Issue link: https://maltatoday.uberflip.com/i/1526203
10 OPINION maltatoday | WEDNESDAY • 4 SEPTEMBER 2024 IN 2024, people in Malta, Germa- ny, Luxembourg, the Netherlands, Uruguay, Canada, South Africa, and many US states live in juris- dictions that have recently enacted legislative and regulatory changes removing or reducing criminal consequences for personal canna- bis use. Most significantly, these jurisdic- tions have meaningfully removed cannabis from the domain of un- sustainable and damaging prohibi- tionist policies. By embracing evi- dence-based and human-centred drug policy frameworks, these ju- risdictions are setting a precedent. If the outcomes of these cannabis reforms are positively impactful, this experience could – and argua- bly should – lead to a broader revi- sion of the legal status of all banned substances. Such a shift would challenge long-standing drug poli- cies, which have often been rooted in ideology rather than science and pave the way for more rational and compassionate approaches to sub- stance regulation. The UN World Drug Report of 2024 estimates that globally, there are more than 220 million canna- bis users. After alcohol, tobacco, and caffeine, cannabis remains the most popular psychoactive sub- stance. Mirroring global trends, the European Union Drug Report of 2024 estimates that around 1.3% of adults in the European Union are daily or almost daily users of cannabis. This widespread use highlights the need for regulato- ry systems that prioritise public health, social equity, and harm reduction over punitive measures. It is high time for drug policy ap- proaches that prioritise people's right to health. Enshrined in the WHO Consti- tution, the right to the enjoyment of the highest attainable standard of physical and mental health pro- vides for a state of complete phys- ical, mental, and social well-being, not merely the absence of disease. This right is also enshrined in Ar- ticle 25 of the UN Declaration of Human Rights (1948) and in Ar- ticle 12 of the International Cov- enant on Economic, Social, and Cultural Rights (1966). While the UN Declaration of Human Rights was heralded as the first global at- tempt at championing a more just world, the International Covenant further reinforced the indivisible, interdependent, and interrelated nature of human, social, econom- ic, and cultural rights. Defining human rights as interdependent, indivisible, and interrelated, the WHO Constitution declares that a violation of one right results in the impairment of other rights. There- fore, the progressive realisation of the right to health needs to ensure a holistic approach, incorporating health, social, cultural, and eco- nomic rights. In this context, the right to health is not simply about access to healthcare services but also about the broader determinants of health, including social condi- tions, economic policies, and le- gal frameworks. It is a recognition that the health of individuals and communities is shaped by a com- plex interplay of factors, and that policies must be designed with this complexity in mind. The right to health and legislative changes linked with cannabis use Although cannabis in Malta re- mains a prohibited narcotic listed under the Dangerous Drugs Or- dinance, the partial decriminali- sation of cannabis in 2021, as well as the introduction in 2015 of the Drug Dependence (Treatment Not Imprisonment) Act depenal- ising small amounts of drugs, are, in part, reactions to the unintend- ed consequences of prohibition and criminalisation. The Maltese government, like many others, recognised that punitive ap- proaches were not only failing to curb drug use but were also caus- ing significant harm to individuals and communities. The cases of Daniel Holmes and Christopher Bartolo underscore the devastating impact of canna- bis prohibition. Neither individual had addiction-related problems nor were involved in violent or criminal activity. As a kidney pa- tient, Mr Bartolo's life was at risk when he was imprisoned on can- nabis-related charges. His impris- onment not only endangered his health but also highlighted the disproportionate impact of drug laws on vulnerable individuals. Similarly, Mr Holmes was robbed of family life and lost a dear friend to suicide in prison. These two persons were not Al Capone or Tony Montana, nor were they threats to society. By locking them up, the criminal justice system was in direct conflict with the universal right to health, negatively impact- ing the health, social, economic, and cultural rights of both Mr Bartolo and Mr Holmes and their respective families. These cases raise critical ques- tions about the role of the State in compensating individuals who have been unjustly punished un- der outdated drug laws. Should the State offer financial compensa- tion to individuals such as Holm- es and Bartolo? If so, how should this compensation be quantified? Should it be based on lost produc- tive years and economic opportu- nities, or should it also account for the emotional and psychological toll, as well as the legal costs in- curred? In various regions across the world, the past 10 years have been decisive for the realisation of health, social, cultural, and eco- nomic rights for people who use cannabis. These developments reflect a growing recognition that drug policies must be aligned with human rights principles. Locally, the successful establishment of Cannabis Harm Reduction Asso- ciations has been a key part of this shift. These associations, particu- larly the availability of cannabis strains with different THC levels, democratic participation by mem- bers, the capping of 500 members for each association, and inform- ative labelling included on each cannabis package, are all measures emanating from the interdepend- ent nature of the right to health. Members of these associations – and also those who produce their own cannabis at home – now have the right to access their cannabis without having to engage with illegal suppliers. They can know exactly what product of which strength they are consuming. They no longer have to wonder if the product is related to organised criminal groups, violence, and hu- man rights violations. It is not an- ymore. This shift not only protects the health of cannabis users but also reduces the social harms as- sociated with the illicit drug trade. One may, therefore, observe that the regulation and non-com- mercialisation of cannabis for non-medical use build upon the interdependent and indivisible right to health. By reducing crim- inal consequences for personal cannabis possession and cultiva- tion, and by allowing individuals to become members of philanthropic cannabis associations founded on harm reduction principles, people using cannabis are now in a better position to prevent health, social, economic, and legal risks. This ap- proach represents a significant de- parture from the punitive models of the past and offers a more hu- Puff, Puff, Pass: The right to health and people who use cannabis Karen Mamo is a lecturer in addiction studies at the University of Malta and Felipe Neis Araujo is a lecturer in criminology at the University of Manchester Karen Mamo & Felipe Neis Araujo