Regulating it right

“Malta has legalised cannabis! Everywhere you look, you find a shop selling cannabis-related products.” Not really! Without promoting the use of cannabis, yet without coercing the person to stop using the drug to receive evidence-based information, harm reduction recognises that people who use recreational cannabis should not be coerced into treatment or the criminal justice system.

The legislative changes enacted in Malta in December 2021, partially decriminalising cannabis for adult use, reflect a growing number of countries adopting a human rights approach to drug policy and control.

Without condoning or diminishing risks associated with drug use, Maltese legislation aims to protect people who use drugs from legal harms resulting from criminalisation and health harms stemming from an unregulated product monopolised by organised criminal groups.

The tolerated public possession of up to 7 grams, the possibility to grow up to four cannabis plants per household for personal use, the expungement of criminal records for cannabis related offences within a decriminalised and depenalised framework, and the establishment of not-for-profit Cannabis Harm Reduction Associations (CHRAs) licensed by the Authority for the Responsible Use of Cannabis (ARUC), aim to provide a holistic approach to address supply and demand reduction measures.

The expansion of harm reduction principles and practices to the use of cannabis is a unique opportunity to recognise that people who use cannabis should not be addressed within a criminalised framework. Without promoting the use of cannabis, yet without coercing the person to stop using the drug to receive evidence-based information, harm reduction recognises that people who use recreational cannabis should not be coerced into treatment or the criminal justice system.

The regulated, the unregulated, and the “cowboys”

The emergence around the Maltese islands of ‘cannabis grow shops’ – places where people who cultivate cannabis can purchase appropriate equipment and material required to cultivate cannabis including seeds, tents, nutrients, soil, lights etc – and the licensing of not-for-profit CHRAs by the ARUC, should not be confused or mistaken with commercial style outlets, both physical and online, better known as ‘Low-THC Cannabis Stores’. The latter are not regulated by the Authority and may not provide cannabinoid products with a THC (Tetrahydrocannabinol, the principal psychoactive constituent of cannabis) percentage higher than 0.2%.

Studies by the European Monitoring Centre for Drugs and Drug Addiction highlight that, in most cases, these retail spaces are also marketing synthetic or semi-synthetic cannabinoids such as Hexahydrocannabinol (HHC). HHC was first described in scientific literature in 1940, yet it is only in recent years that it has garnered commercial interest. HHC is sold as low-THC cannabis flower, concentrate, and resin that have been sprayed or mixed with HHC, and food products (commonly known as ‘edibles’) such as sweets. Based on origin, HHC is classed as a semi-synthetic cannabinoid. This is because the HHC detected on the market is synthesised from cannabidiol (CBD), which in turn is extracted from low-THC cannabis (hemp). The pharmacology and toxicology of HHC in humans has not been studied. 

More recently, there has also been an increase in the number of pages marketing their cannabis products or inviting persons to join a closed messaging group to obtain locally grown cannabis. These so called ‘cannabis industry cowboys’ have not been licensed by the ARUC, are on a completely different spectrum when it comes to a not-for-profit basis and adopting harm reduction principles.

A harm reduction vision

On 8th June 2023, the ARUC launched its harm reduction vision for the second half of the year. On this occasion, it emphasised that this fundamental re-orientation of national policy on cannabis is not aimed at promoting the use of mind-altering substances such as THC or to act as a basis for cannabis commercialisation.

Earlier this month, the ARUC issued the first two CHRA licenses for the cultivation and distribution of cannabis for non-medical purposes and continues to regularly update its online presence through aruc.mt, including the official list of registered CHRAs.

What are the key objectives of harm reduction principles within a regulated not-for-profit framework for the adult non-medical use of cannabis?

  1. To ensure that people who use cannabis have access to high quality cannabis products developed under close scrutiny and following strict cultivation, storage, transport, and distribution criteria.
  2. To establish a comprehensive and multi-disciplinary harm reduction approach for Cannabis Harm Reduction Associations (CHRAs).
  3. To reduce legal and social risks for people who use cannabis by providing a safe and regulated outlet where to obtain cannabis.
  4. To adopt non-judgmental language and educational tools to combat stigma and discrimination suffered by people who use cannabis, in particular people hailing from difficult socio-economic backgrounds or incarcerated for their cannabis possession and/or cultivation.
  5. To monitor prevalence levels, including local trends, and propose appropriate measures to reduce high-risk cannabis use.
  6. To recognise the negative unintended consequences of punitive drug policies and adopt appropriate restorative social justice and social equity tools to address injustices and abuses.
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