Cannabis Use and Dependence: Public Health and Public Policy

There have been ongoing debates on the issue of cannabis use in all developed societies. These debates have centred around two major themes. First, to what extent does cannabis have harmful effects on users? Second, what is the appropriate legal and public health response to cannabis? Rational debate in this area has suffered serious setbacks from those advocating for or against the use of cannabis. This difficulty is clearly stated in Reuter's foreword to this book by Hall and Pacula.

The reformers' claim that there are no harms is simply wrong … the drug warriors' claims as to the severity and breadth of its harms are hugely exaggerated.

Hall and Pacula attempt to redress the balance by presenting a reasoned and scholarly assessment of the key issues in this area. Their treatment is thorough, clear and exemplary for the way it navigates a complex maze of evidence, debate, legal and ethical issues in an unbiased way.

The contents of the book are presented in a series of chapters that review issues relating to the use of cannabis. These include: effects on health and wellbeing; the benefits of cannabis use; comparisons with alcohol and tobacco; and legal/policy options for addressing cannabis use. Each chapter contains clear and accurate summaries of existing research and debate, which make the book an essential reference source for those with an interest in this area.

The important outcomes of the book are a number of ‘bottom line’ conclusions that should form the foundations of any rational debate and policy regarding cannabis. These conclusions may be summarized as follows.

• 1 Cannabis is not a harmless drug and its use may have harmful consequences for physical health and psychosocial adjustment.

• 2 At current levels of usage, cannabis is less harmful than alcohol or tobacco.

• 3 Decriminalization of cannabis probably offers the best route for addressing the legal and public health issues relating to cannabis, but any policy decision in this area will involve ‘a choice of evils’ that weighs up the costs of prohibition against the costs of liberalization.

The last sentence of the book restates the concerns raised by Reuter's foreword.

Cannabis policies are too important to be left … to partisans of the falsely simplified forced choices that are usually represented in public debates on cannabis policy.

In writing this book, Hall and Pacula havemade amajor contribution to improving the clarity and rationality of the cannabis debate and it should be essential reading for anyone who wishes to make a constructive contribution in this area.

David M. Fergusson

Christchurch, New Zealand