Legal Highs
Welcome to the Cannabis Revolution
By Marco Evers and Laura Höflinger
Ms. Zeng speaks quietly, almost in a whisper, with a strong Chinese accent. How long have you been having trouble sleeping, she asks her customer.
Maybe a few weeks, he replies. Ms. Zeng asks if he feels that cannabis helps him fall asleep.
"Definitely," he replies. The non-medical practitioner then gives him what she gives all her patients, regardless of their symptoms: a prescription for medical marijuana.
A prescription issued by Ms. Zeng allows a patient to obtain medical cannabis in any form at the Canna Clinic. Behind the counter are jars filled with dark-green bundles of various strains of marijuana, from "B52" to "Afghan Kush" and "BC Bud." Cannabis cookies are also on display, along with cannabis-infused honey. Today's special is pre-rolled joints and cannabis chocolates for $2 (€1.8) apiece.
Here in Vancouver, British Columbia, anyone who submits to a pseudo-medical examination can buy as much cannabis as they like. The city is home to a population of some 600,000 and at least 80 specialized stores for cannabis, despite it being illegal in Canada.
So long as the stores don't sell the drug to anyone under-age, they have no need to fear police recrimination. The police answer to the city council, which in a spirit of rebellion decided that Vancouver's finest had better things to do than crack down on cannabis users -- such as tackling heroin or crystal meth.
The border to the US lies to the south of the city. Anyone driving from Vancouver to Seattle, a distance of 230 kilometers, will soon realize that they are witnessing historic change. The era of global prohibition of cannabis is drawing to a close. The road to Seattle is strewn with stores such as the Healthy Living Center and Green Theory (nominated "Best Cannabis Store" by Dope Magazine).
These days, Seattle itself boasts more marijuana stores than McDonalds. In Uncle Ike's Pot Shop, located next door to a church, over a dozen friendly sales assistants jostle to service the customers.
The store sells a range of cannabis products to smoke, eat and imbibe, as well as highly intoxicating leaves to mild ones, cannabis ointments and massage oils.
The police only intervene if someone lights a joint in public. As of July 8, 2014, adults over 21 in the US state of Washington are legally permitted to use cannabis in private. The same is true in Colorado, Alaska and Washington, D.C. A similar law is set to come into effect in Oregon soon and another will likely be introduced in California next year.
These developments seem surprising given that the US once declared a "war on drugs." It is now at the forefront of liberalizing cannabis -- its third most popular addictive substance, after alcohol and tobacco. For the first time ever, the majority of the population now believes that it should be made legal. Many expect that this is where the whole country is headed over the next five years.
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The Situation in Germany
What's happening is nothing less than a revolution, and one that will likely have repercussions around the world. Including in Germany, where debate about reconsidering drugs policy is still very much in its infancy.
A SPIEGEL survey shows that for the time being, a majority of Germans (59 percent) want to see cannabis remain illegal. Nevertheless, support for continued prohibition is dwindling, especially among young people and the highly-educated.
The Green Party, the Left Party and the pro-business Free Democratic Party (FDP) have already come out in favor of legalization. City governments in Hamburg, Cologne, Berlin and Frankfurt are pushing for controlled legalization in a bid to shrink black markets in troubled neighborhoods. A growing number of doctors, police officers and lawyers also support lifting the cannabis ban. Not because they deem it harmless -- but because legalizing it would make it easy to contain the harm it can do.
Hubert Wimber recently retired after serving for nearly 18 years as chief of police in Münster, a student town where cannabis use is widespread. He is all too familiar with the vagaries of the German Narcotic Drugs Act. "We have had no success with it whatsoever," he says.
Although the daily drudgery of fighting drugs was relieved by the occasional coup -- cleaning out a basement cannabis plantation or arresting a dealer -- their impact was always neutralized almost immediately. A new basement plantation would be grown, a new dealer would go into business.
Now that he's retired and no longer needs to abide by the rules, Wimber wants to help start a drugs revolution in Germany. He's planning to open a German chapter of Law Enforcement Against Prohibition (LEAP), which he hopes will attract similar-minded police, lawyers and judges just as it did in the US, where it originates.
Its "professionality," Wimber hopes, will ideally spur debate on how to proceed against drugs in Germany. "The billions wasted on tackling and penalizing drugs use would be better spent on education and prevention," says Wimbers. For now, there is by no means majority support for his approach among German police chiefs. "Being rational doesn't get you far with this issue," he says.
The pro-legalization camp's main argument is this: Given that the cannabis ban has failed completely to eliminate the drug, damage-limitation is the second-best solution for governments. The state should regulate the drugs market much like any other, tax it, decriminalize its users and focus on public health and consumer protection.
A Global Shift
Countries all over the world are in the process of revising their policy on cannabis. So far, Uruguay is the only country to have introduced wholesale legalization of the growing and selling of cannabis. Spain and Portugal, the Netherlands and the Czech Republic have introduced such sweeping legalization measures that an outright lifting of the ban is only a step away.
The UN General Assembly Special Session on Drugs (UNGASS) is set to convene in April next year. A major breakthrough could be in the cards. One thing is clear: that a global consensus on a cannabis ban no longer exists.
Former UN secretary general Kofi Annan is a member of a distinguished panel, which is paving the way for a radical rethinking of drug policy. The Global Commission on Drug Policy is keen to end the war on drugs -- which it believes cannot ever be won, and which has claimed even more lives than drugs ever have. The Commission also wants to stop criminalizing drug users, regardless of whether they're using cannabis, ecstasy or heroin.
Annan and his fellow panelists -- who include over half a dozen former presidents -- are calling for a drug policy based on rationality. Value-based judgements -- eg. "drugs are evil" -- should be taken out of the equation and replaced with scientifically-sound facts. The panel's priority is to limit the damage done by drugs and this, they argue, involves governments boosting investment in education, prevention and constructive therapy.
The panel takes its cues from the anti-tobacco campaign. In the wealthy nations, the number of smokers is on the decline -- not because they are penalized by legislation but because they are more aware of the health risks. For their part, governments have raised taxes on tobacco and introduced public smoking bans.
The international movement to liberalize drug policy is driven by a dramatic shift in attitudes. There is now much greater social acceptance that cannabis is not just used for recreational purposes but has legitimate therapeutic and medical benefits that have been known about for millennia. Scientists have proven what healers have long understood: hemp reduces pain, relaxes muscles, boosts the appetite and has anti-inflammatory and mood-lifting properties.
Medical Breakthrough
In therapeutic quantities, cannabis does not neccessarily induce a high. It can help reduce nausea in cancer patients undergoing chemotherapy; reduce the dependency of patients suffering acute pain on opiates if not replace them altogether; cannabis-based oromucosal spray can reduce spasms in multiple sclerosis sufferers, while clinical studies are currently underway to see if cannabis extract can help reduce the risk of attacks in children suffering from severe epilepsy. Side-effects can include a racing heart, dry mouth and drowsiness, but are no worse than those of many other licensed medicines.
Even though cannabis can be a useful if not indispensable medical aid for a surprising number of people suffering from chronic conditions, patients in Germany who could benefit from medical marijuana continue to be prosecuted with relentless zeal. Cannabis remains illegal, no matter how helpful it might be to many individuals. A SPIEGEL survey shows that 90 percent of the population would like to see the ban lifted and medical cannabis made freely available to patients. But to no avail.
Diagnosed with a brain tumor, Robert Strauss from Augsburg found he could only alleviate the pain in his spine with cannabis. In February 2014, the German Federal Opium Agency granted him a highly unusual special dispensation for medical cannabis. But when he presented it to police in Augsburg, they made his life "hell," as he told the daily Süddeutsche Zeitung.
He was repeatedly stopped on the street and told to empty his pockets. One evening in September, the police raided his apartment and seized the cannabis he was legally allowed to possess along with a cannabis plant in his kitchen. A criminal investigation into illegal possession and suspected drug dealing was launched against him.
Denied cannabis, Strauss was forced to resort to prescription painkillers but unlike cannabis, these left him drowsy. As a result, he had a bad fall which he never recovered from. He died in January at the age of 50 -- a victim of German drug policy.
Other countries, meanwhile, are leading the way in terms of compassionate care. In Israel over 20,000 people with chronic conditions have been permitted to use medical cannabis. In Canada over 50,000 people are authorized. Health authorities expect a ten-fold increase in this figure within the next decade.
In California, where medical cannabis has been legal since 1996, it's used by hundreds of thousands of patients suffering from cancer and depression, by people with HIV, arthritis, Crohn's Disease and multiple sclerosis. Reliable proof that it is effective is rare, and based usually on nothing more than the testimonies of doctors and patients, all of whom arefree to experiment with dosage.
California is currently home to over 1,000 dispensaries. Delivery services even drop medical marijuana off at private homes. In the US, 23 states have introduced laws making it simpler for patients to come by cannabis easily and legally. Over 2 million people in the US use pot for medicinal purposes.
The Simplest Solution
And Germany? So far, the Federal Opium Agency has only authorized 449 patients to use medical cannabis -- a figure that suggests a shocking number of people are being denied help.
Franjo Grotenhermen, doctor and chairman of the International Association for Cannabinoid Medicines (IACM) has done the math and calculated that up to 1.6 million people in Germany could benefit from the use of medical cannabis. The government's continued refusal to relax the rules amounts to what he calls "massive, long-term failure to render assistance."
What's worse is that the fortunate few permitted to use cannabis are faced with a Kafkaesque situation. The only supplier of medical cannabis is a state-licensed Dutch company which has been struggling with delivery problems for over a year. "Deliveries rarely arrive," says 62-year-old Axel Junker, deputy spokesman with the German chapter of the IACM.
Even when deliveries do arrive, health insurers generally refuse to pay the costs of medical cannabis, which can be as high as several hundred euros a month.
Many patients are left with a paradox: They can't afford to buy what their doctor has prescribed, nor can they always buy the medical cannabis they need even when they authorized to do so. They are therefore left with no chance but to grow it themselves or to buy it on the street. Both options make them criminals in the eyes of the government.
There is a straightforward solution -- one which Austria, the Netherlands and Canada have already implemented. These countries are home to state-approved medical marijuana companies that make the drug available to people with chronic conditions. Germany has so far refused to follow their lead. According to a spokesperson with the Health Ministry, the topic is currently "in discussion."
But it's no longer just a ray of hope: German Health Minister Hermann Gröhe (CDU) has announced plans to improve access to cannabis at least for people who are seriously ill. Starting in 2016, health insurance companies will be forced to cover the costs. More patients should be eligible for cannabis medication than before -- though it still won't be up to doctors and patients to decide who gets what, but the state.
But Gröhe isn't striving for true liberalization -- he's more concerned about preventing abuse than helping those who are suffering.
The Science of Cannabis
When someone sucks cannabis smoke into his or her lungs, their brain is flooded in seconds with at least 60 substances, called cannabinoids. The most important ones are the sedative CBD (cannabidiol) and, above all, THC (tetrahydrocannabinol) -- the substance that, at high doses, intoxicates users.
Cannabinoids are effective because humans themselves produce similar molecules, so-called endocannabinoids. These messenger substances are essential for the healthy functioning of the mind, playing a key role in the parts of the brain responsible for alertness, thinking and feeling.
Cannabinoid receptors also exist in other places -- including in the immune system, heart, skin, blood vessels and pancreas. The wide spread of these receptors might explain why so many therapists and patients describe such a broad range of effects.
When these links were discovered years ago, they caused a sensation: Cannabinoids are not foreign bodies, not poison, but something that the body actually needs.
Some diseases are caused when certain messenger substances suddenly go missing in the brain. Parkinson's disease, for example, is caused by a shortage of the neurotransmitter dopamine. The discovery of the endocannabinoid system has substantiated the hypothesis that some neurological or psychiatric disorders result from an underproduction of endocannabinoids -- and that, as a result, cannabis products are the best way to treat them.
Which conditions, exactly? "That is not yet known," says Kirsten Müller-Vahl, a professor of psychiatry at the Hanover Medical School. But she has her suspicions about specific forms of schizophrenia, for example, as well as the attention disorder ADHD or Tourette Syndrome, a disease that leads to agonizing tics.
For years, Müller-Vahl has successfully treated the most severe Tourette cases -- those who have no other treatment options left -- with cannabis-based medication. Many of her patients consider them to be more effective than the neuroleptic drugs they usually get prescribed. And they also report fewer side effects.
A Safe Drug
Müller-Vahl doesn't understand why Germany still demonizes the drug. At least for adults, she claims, "the danger of self-harm through cannabis is small." In many ways, the substance is very safe, safer than many legal substances.
Paracetamol, the painkiller taken by millions of people, can be extremely dangerous; a single overdose of the over-the-counter medication can destroy a person's liver. An overdose of opioids like morphine can be equally deadly. And then there's alcohol. If you drink a bottle of korn, a type of German cereal-based liquor, in one go, you can poison your brainstem to the point that you can no longer control your breathing and heartbeat. As a result, people regularly drink themselves to death.
So far, however, nobody has managed to die from smoking pot.
The global number of deaths from cannabis overdoses stands at exactly zero, and the reason for it is this: In the brainstem, the oldest part of the brain from a development standpoint, there are barely any receptors for cannabinoids, making it immune against the drug. But it can do damage in the rest of the body. People who have smoked pot for years have a higher risk of cancer of the mouth and throat area. People who smoke hash mixed with tobacco -- a practice that is common in Germany, unlike in the US -- are also exposing themselves to the considerably larger range of dangers associated with tobacco.
Back in the day, experts claimed hash was a gateway drug -- that people who begin using it would invariably end up using heroin. Despite having been scientifically refuted, this thesis refuses to die in politics. The Netherlands have had an extremely liberal cannabis policy for decades, while simultaneously having an extremely low rate of recurring heroin use among junkies.
Now doctors are discussing whether cannabis could be used as an "exit drug": alcoholics as well as pill, heroin and cocaine addicts can better endure withdrawal if they smoke marijuana in the process.
Danger for Youth?
Cannabis, of course, has a risk of addiction, but it is smaller than many people think. Nine percent of users become addicted, according to a study by the National Academy of Sciences in the US. The potential for addiction is thus far below that of alcohol (15 percent), cocaine (17 percent), heroin (23 percent) and tobacco (32 percent). The degree of addiction is also apparently comparatively milder -- at least among adults.
There are considerably greater health and addiction risks among youth. During the teenager years, the brain undergoes a delicate restructuring. Many studies show that cannabis -- just like alcohol -- intervenes in this process and can impede it. This means that consumption of pot during this period can have permanent consequences for young people, because it can change their brain structure.
Researchers have identified several cognitive deficits among young people who smoke even just one joint per week. Many are worse at learning and are less attentive. The regular smoking of marijuana tends to lead to worse grades among adolescents. The question of whether their abilities return to normal after a longer period of abstinence is still being debated.
Consumption can have a particularly strong effect on adolescents with psychological instabilities. Smoking marijuana raises the likelihood of later psychosis many times over, and those who are predisposed to it can also become sick earlier.
The most important question in the legalization debate should thus be this: How can adolescents better be kept from consuming cannabis -- through a general, widely circumvented ban on the substance? Or through controlled availability to adults with simultaneous youth-protection measures?
Neither option is ideal. Adolescents tend to be curious. But clearly, prohibition has failed, spectacularly, to keep teenagers from using -- on average, Germans smoke their first joint at 16.
If cannabis possession weren't a criminal offence, it may become easier for young people to speak about it openly with teachers, parents or drug counsellors. Thus, reformers believe, a more trustworthy atmosphere would emerge, in which education about the dangers of consumptions could be more effective.
A Crime Without a Victim
Even US President Barack Obama was an enthusiastic pot smoker in his youth -- and he apparently still managed to do pretty well as an adult. When he declared last year that he doesn't believe marijuana "is more dangerous than alcohol," he set off a firestorm. Parents accused him of playing down the harmful effects of cannabis.
In fact, the opposite was true: Obama was playing down the harmful effects of alcohol. "It is completely indisputable that comparatively, alcohol is much more dangerous. Its bodily and psychological consequences are more serious, its social costs are much higher," says psychiatrist Müller-Vahl.
Alcohol ruins livers, brain cells and marriages. Drunk men tend to become more violent. A few vodkas too many and peaceful people turn into violent abusers, rapists and even murderers. A third of all violent crimes in Germany are committed by people who have lost inhibitions through alcohol.
Pot-related crime tends to be restricted to pot-possession (and to driving under the influence).
The drug's high makes people euphoric but relaxed. Lots of things become more intense: Feelings become stronger, jokes become funnier, landscapes more impressive, music better, thoughts freer. And time goes by slower. Why should this high be banned?
What is so reprehensible about cannabis smoking that it rises to the level of a criminal offense? People who smoke a joint or even just own a pot plant have committed a special kind of crime -- a victimless one.
Its perpetrator damages at worst him or herself. But it is rare in German law to turn potential self-harm into a crime. "One cannot massively criminalize a behavior that does not harm others," says Bremen penologist Lorenz Böllinger, who has launched a petition against the banning of cannabis.
Half of all German criminal law professors signed the petition in the past year.
Free citizens must have the option to decide how to ruin their own health -- with cigarettes, too much or too little sport, or by eating five sausages a day. Why should it be any different with cannabis? The fact that pot carries risks doesn't make a ban any more understandable -- after all, many things in life are both risky and legal, like driving a car, or riding a horse, or sex.
Germany's federal drug commissioner was recently asked why alcohol is legal and hemp is not.
Marlene Mortier (CSU), a trained farmer, grumpily answered: "because cannabis is an illegal drug, period."
The answer sounds naïve, but it happens to sum up the problem perfectly. On March 30, 1961, dozens of countries, under the umbrella of the United Nations, signed the so-called Single Convention on Narcotic Drugs, in which they committed themselves to fighting illegal drugs, including cannabis, on a wide scale.
At the time, the substance was not widely available in Europe or the United States, and little was known about it. And yet, the experts of the time agreed that the plant is an especially bad one, with no advantages for humanity.
Since then, cannabis has been damned globally. This demonization has, among other things, put hundreds of thousands of people into jail. It has also massively hampered medical research on the substance. And first and foremost, it failed to contain the drug. According to the World Health Organization (WHO), about 150 million people around the world smoke marijuana.
Colorado's Experiment
John Hickenlooper was opposed to legalization, but he didn't have an option. As a governor of Colorado, he had to respect the referendum that made his state into a pioneer, and now for the past 18 months, he has been in charge of what he calls "one of the great social experiments of the 21st century."
So far it's been going surprisingly well. "Canna-business" is now the fastest growing industry in America, and Colorado is right in the middle of it. Tens of thousands of new jobs and over one thousand new companies have been created as part of this "green rush."
Drug tourists are streaming into Colorado. Bus tours bring people to Denver's best joint factories. There are cannabis cooking courses and there is cannabis yoga. The Denver Post launched a cannabis desk to cover the "social experiment."
The University of Denver is training lawyers who specialize in serving the needs of hemp farmers. People who were formerly traditional dealers -- experts in camouflage and obfuscation -- are now taking classes in tax law and accounting. Professional labs test the plant products for active-ingredient content and purity. Those that don't meet their strict quality standards are not allowed to be sold.
As before, only a minority of Coloradans smokes pot. Before it was legalized, 16.1 percent of the population used cannabis. One year later, the number stands at 18.9 percent.
More Money for the State
People who favor prohibition tended to argue that when cannabis would be legalized, stoned drivers would cause catastrophic accidents. There have been individual crashes of the sort -- but overall, the number of car crashes has gone down, along with the crime rate.
Despite legalization, the pot business isn't like any other. People who sell weed have trouble getting a bank account, because they are restricted by federal US laws against money laundering. As a result, weed can only be purchased with cash in the stores. When marijuana companies pay their taxes every month, they take bags of money with them to the tax office.
Colorado took in over $ 76 million from taxes on cannabis last year-- less than expected. As citizens had decided in the referendum, a large part of the money is ploughed into the construction of new schools. In the future, it will also fund prevention programs for adolescents.
So far, nobody knows if that latter part of the social experiment will work. The effect of the liberalization on young people will only become apparent in a few years. But none of the specialized companies seem to be selling their product to teenagers. If they do, they run the danger of losing their license.
In a recent interview, Governor Hickenlooper had to admit that some of his concerns about legalization were unfounded. He is now happy that they are "keeping" the millions of dollars from the cannabis economy in Colorado instead of "supporting a corrupt system of gangsters."
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