Cannabis Harm Reduction Associations – why and how?

By establishing a harm and risk reduction approach, the licensing of associations will further ensure the reform is a comprehensive tool capable of positively impacting the health, social, and legal realities linked with cannabis use in society.

Around 3.7 million EU citizens are estimated to be daily or almost daily users of cannabis, according to a report by the European Monitoring Centre for Drugs and Drug Addictions (EMCDDA). The trend of cannabis use in Europe has been on the upward trajectory since the mid-20th century.

For decades people in Malta had access to mostly illegally imported and untested cannabis originating from Morocco, Libya, Albania, and Sicily. The criminalisation of people who use cannabis created several unintended negative consequences directly impacting their health and wellbeing. In fact, the National Report on the Drug Situation in Malta of 2021 explained that, as was the case in previous years, data gathered by the national focal point illustrates that cases related to cannabis possession made up most of drug law offences in 2020. Taking as a time frame the years between 2017 and 2021, the National Report on Drugs (2022) illustrates that a total of 1,763 drug law offences related to possession charges were recorded in Malta, out of which those related to cannabis amounted to 1,187.

The function and purpose of regulating the adult non-medical use of cannabis through the partial decriminalisation of cannabis and the establishment of not-for-profit Cannabis Harm Reduction Associations (CHRAs) revolves on the core principles of a not-for-profit and a harm and risk reduction approach. Therefore, without promoting cannabis use, encouraging the recruitment of new users, or ignoring risks associated with cannabis use, the establishment of Cannabis Harm Reduction Associations aims to primarily provide a safe space for the communal cultivation and distribution of cannabis, whilst advancing an educational and public health approach. Most importantly, Cannabis Harm Reduction Associations will only accept people who are already familiar with the psychoactive effects of THC, and therefore have already used cannabis in the past. This is a unique practice aimed at preventing the normalisation of cannabis use or the promotion of cannabis within broader society.

Cannabis Harm Reduction Associations: how do they work?

CHRAs are licensed by the Authority for the Responsible Use of Cannabis (ARUC) to cultivate only a limited number of cannabis plants reflecting the number of members and consumption levels and need to follow strict cultivation and quality testing measures ensuring that their plants are free from any microbiological or chemical contaminants (including refraining from using Plant Growth Regulators). These measures will further ensure that people who become members of these associations are provided with natural cannabis, and not sold risky products found in the broader cannabis market, such as synthetic cannabis (known as K2/Spice) or semi-synthetic cannabinoids such as HHC.

Without commercialising the use of cannabis, the establishment of a regulated framework for adults who already use cannabis and the creation of safe non-commercial spaces such as CHRAs will be pivotal to advance sound and long-term drug policy reform. Anonymous data about health and cannabis practices within these CHRAs will provide policy makers, researchers, and health workers with important additional investigative tools for better mapping of local trends and prevalence levels. Presently, the collection of yearly national data is only obtained from people seeking treatment and information provided by the police pertaining to drug law offences and drug busts involving international trafficking rings.

Cannabis Harm Reduction Associations have several tools to implement a harm reduction approach, including educational activities organised within the Association’s premises. Activities range from the comprehensive dissemination of health information on cannabis use and proposed less risky methods of consumption, to a broader understanding of cannabis regulation, including considerations for sustainable development, environmental protection, and restorative justice tools. Information about the properties of different strains, including expected effects and how to prevent risks will also be imparted by trained employees working within these not-for-profit associations. In turn, such environments facilitate the exchange of experiences and best practices without the fear of criminal consequences.

Harm reduction training programme

On 28 and 29 November, the ARUC organised the first Harm Reduction Training Programme for licensed and in-principle CHRAs with the expert participation of local and foreign experts. These included Prof. Tom Decorte from the University of Ghent in Belgium, Mr Òscar Parés Franquero and Ms Anna Obradors Pineda, both drug policy researchers from Catalunya, and Mr Mike Orland on behalf of Aġenzija Sedqa. The training programme focused on several topics, particularly the core and operational principles of a not-for-profit model, practical harm reduction tools applied within CHRAs, the role of contamination prevention and quality testing when cultivating cannabis, considerations for vulnerable people between the age of 18 and 25, and the role of data protection when handling sensitive personal information.

A commitment to harm and risk reduction

Preventing risks, especially for vulnerable groups, will remain at the helm of ARUC’s mission, a spokesperson for the Authority told The Journal. In fact, the ARUC has already published a Directive on Harm Reduction establishing key foundational elements how CHRAs should operate, including considerations for young persons under the age of 21. The latter will not be allowed to access cannabis higher than 15% THC and will be provided with age-appropriate harm reduction tools such as access to the Lower Risk Cannabis Use Guidelines. CHRAs require clear labelling on the final product, including a number of mandated health warnings by the ARUC, whilst refraining from attracting new customers with fancy signage and/or advertisement of any type.

On 30th November, the ARUC, in collaboration with the Faculty for Social Wellbeing and the Unibversity Students’ Council (KSU), organised a public lecture on cannabis, harm reduction, and health. The following day the Authority also successfully facilitated the 2nd Thematic Roundtable on cannabis and health for Government entities.

“By establishing a harm and risk reduction approach – therefore looking at the use of cannabis in society from a public health, human rights, sustainable development, and social justice lens – the licensing of CHRAs will further ensure the reform is a comprehensive tool capable of positively impacting the health, social, and legal realities linked with cannabis use in society,” said the ARUC spokesperson.

You might also be interested in reading: Regulating it right.

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