Alcohol and tobacco are more dangerous than illegal substances, according to an Okanagan medical health officer who is endorsing regulation and a public health framework to legalize them.
“It’s absolutely true,” said Andrew Larder, who is based in Kelowna. “Tobacco and alcohol, using very crude measures of health impact, are much worse than some of these other substances. It makes sense to us as health-care professionals and public health practitioners that we use what we have learned from trying to regulate tobacco, trying to regulate alcohol and the failure of prohibition against alcohol in the last century. We need to learn from that and use the evidence we have to take the best possible approach that will ensure the minimum impact of these things on the health of the population.”
Larder said about 17 per cent of all deaths in B.C. are attributable to tobacco, four per cent to alcohol and less than 0.8 per cent to other illegal substances.
The recent Stop the Violence B.C. report calling for regulation of illegal substances like marijuana is very much in line with the Health Officers Council of B.C. discussion paper, Public Health Perspectives for Regulating Psychoactive Substances, released in November that looks into what is effective in controlling substance use and minimizing harm. In it, they argue, current prohibition of some substances have had many failures and harms including accelerating the spread of HIV and hepatitis, overdose deaths, creation and aggravation of health and social problems due to criminalization, stigmatizing and discrimination. The paper also points to prohibition of substances to fuelling the existence of an illegal market that produces crime, violent injuries, deaths and corruption.
The report released last month advocates for a strict regulatory framework and public health approach to legal cannabis sales. It also points out that marijuana use by teens has increased since the 1990s, despite heavy spending on drug enforcement.
“We are not saying it’s safe at all … What we are saying is that there is evidence out there to give us indication of the best way to minimize the harm and damage that is associated with them. That is to regulate them using a public health framework,” said Larder.
According to the medical health officer, there are two extremes: one being the substances are illegal and time is devoted to fighting the people using and giving them criminal records. The other end is the free market.
“Which is how we buy potato chips. Certainly we aren’t advocating either of those, but what we are supporting is a framework really along the lines of how we deal with alcohol and tobacco already,” said Larder.
That includes control over availability of where it is sold, supply, production, quality, age of who can purchase, how it is purchased, prices and taxes. Demand would also be controlled by providing people with information about the impacts and potential harms and risks of using each substance, just as cigarettes have sometimes graphic images on the packaging warning of the dangers of smoking. Larder said enforcement is involved to ensure people can stick within the rules set up in the framework.
“With alcohol and tobacco, there are controls on where it can be used and making sure there are appropriate health and social services to assist people to deal with the health problems that might result from the use and also any social problems that might occur and to have those services available without stigma,” said Larder. “You can tailor the precise details of the framework depending on what we know about health risks associated with using that substance.”
The Medical Officers of B.C. report was designed to be a launching pad of sorts to promote and stimulate discussion on moving away from a purely criminal law enforcement approach to illegal substances to one that is more evidence based.
“We want to try and engage people, provide them with information that will encourage debate that might move us to a place where we do a better job at protecting the population,” said Larder.
