice benefits for adults, yet overall public health impacts are uncertain. Legalisation may not categorically improve health or social outcomes for youth. Legalisation remains a well-intended, while experimental policy option towards more measured and sensible cannabis control and overall greater policy coherence, requiring close monitoring and possible adjustments depending on setting-specific outcomes.
非医用大麻政策正在发生变化，包括朝着合法化和监管框架的方向发展。新西兰将于 2020 年就大麻合法化举行全民公决。我们审查了有关大麻使用和健康/社会危害的数据；政策改革方案；其他地方的改革经验和结果；以及其他相关考虑因素，以便为即将到来的公决提供政策选择的信息。
确定并全面审查了相关的流行病学、健康、社会、刑事司法和政策研究及数据。
大麻使用很普遍（包括在新西兰），与健康和社会危害风险相关，主要集中在年轻使用者身上；主要危害归因于刑事定罪。“非刑事化”改革产生了矛盾的结果。现有的大麻合法化框架在主要参数上有很大差异。合法化提供了一些明显的优势，例如规范使用、产品和用户教育，但结果取决于基本的监管参数，包括商业化和政策生态。虽然使用情况没有重大变化，但迄今为止，合法化经验尚无定论，包括健康和社会结果喜忧参半，一些危害增加，非法市场仍然活跃。目前尚不清楚合法化是否会减少年轻人的大麻接触或社会危害（例如来自执法）。
含义/结论：目前还没有关于其他地方合法化结果的明确总体证据，也没有证据可以轻易转移到其他环境。合法化对成年人有直接的社会公正效益，但总体公共卫生影响尚不确定。合法化可能不会明确改善年轻人的健康或社会结果。合法化仍然是一种意图良好的实验性政策选择，旨在实现更有针对性和更合理的大麻控制，并实现更大的政策一致性，需要根据具体情况进行密切监测，并可能根据具体情况进行调整。
