The Court stated that the possession of cannabis is protected by Article 19 of Argentina’s Constitution, which states that “private actions that in no way offend public order or morality, nor are detrimental to a third party, are reserved for God and are beyond the authority of legislators.” Recent developments in Canada and nine US states signify the growing momentum of the trend toward the legalization of recreational uses of cannabis and the development of more complex regulatory models to govern legal cannabis markets.In different ways, these jurisdictions grant licenses to professional farmers and pharmacies to produce and to sell cannabis commercially and exempt individuals from criminal responsibility for noncommercial uses. The trend toward liberalizing cannabis prohibitions illustrates the recursive nature of transnational processes of legal change. The networks of actors participating in these processes—comprised of grassroots activists, legislatures, bureaucratic elites, criminal justice actors, scientists, journalists, and public health officials—created new regulatory models that gradually transformed the application of cannabis prohibition norms in various jurisdictions. These actors invoked the indeterminacy of treaty provisions, contested the framing of cannabis use as indicative of a moral malaise, and highlighted the diverse ways in which the enforcement of cannabis prohibitions produces social harms that are severer than those generated by cannabis use. They also utilized the space for norm-making provided by the mismatch between the institutions and actors that formulate global norms and those assigned with the actual implementation of these norms in national and sub-national settings. The success of these campaigns warrants a reflection on the conditions under which local and national acts of contesting TLOs can reshape the agenda of global actors invested in preserving the current normative settlements. The following section focuses on this question. The rapid and widespread transnational diffusion of new models of decriminalizing, depenalizing or legalizing the use of marijuana serves as a product and a catalyst of the declining capacity of the cannabis grow system prohibition TLO to shape the policy choices of criminal lawmakers and the routine practices of enforcement officials.
However, to what extent do these reforms change the agendas of the global actors that play key roles in shaping and maintaining the normative and institutional structures of this TLO? Faced with the global spread of cannabis liberalization reforms, the INCB has positioned itself as the most steadfast defender of the normative expectancies of the cannabis prohibition TLO.In its annual reports, the Board contested the legitimacy of the legal interpretations underpinning states’ engagement with decriminalization, depenalization, and legalization initiatives. The Board repeatedly expressed its concern that the introduction of civil sanctions for possession offenses was sending the wrong signal, downplaying the health risks of marijuana use.Most recently, the Board condemned Uruguay and Canada for adopting legalization schemes, stating that such reforms constituted clear breaches of the international conventions. The literature examining the roles of naming and shaming mechanisms in international politics observes that most countries are inclined to bring their laws into formal compliance with international standards to avoid being stigmatized as “deviant states.”The efforts of the INCB to achieve such influence by condemning countries deviating from the prohibitionist expectancies of the international drug conventions failed to generate such adaptive responses.Some countries have practically ignored the Board’s proposed interpretation of the international obligations set by the conventions. Others have argued that the Board’s interpretive approach was too narrow and relied on selective use of the available evidence-base concerning the medical uses of cannabis. Still others contended that the Board was exceeding its mandate when it adopted a hostile stance toward legitimate policy choices of sovereign states.The limited impact of the Board’s attempts to delegitimize the adoption of non-punitive models of cannabis regulation provides important insights into the conditions under which naming and shaming strategies can succeed.One reason for this limited impact is that some of the central countries pioneering the experimentation with decriminalization and legalization schemes are not particularly vulnerable to economic and reputational pressures.Supporters of cannabis liberalization reforms across Europe and North America justify these policies on the grounds that they are needed to reconcile drug policies with fundamental human rights values as well as with human development concerns.In this polemical context, it is unsurprising that the INCB, which has long failed to restrain the human rights abuses inflicted in the name of the war on drugs, has not succeeded in harnessing transnational civil society actors to support its line of attack on the perceived departures from the settled interpretations of the international drug conventions. Whereas the INCB has remained unambiguously committed to the task of defending the normative settlements of the cannabis prohibition TLO, the approach taken by the US has been marked by ambivalence.
President Barack Obama’s administration adopted the ambiguous position of respecting the decisions of US states legalizing the medical and recreational use of marijuana while continuing to condemn steps toward legalization in Latin American and Caribbean countries. Responding to shifts in national public opinion, the administration set out lenient guidelines for the federal prosecution of marijuana users in states that had legalized its medical and recreational uses.It thereby allowed legalized drug markets to take roots in Colorado and Washington, and subsequently in other states. Like other national governments, the US federal government invoked its domestic constitutional principles to argue that its policies are in compliance with the international standards. However, during the same period, the US continued to apply its strict punitive approach to evaluating the compliance of other countries with the UN drug conventions. The annual certification process continues to include assessments of the extent to which the seventeen countries currently identified as “drug majors” are willing to eradicate the cultivation of cannabis and to penalize its growers and sellers. With a majority of Americans supporting the legalization of marijuana and a majority of US states already implementing decriminalization schemes for medical marijuana, lawmakers in the House and Senate are facing increasing pressure to end the federal ban on cannabis. Despite efforts by Attorney General Jeff Sessions to revive the zero-tolerance approach of the federal government, President Donald J. Trump has recently expressed his intention to support such reforms. It is too early to predict whether and when such a change will take place or how it will impact the federal government’s foreign policy stance on the issue of cannabis legalization. However, as long as the US adheres to this “do as I say, not as I do” message, its ambivalent posture enables further steps toward the unsettling of cannabis prohibition norms. Nevertheless, it is important to note that despite its declining regulatory effectiveness, the cannabis prohibition TLO continues to exert considerable influence on the development of drug policies at the international, regional, national, and local levels. In this context, it is notable that countries that have liberalized their cannabis laws emphasize their commitment to remain bound by the confines of the current treaty regimes of the international drug control system. Remarkably, the extensive recognition of the severe failures and counterproductive effects of the cannabis prohibition TLO has not generated viable political efforts to amend the international treaties underpinning its operation. To a considerable extent, the reluctance to renegotiate the treaty norms governing cannabis policies stems from the notion that the cannabis prohibition TLO is embedded within the mega-TLO of the international narcotic control system.This serves as a powerful mechanism of issue linkage, leading countries that support cannabis liberalization reforms to avoid initiating formal treaty amendments out of concern that such actions might destabilize the settled norms prevailing in other issue-areas of narcotic control.
The fact that the UN drug conventions regulate the global trade of both the illicit and licit uses of drugs, including substances on the World Health Organization’s list of essential medicines, further escalates the stakes in renegotiating the terms of these treaties. In addition, the reputational costs of defecting from UN crime suppression treaties might be higher than those suffered by persistent objectors in other areas of public international law. The branding of countries as pariah states, or “narco-states,” as it were, carries a stigma that resonates with the censuring functions performed by criminal labels in domestic contexts.These factors help explain why current efforts to restructure the regulatory frameworks governing cannabis markets are contained within the narrow space of policy experimentalism created by the textual ambiguity of the current treaties. Under these circumstances, many of the inherent weaknesses of the prohibitionist approach resurface in the new regulatory landscapes created by the decriminalization and depenalization of possession offenses. The involvement of criminal organizations in illicit drug markets remains of intermediate sanctions has a net-widening effect, which expands the use of control measures against low-risk drug offenders.Most fundamentally, the insistence on promoting drug liberalization reforms within the confines of the current system constrains the capacity of individual states and of the international community to imagine more effective and humane alternatives, such as those offered by harm-reduction and development-centered approaches.With the majority of U.S.states having adopted legislation to medically and/or recreationally legalize cannabis, the already high prevalence of cannabis use is expected to further increase nationwide, especially among existing users.States that allow the legal use of cannabis grow lights for medicinal purposes have higher rates of cannabis use and cannabis use disorder in national survey data and specifically within the Veterans Health Administration.Veteran advocacy groups have been created to further veterans’ rights to access cannabis for medical purposes and discuss its use with their VHA providers.There are also published reports that veterans perceive cannabis to be a low-risk or safe substance unlike other drugs of abuse and expect cannabis to provide relief from symptoms of combat-related trauma.However, there has been little research on the patterns and correlates of MC use specifically among veterans.Growing research indicates that rates of cannabis use and CUD are particularly elevated among veterans with post traumatic stress disorder and major depressive disorder.These individuals are particularly likely to use cannabis as a means of coping with negative affect and with sleep disturbances.Nonveter an research also identifies cannabis use as an emotion-regulatory strategy to reduce or manage perceived aversive psychological and mood states.However, although such sleep and emotion regulation motives are commonly endorsed reasons for non-MC use among veterans in general, little is known about potential differences in motives among veterans using MC relative to those using cannabis recreationally for non-medical reasons.Motivation for MC use has been examined in non-veteran populations , with the most commonly endorsed reasons for use being pain, anxiety, and sleep problems.
Besides pain management, relief of anxiety, especially PTSD, appears to be a prevalent motive for MC use in community samples and among veterans.Indeed, PTSD is now recognized as a qualifying condition by the majority of states permitting legal access to medicinal cannabis.Sleep disturbance, particularly in conjunction with PTSD, is associated with more frequent and more problematic use of cannabis in non-veteran samples and with frequent cannabis use and CUD among veterans.Thus, MC use may be driven by specific motives for use that are inter-related with certain comorbid conditions that are particularly prevalent in veteran populations.Medical dispensary patients also report using cannabis as a substitute for prescription medication and for alcohol , with the most common motives for using cannabis instead of alcohol or illicit or prescription drugs being fewer perceived side effects, better symptom management , and decreased severity of withdrawal with cannabis.Indeed, the vast majority of MC patients self-report at least moderate symptom relief across all conditions.Preliminary prospective research found a 42% reduction in use of prescribed opiates over 3 months following the initiation of MC treatment.Yet, cannabis used specifically for pain management among MC users is significantly associated with past history of more severe substance use patterns including use of alcohol, illicit drugs, and non-prescribed pain relievers.In contrast to the growing literature on MC use, only a few non-veteran studies explicitly compared MC and RC users on cannabis-related behaviors and motives.MC users were found to have poorer health but lower levels of alcohol and drug use disorders relative to RC users.Compared with RC users, MC users have reported lower frequency of alcohol and drug problems during a visit to the emergency department and primary care clinic.Among MC users, patients with state legal access to cannabis had lower rates of other substance use relative to cannabis users without access to MC who might have used cannabis recreationally.To date, there has been little research on MC use in veteran populations, with only one study differentiating between MC and RC use in veterans.