Sometime around 1979 the family running the drug business in Dublin had a product ‘drought’ which was beginning to take off in terms of sales.
youThat product, cannabis, was selling well, but a new drug, heroin, had an even higher profit margin. And so, to launch heroin, there was a planned cannabis ‘drought’ to encourage users to take the new product. And many, of course, did. We have had a drug problem ever since, mostly confined to inner cities (and Dublin in particular) and very little we have been able to do about it.
Everyone has their opinions on the drug business, and to clarify, we are talking about the illegal drug business here, and sometimes they are very divergent. The one thing that everyone accepts is that we have a drug problem in terms of large numbers of people who use drugs recreationally and large numbers of people who are addicted to drugs like heroin and cocaine.
Next month a Citizens’ Assembly will be held to discuss the issue and coinciding with that, irish medical times will publish a special issue on cannabis to try to examine the prevalence of cannabis in society and to examine whether or not it would be a good idea to legalize cannabis, as has been done in several other countries.
There are many issues involved in the legalization of cannabis; The first is whether one is talking about actual ‘legalization’ or ‘decriminalization’, which are different things.
Even within that framework, some anti-legalization people would suggest that decriminalization leads to legalization, so there is no point in separating them.
Whatever the terminology or nomenclature, the pressure on the Irish government to legalize cannabis comes from legalization elsewhere. Irish governments aren’t known for being the first to introduce new concepts (the workplace smoking ban is a major exception to that rule), but as more states around the world legalize cannabis, calls for legalization here become stronger.
Then there is the whole issue of medical cannabis. Should patients be allowed access to the drug if they believe it relieves pain or reduces symptoms? And do they need a doctor to approve the use of the drug? What about the patient who is using cannabis as a medicine who moves to Ireland?
Whatever the answers to these questions, it is clear that we need to have a national conversation about drugs, their medicinal and recreational uses, and what we are going to do to regulate their use. With a little luck, irish medical times will make a positive contribution to that debate by airing the variety of views that exist in Irish medicine and providing a medical angle to this crucial debate.
Many of these things are unknown. We really don’t know what the future holds for us and how our actions might affect future generations. It is too early to say what the effect of the French Revolution will be, Mao asserted, and equally we do not know what effects legalization or decriminalization would have.
We can look at other countries and examine what happened in other jurisdictions, but we are different from, say, Colorado or Columbia, and while you can perhaps expect some correlation between some countries that have legalized cannabis, there are also huge disparities.
One thing we do know for sure: We have a huge drug problem in this country, and we can’t just ignore it and hope it goes away. The pandemic, if anything, seems to have increased problematic drinking, and with the decline in country pubs and more people drinking at home, the nature of drinking has also changed.
All of these things are connected from a health and medical perspective. Today we will see the traditional Irish tolerance for alcohol consumption, for example. People travel to Ireland because of our reputation for “having the craic” or, more accurately, because of our willingness to ignore drunkenness and tolerate it to some degree.
How would the decriminalization of cannabis affect the consumption of alcohol? Would people change or just add one more drug to the mix?
All of these questions are complex and involve a certain amount of speculation. In the past, compassion has been a driver of changes in the law, such as reform of divorce, abortion, or homosexuality statutes, and hopefully compassion will be the driver this time as well.
And it is vitally important that all sides of the debate are heard. We look forward to contributing to that debate and providing a forum in the April issue of irish medical times so that all opinions are heard.
International evidence suggests that the War on Drugs has failed. It is impossible to prevent drugs from entering a country when there is great demand and profit. A different approach has been long overdue and perhaps now we are at the beginning of this change in Ireland.
We look forward to a healthy discussion and a Happy St. Patrick’s Day, whatever your drink! 
