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Peter Cohen (2001), Senate Hearing. Proceedings of the Special Committee on Illegal Drugs, Issue 3 - Evidence for May 28 - Morning Session. Ottawa: Canadian Senate. On-line: http://www.parl.gc.ca/37/1/parlbus/commbus/senate/Com-e/ille-e/03eva-E.htm (accessed 12 June 2002).
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[Français]

Senate Hearing of Peter Cohen

Special Committee on Illegal Drugs, Canadian Senate, May 28, Ottawa, Canada

Peter Cohen

Ottawa, Monday, May 28, 2001

The Special Senate Committee on Illegal Drugs met this day at 9:10 a.m. to reassess Canada's anti-drug legislation and policies.

Senator Colin Kenny (Deputy Chairman) in the Chair.

[English]

The Deputy Chairman: Honourable senators, seeing a quorum, I call the meeting to order. The Chairman is unable to be here today as he is presiding over a meeting of the committee on science and technology at the NATO Parliamentary Assembly, in Vilnius. He sends his regrets to the witnesses and members of the committee.

Today we are continuing the work of this committee which was authorized by the Senate, and that is to study and report on Canadian policies concerning cannabis and its derivatives, the effectiveness of those policies, and alternative approaches. Further, the committee will be examining the international context of policies regarding cannabis, the health and social effects of cannabis, and the potential effects of those policies on other policies. The committee is aiming to table its report by August of 2002.

In the course of its deliberations in preparing to draft its report, the committee will consult with eminent experts in a variety of fields of study and professions, as well as the Canadian public.

Our first witness today is Dr. Peter Cohen. Dr. Cohen first entered the field of drug research in 1980 by way of a course in sociology on the history of social problems. In his view, human construction of cultures and societies can be partly understood by studying what a society defines as a problem and why. Since then, he has studied the so-called drug problem as one of the many social constructions of western culture, based on complex prejudice and ideology. His main interest is to conduct empirical research on typical drug myths such as those relating to addiction to cocaine or to cannabis as a stepping stone to more dangerous drugs. Large-scale epidemiological drug use research in the city of Amsterdam and later in the Netherlands as a whole has been conducted. Dr. Cohen is currently Director of the Centre for Drug Research at the School of Social Science, University of Amsterdam, doing research funded mostly by the Dutch Ministry of Health.

Among his numerous publications on drugs, which may be found at the CEDRO Web site - www.frw.uva.nl/cedro - are: Drugs as a social construct, (1990); Re-thinking drug control policy. Historical perspectives and conceptual tools (1994); The case of the two Dutch drug policy commissions. An exercise in harm reduction 1968-1976 (1994); Cannabis use, a stepping stone to other drugs? The case of Amsterdam (1996); Shifting the main purposes of drug control: From suppression to regulation of use. Reduction of risks as the new focus for drug policy (1998); and, Is the addiction doctor the voodoo priest of Western man? (2000).

Welcome to the Senate, Dr. Cohen. Please proceed with your presentation and we will follow with questions.

Professor Peter Cohen, Director, Centre for Drug Research, School of Social Science, University of Amsterdam: Honourable senators, I am pleased to be here. I hope to be able to answer your questions about the situation in the Netherlands.

The research into the use of drugs is complex because not only is the definition of drugs rather unclear, but also there is no standard for the way in which we describe the use of drugs. Therefore, the use of drugs is often described in qualitative terms and it is difficult to quantify the description of drug use.

Another complexity in drug use research is deciding which groups will form the basis of the research. It is easy to look at the alcohol use of people who live in the streets. You will find that the function and usage of alcohol in that group is different from the use of alcohol by people who have regular jobs and who drink wine with their meals. Different groups can use the same drug in so many different ways, and it can be functional within so many different lifestyles. It is easy to understand that among those who research drug use there is much misunderstanding about what actually happens and the effects of drugs.

Drugs are used for particular functions within particular contexts that are sometimes culturally defined and sometimes economically defined. For instance, cocaine use in poverty- stricken areas of American cities is completely different from cocaine use among rich stockbrokers. The functions and rules for the use of that substance are completely different. It is easy to understand that so much misunderstanding exists in the world about drugs; their effects both positive and negative.

In Amsterdam, from the beginning of our research, we have tried to construct representative samples of drug users. We did not go to the prisons to single out particular types of drug users who were prisoners; and we did not go to clinics to look at particular subgroups of people with drug problems. We did go into the population to try to construct large representative samples of drug users in order to be able to view how most users of drugs, whether cocaine, cannabis, alcohol or amphetamines, use those drugs, how they construct their rules of control around that, how they describe their own careers, and what they say about the advantages and disadvantages of the different substances. At the heart of good drug research is where you look, how you account for your sample, and how good your sample is.

It is possible to make a million different observations on the use of drugs depending on where you look. Always bear in mind that whenever people say something about the effects of the drug, they may be right, but the ability to generalize those observations may be very limited.

Today I would like to discuss with you the effects of the decriminalization of drug use on the general population. That is where my expertise lies and I believe it is extremely important to consider that area.

[Translation]

Senator Poulin: As you know, Mr. Cohen, the issue being studied by the Special Senate Committee on Illegal Drugs is the focus of attention throughout the world at the moment, and there are a number of reasons for that.

First of all, I would like you to take the time to summarize the policy currently in effect in your country so that we can properly understand your reference scheme.

[English]

Mr. Cohen: You asked me to give a short resumé of the present-day Dutch policies in the area of drugs. I will try to do that although it is a rather long and complicated history.

In the early 1960s, something quite new happened in Amsterdam. Young people started to smoke marijuana. Before the 1960s, that kind of habit was not observed except, perhaps, in the case of some musicians. It was not a fashionable fad until the early 1960s. The first reaction of the Dutch government was negative. In fact, they were quite alarmed.

The Amsterdam health system included doctors who were working for the Municipal Health Service, a kind of institution created in the 1920s in the Netherlands to cater for the health care of people who would not easily enter the primary health care system. These doctors were the first to observe this drug use among young people. They went to the parks where they had their little parties and played music. From the beginning we had experts who were looking with different eyes at the drug use of the young people; they took a less conservative view from the start. The doctors mixed with the young people and watched what was happening.

In the late 1960s, when the Dutch government decided to establish a commission to examine the drug use problem, medical people and sociologists were part of that commission. They were already knowledgeable about the drug use in certain groups. They had a far less fearful attitude toward drug use. They saw that many of the young users simply drifted out of marijuana use when they got older. We found that again later when we did systematic studies into cannabis-use careers.

At the first committee hearing, which was presided over by a criminologist, the general feeling was that most of these drug users would be extra-drug users quite soon. In the time that they would be using these drugs, it would be more harmful for them to be sucked into the legal system and penalized by fines or even prison sentences. They tried to come up with solutions that would keep these people out of the judicial system.

This was a rather revolutionary conclusion, but it was taken over and shared by the government commission which reported in 1972, just one year before the famous Le Dain commission reported in Canada. The Le Dain commission and the Baan committee in the Netherlands were similar in their conclusions: Try to decriminalize drug use during the short period that it happens so that these people will not be burdened with the heavy social consequences of a prison sentence or even worse.

In 1972, the Baan committee reported and there was already some public discussion going on about decriminalization. The Baan committee recommended that we decriminalize all personal drug use, not only cannabis, so that the usual period of drug use, being only a few years, would not be disadvantageous to the users.

Basically, that is the story of what happened in the Netherlands. Individual drug use and small-time dealing is never prosecuted. The decriminalization of cannabis has gone further than the decriminalization of other drug use because, under Dutch law, the distribution of cannabis-type drugs became more open, but also more controlled.

After the 1970s and the early 1980s, people started their small hashish and marijuana shops, which were called coffee shops for some reason. Now we have about 850 shops where the public can come in and buy a quantity of up to five grams of marijuana or hashish, which is an amount that most people will not use in a week or even a month. The amount used to be 30 grams, but that was diminished because of pressure from our powerful neigh bours. The shopkeeper is allowed to have a stock of 500 grams of these substances in the shop.

This has resulted in a kind of cannabis market which is very developed in the Netherlands. Many varieties are offered, from very mild to very high potency. It is somewhat like alcohol which varies from low-alcohol beers to whiskeys of 40 per cent alcohol or more. The whole gamut of marijuana-type drugs is sold in these shops.

The people who like this type of substance - which is only about 15 to 18 per cent of the Dutch population - go to these shops to buy their cannabis. The age at which people can enter these shops was raised in 1995 from 16 to 18. That was also as a result of pressure, mainly from France.

There is discussion about lowering the age again because people between 16 and 18 who use this substance - of which there are not so many - must now go to the streets and buy from non-regulated sources. That is not considered to be an advantage. Mayors in the Netherlands are asking the government to lower the age back to 16 which is what it was between the 1970s and 1995.

Would you like me to go into the treatment policies in the Netherlands?

Senator Poulin: I will leave that area for my colleagues.

You have already touched, Professor Cohen, on my second question. Here in North America we are hearing much good news about the strength of the new European Union. You spoke about the influence of certain of your neighbours. Could you speak to us about the relationship between the Dutch policy and practices and the policies and practices of other countries which are part of the European Union? Is there a gap? Is there a link? Are there common tables where the policies and practices are discussed?

Mr. Cohen: There is a big gap. The gap is becoming smaller, but it is still in existence. The acts of the Dutch government, and later all the municipalities, to put into place a system of rules within which people could buy and have completely open access to cannabis-type drugs have created a unique set of rules in the European Union. It does not exist in any other country.

Since the 1970s, the Dutch have often been accused, with periodical phases of intensity, of poisoning the youth of other countries. Some young people would come to the Netherlands to go to these shops to buy cannabis-type drugs. This was considered a very bad influence on the youth of other countries. Slowly now, however, the governments in other countries, mainly Spain, Italy, Greece, Germany and France are recognizing that their people between 15 and 50 will use cannabis-type drugs and that it is not so much dependent on the availability of them in the Netherlands. They recognize that it is an international phenomenon not caused by the existence of this system in the Netherlands.

The Belgians have now gone further than all of these others countries and are approaching the Dutch system.

In Germany, there is a split between the north and south. The northern states in federal Germany would like to go further in the direction that the Netherlands has taken, but they cannot find majority acceptance in the government because the southern states do not want to go in that direction. In the north of Germany, almost no cannabis-related arrests are made, but in the south there are many. Germany is not really an entity in this area of policy.

The French have moved quite considerably during the last five years from being the most active and negative criticizers of the Netherlands to being curious about it. Two official groups of observers have come to the Netherlands to look at the Dutch drug policy. There is now much contact between Dutch and French drug researchers, and that is which is all organized by the French government. The present French Minister of Health has asked for studies to be done in France to see how far Dutch-type policies could be realized within France. The sharp enmity between France and the Netherlands that caused some of the changes in the Dutch drug policy has changed completely, and with surprising speed.

No European countries are repeating the very sharp criticisms we have experienced over the last 15 years. Clearly, Europe is slowly, but in my mind certainly, going into a phase of decriminalization of cannabis-type drugs. The speed at which they do this, and also the type of development that they will choose for this, will be different because the cultures are so different.

The Swiss government has come forward with a highly detailed proposal of law which I have just finished studying. The Swiss government's proposal goes much further than Dutch drug policy ever went. It not only decriminalizes consumption and access to the drug, but it also tries to create rules for the production of cannabis-type substances, their distribution, their stocking, et cetera. This type of legalization, which goes much further than decriminalization, is already starting in Europe. Actually, there has been very little negative comment about this proposal of law from the Swiss government, and I think it can act as an important model for other governments to consider.

Once again, over the last 20 years, the Dutch type of drug policy, which was mainly defined by no police intervention in individual drug use, has been criticized tremendously, and this has perhaps caused a kind of disinterest in the present Dutch government in going further, although I am sure that the population in the Netherlands is ready is go further into a direction of partial or even complete legalization, as well as the production and distribution aspects of cannabis-type drugs.

Senator Poulin: My last question, Professor Cohen, deals with the same issue as it relates to a North American perspective. When you spoke about the 1960s in the Netherlands, it reminded me of how Canada had its eyes on California at that time. They went through the same phenomenon of a subculture making use of marijuana, with the powers that be often closing their eyes to that practice. Moreover, the United States went through a period of prohibition to which Canada did not subscribe although, historically, Canada has been a very strong part of North America and has always looked south in terms of trade, culture and practices.

From a European perspective, how would you assess the influence of the United States on Canadian policy, and how do you see the closeness or the gap within the European Union countries having an impact on North America?

Mr. Cohen: We all have the problem with North America. In my private encounters with people, I always say that the Americans are the "Taliban" of drug policy. We must deal with them. They are a powerful ally. They try to exert quite a lot of influence on drug policy in the Netherlands. I have never seen much of a result from that, but they have always tried to do that. The American foreign ministry has invited me to visit a few times, and I have always experienced these visits as very well-organized propaganda tours. They do this with many other people. They invite hundreds of police people, judges, prosecutors, treatment people and doctors into the country and they try to convince them that their policies are the best on earth. Up until now, they have had very poor results in the Netherlands.

Canada did not take the same direction as the United States of America, for instance, in relation to alcohol. When the ideas about prohibition of alcohol and drugs were designed in the 19th century, they erupted into a full prohibition of alcohol and other drugs in the United States of America. For its own good reasons, Canada never followed that example of alcohol prohibition. Using the same logic one could say, "Let us stop following the example of the Americans in relation to the prohibition of other substances, because basically the same questions and the same solutions apply. "

The prohibition of the use of alcohol and drugs provedto be totally destructive during the prohibition between 1920 and 1933. When the Americans tried it, it resulted in the most atrocious social consequences for the country as a whole, and the United States has been forced to retreat from that strategy. More and more countries are recognizing that the prohibition of other drugs has the same disastrous consequences for their social system as the prohibition of alcohol during those times, and they are asking themselves the question, "What shall we do?"

I can see that your proximity to the United States of America introduces a particular problem that we do not have. However, we have other powerful neighbours that are five to ten times as big as the Netherlands and which have been quite aggressive in relation to Dutch drug policy. Defending the basic reasons for our drug policy against all these attacks has ultimately resulted in our neighbours changing more than we have. More and more, people are seeing that this strategy of prohibition is more negative in its effects.

In the international globalization of affairs, people buy not only American cars but also Japanese cars and Italian cars, and we have fruits from all over the world. By the same token, drugs from all over the world will enter lifestyles in our highly developed and very rich democracies, and it slowly becomes impossible to stop this process of renovation of how people want to live.

For many people in the Netherlands, the reasons to prohibit these drugs were created in the 19th century, in the same time that masturbation was seen as extremely negative and destructive. This is very old language and age-old thinking. These reasons have become obsolete for most people. Most people no longer know why these drugs were prohibited in first place. Experienced cocaine users in the city of Amsterdam use this drug with an ease and control that has nothing to do with the original stories that made people sensitive to its prohibition. Things have changed enormously.

Although exotic drugs will not become popular in the next 50 years, their use will increase. When you speak about millions of people transgressing a law that cannot be maintained, something must break or change.

Senator Rossiter: Thank you for coming, Professor Cohen. We appreciate your testimony. I would like to follow up on Senator Poulin's question about treatment policies in the Netherlands.

Mr. Cohen: Would you like me to explain some of these policies?

Senator Rossiter: Please do.

Mr. Cohen: The number of people who go into drug treatment in the Netherlands is rather low. It is estimated that somewhere between 25,000 and 35,000 need some type of drug treatment, of which some 15,000 have some treatment. The precise figures can be found on several Web sites in the Netherlands which I will be glad to give you.

The main treatment that was initiated in the 1970s was around the repetitive and frequent use of heroin. Heroin was introduced in 1972 by soldiers from Vietnam. They came to the Netherlands for their four weeks or six weeks of free time, and they brought heroin with them. At that time it was unknown in the Netherlands. Opium users in the Netherlands shifted to heroin in 1972, and most of this use was intravenously. This came as a new fad to the Netherlands. People did not know how to do this well, and it created all types of problems.

Treatment settings were designed to wean these people away from heroin. There was a drug-free treatment atmosphere in the design of treatment forms that had to be created from scratch because there was nothing available.

Senator Rossiter: Did people go into these programs of their own free will?

Mr. Cohen: Mostly they did, yes.

These treatment forms became unpopular because the kind of treatment ideology was so harsh on these people that they escaped. The first methadone treatment was experimented with in 1968 by a young doctor in Amsterdam. Over the 1970s, the availability of methadone increased somewhat until, in the early 1980s, it became the staple of drug treatment, trying not to get people off their opiates but to make it possible for them to live a life with opiates; taking them out of the criminal market, the heroin market, and giving them methadone. In the beginning, there was only low dosage methadone in the Dutch treatment system. Over time, it increased to include high dosage methadone. It is still the main treatment that is given to heavy drug users in the Netherlands, together with some economic and other support. For instance, mothers who have problems with the education of their kids will get assistance. Housing assistance is also available. All kind of social assistance is available to these people, although there are not many of them.

For the past two years, a new form of treatment called heroin maintenance has been made available. If people do not want to stop their heroin use, and methadone does provide give sufficient help, they can legally obtain heroin. Most heroin users in the Netherlands are now heroin smokers. The heroin available on the black market is the base form of heroin which can only be smoked. Little intravenous use is left. People in the heroin maintenance system can get both IV heroin and smokable heroin. Both varieties are prepared for these users. Currently 750 people use the heroin maintenance system. If it goes well, and it has been going well so far, then this system will be slowly expanded.

However, real life has changed. First, opiates have becomeless popular, even among this particular group. Second, the price of heroin in the Netherlands is now so low - between 30 and50 guilders per gram, or between Can. $20 and $30 per gram - that it is hard for treatment heroin to compete with street heroin. There is almost no threat to the dominance of particular circles in the Netherlands who own the heroin black market, so that market is stable in price and in quality. That means we do not see the kinds of accidents that result from highly variable levels ofheroin purity. The heroin is almost always the same purity at 30 to 40 per cent.

The average age of people in the Dutch treatment system is increasing by almost one year each year. That means that the marginalized lifestyle of drug users, living on the streets or with friends, is going down a lot. It was never a very popular lifestyle, but we do not see many new people going into it to replace the older ones. The oldest people now in the Dutch treatment system are approaching 60. The Minister of Health, together with some municipalities, is now preparing a policy paper, exploring whether special old-age homes should be provided for this particular group because they mix very poorly in the normal old-age homes in the Netherlands. Their lifestyles have been so different during their whole lives that it may be a good idea to give them their own old ages homes where they can be together. It is important to note that many of them have survived.

That is my brief summary of Dutch treatment.

Senator Rossiter: It is amazing to consider that the black market, as you say, is almost policing itself with the quality of its product. Does that happen anywhere else?

Mr. Cohen: I do not really know. I think the German drug market is dominated by the same groups as the Dutch drug market. It may happen there, but that is not one of my specialities. Perhaps the next witness will know more about that.

Senator Rossiter:You state in your treatise here:

A serious pre-condition for improving upon present drug controls has to be the loosening of the suffocating grip of international drug treaties. These treaties have to be reformed and probably ultimately abandoned to make room for local differentiation of drug policy.

How would that come about? What force would make the principal parties abandon their positions?

Mr. Cohen: I do not know. At the moment, in the Netherlands, people are speaking again of trying to change the Dutch participation in the global drug treaties so that it will be more possible that Dutch developments in drug policy will happen. You should not forget that there is almost no global treaty system that is so well guarded and so severe in its expulsion of any deviation as these drug treaties. As I said, they are a product ofthe 19th century. They were thought up and designed inthe 19th century and put into practice in the early 20th century. The bureaucracies that guard these treaties have grown and grown. The treaties are made more precise and more severe almost every year.

I consider these treaties part of a policy of suffocation for any deviation. There is almost no state or human behaviour which is governed by such severe global treaties as drug use and drug trafficking. Under these treaties, even local traditions such as the chewing of coca leaf is impossible, although people have been doing that for thousands of years.

We must abandon the idea that drug policy can come from one set of general rules. Nations should at least regain their autonomy in this area by saying, "Though this is a good set of rules to consider, some of the rules are impractical and costly for our population, so we must deviate from them." The Swiss, who never undersigned New York, 1961, have maximum freedom in doing so. They exercise this freedom now. Individual countries could consider saying, on all the rules about cannabis, "We will put a question mark next to them, and we will simply decide to deviate from this path for the next 10 or 20 or 30 years and see what happens."

If more countries go in that direction, then at a certain moment the UN must decide to relax its iron grip on global drug treaties to enable nations to escape their destructive force. I see these treaties as a real destructive force against local autonomy and against inventiveness and creativity in solving all these problems.

Senator Banks: Professor Cohen, thank you for coming.

You told us that our institutional attitudes in dealing with drugs in Canada, and with cannabis in particular, are based on mythology. Do you have an opinion on why that is so? You mentioned the 19th-century attitudes which helped to develop our drug policies. On what are those attitudes based? They must be based on something because many people have subscribed to them. In this country, most of us are still brought up with the mindset that drugs are bad, period, end of statement, no parentheses, no modification: Drugs are bad. Yet, examination reveals, as you said, that many cultures in the world have used drugs of one kind or another over centuries. That does not make drug use good, either. Many cultures used to settle differences by killing each other. That does not make it okay.

On what mythological or other foundation, is our tendency to prohibit drugs based?

Mr. Cohen: This is one of my hobbies and it is very dangerous to ask questions about this because, once I start talking about it, it is difficult to stop me. I will try to restrain myself.

I have just published an article that deals with this problem. The title of the publication is, Is the addiction doctor the voodoo priest of Western man? I try to answer this question. Why, suddenly, in the 17th and 18th centuries, did all these ideologies abound in the individual who must be free-governing, self-propel ling and self-navigating? Where do all these ideas come from? My thought up to now, although I changed when I researched the question further, was that the root of all these ideas about the individual are based in the Reformation.

Following the Renaissance in Europe we had the Reformation, wherein the new ideology was that people had an individual relationship to God. They were now able to seek salvation for themselves, rather than through the church as an instrument for salvation. An individual relationship between man and God would be possible. This gave birth to theories of the individual as a self-controlled, autonomous and self-responsible person that we have until now. As well, there were diagnosed forces that would take people away from their individual relationship with God, or with the world around them, in the sense that they were autonomous.

During the Victorian period, the basic force that would deviate people from their course would be sexuality. We have emerged from of a period of sexual phobia that lingered for a long time, in which sexuality was seen as a force that would take people in its grip and make them bad people. Therefore, we had to protect youngsters, certainly, and older people from the seductions of sexuality. Pornography became prohibited, intercourse outside marriage became something looked down upon - a taboo. Sexuality was seen as a significant enemy of the Western individual. At the same time, ideas started to be born about alcohol as an enormous force that would take people's individuality away, as well as their own willpower, their own possibility to be himself or herself.

Senator Banks: It does that.

Mr. Cohen: It does it to a certain degree in some people, but for most people it does not. Most people drink alcohol in a way that is recreational, which emphasizes pleasures they already enjoy. Only under certain circumstances can they take in so much alcohol that they liberate themselves - and I see it as a kind of liberation - of individual constraint.

Drugs and alcohol were viewed, like sexuality, as forces that would threaten the autonomy of the individual, and had to be banned. This attribution of the enormous power of alcohol and drugs is a product of the 18th century and certainly the 19th century.

When you look at this phenomenon with an empirical eye, when you look at drug users and alcohol users as they exist, you can see that for most people the use of alcohol and drugs is not at all this terrible force that takes away their individuality. On the contrary, it is one of their adaptations that makes it more possible for them to live the type of lifestyle that they choose for themselves.

You can look at drugs from two different perspectives. You can look at the worst case of the alcoholic in the street who does not seem to have a useful life, and you can say, "Look at what alcohol does." However, you can also look at the fact that there are far more alcohol users who do not show this pattern of use, and this functionality of use, and use alcohol in a completely integrated lifestyle. The same is true of drugs.

An empirical examination of the theory that the force of drugs and alcohol takes away the individual power of autonomy and self-determination reveals that most people simply do not behave that way when they use these drugs.

Senator Banks: We have heard from detractors and critics of the system in the Netherlands that among its effects is a considerably increased use by a larger proportion of the population of cannabis in particular and what we call illegal drugs in general. In your experience, is that true?

Mr. Cohen: In my experience, it is not true. The data from Germany and France indicates the national levels are somewhat similar, which is around 16 per cent of lifetime experience with cannabis. That applies to Germany, France and the Netherlands.

One problem is that you need costly national surveys to measure drug use in a meaningful way. The other problem is that within a country there can exist considerable differences. In a city like Amsterdam, where many artists, actors, financial people and people who work in publicity live, the proportion of people who have been using cannabis is approximately 40 per cent. That is about three times the national average. In the rural areas of the Netherlands about 10 to 12 per cent of people have used cannabis.

We have designed a way of looking at cannabis use and drug use in the Netherlands by defining seven different samples of the population. We not only look in big cities, but we also construct samples of municipalities of lower address density. Therefore, we are able examine cannabis use in the stratum of lowest density municipalities in the Netherlands, and we then continue up the scale until we reach the highest density areas in the country - areas with more than 2500 addresses per square kilometre. We find that the denser the area, the higher the probability that people will have used drugs.

In terms of our national averages, we are in the same league as Germany and France. We are considerably lower than the U.K. or Denmark, and much lower than the U.S.A. The U.S.A. has levels of drug use that are double to triple the levels in the Netherlands. I do not say that this is because of drug policy, because it is my firm opinion that drug policy in itself has very little influence on the number of people who use drugs or who do not use drugs.

The incredibly easy availability of cannabis type drugs in the Netherlands has not at all changed the number of people who want to use it, because the decision to use it is based on the cultural composition of the population, who your friends are, the image of drugs and the economic situation of individuals. It does not matter what the government thinks about these drugs.

I do not see any epidemiological evidence at all for the general observation that drug policy in the Netherlands has increased the number of people using drugs.

Senator Banks: As a corollary to that, we have also been told by many witnesses that cannabis is a gateway drug, that use of cannabis may be because it simply leads to the next drug up the scale, or maybe, because of associations with people who provide it who are mostly in the criminal element, the use of cannabis leads to the use of harder drugs.

Do you personally believe that cannabis is addictive? Do you find in the Dutch experience that the ease of access to cannabis has led to those people who have that access using progressively harder drugs?

Mr. Cohen: Your question about whether cannabis use is addictive is difficult for me to answer because the definition of "addiction" is so vague.

Senator Banks: Physiologically addictive.

Mr. Cohen: Physiologically, it is not addictive.

On the second question, we have done precise computations to see if this gateway theory applies to Amsterdam. Amsterdam is the city in the Netherlands where drugs are most easily available, their prices are lowest, and it has the culture in which drugs are most accepted. As we say, drugs are most "inculturated" in the city of Amsterdam. We have examined our large samples of population to determine whether those who have ever used cannabis also use the other drugs.

We have several different definitions of what a gateway is because, if you want to research it, you must quantify what you mean by "gateway." We have said we would simply make the hypothesis that if cannabis really is a gateway drug, at least50 per cent or 75 per cent of the people who use it or have used it must also have at least a minimum experience with other drugs.

We found that of all lifetime cannabis users in the city of Amsterdam, just a little over 20 per cent also have lifetime experience with cocaine, which is the next most popular drug on the scale of popularity. Almost 80 per cent of all lifetime users of cannabis have no experience with cocaine at all, although cocaine is easily available in the city and not very expensive. Most users of cannabis do not, for some reason or another, decide to also be curious about cocaine.

Heroin use in the city of Amsterdam has always been very low. It is almost immeasurably low among cannabis users, but we can measure a few per cent.

The nice thing about the gateway theory is that at least it is a theory that is testable. You can say, "If there is a gateway phenomenon, we should be able to observe this in users of cannabis." In the city of Amsterdam, where access to cannabis is as easy as access to bread in Ottawa, we do not find this gateway phenomenon to a high level, but we find some level of it.

As I said, of all cannabis users, 22 per cent have ever used cocaine. However, when you start to analyze their cocaine experience, most of this experience is floating. People want to have tried it. They have heard about it, and they want to try it, but nine out of ten cocaine users never use more than an experimental amount of it.

I do not know if a gateway phenomenon would exist in Canada, but it is perfectly possible to check on this because, in Canada, epidemiological data is collected about drug use in the population. It should be easy for your committee to ask, for instance, the Addiction Research Foundation in Toronto to look into this phenomenon and to find out to what degree and how it exists.

Senator Kinsella: Is there literature on the relationship of public taxation to the use of leisure drugs? Are those legal drugs that are available in the coffee shops subject to tax in the Netherlands?

Mr. Cohen: The Dutch government wanted to put value-added tax on all sales of cannabis-type drugs in the coffee shops, but some sellers said that they found that to be unjust. They said that they wanted to pay value-added tax, but they also wanted to have a fully legal status. They said that, as long as they do not have a fully legal status, which has all kind of disadvantages for them as sellers, they would not be willing to pay VAT. One seller took his complaint against the Dutch state to a EU judge in Strasbourg, to the court where you can make a complaint against states. The Dutch authorities lost that action. From that moment on, the coffee shop owners have paid only personal income tax on the gains from their shops. There is no value-added tax, or a special tax, as we know it, for instance, in the Netherlands on alcohol. You pay special taxes on that substance.

Senator Kinsella: Is there anything in the literature that examines this question from a public policy standpoint? We know the cost of dealing with the leisure use of drugs from the standpoint of public education. You mentioned counselling. Of course, there is a cost attached to counselling, et cetera. Has anyone considered imposing an excise tax or a special tax on the sale of these substances, together with the GST or a VAT?

Our chairman introduced in Parliament - and it was passed by the Senate - the innovative idea of raising revenue on tobacco sales for the development of educational programs. A special foundation will be established. As a sociologist, I take it your hypothesis is that drugs are here to stay, and that we have not been very successful in trying to understand the nature or the essence of drugs and the psychology and sociology of the human behaviours that relate to drugs. What if we change the paradigm? If there are social costs associated with usage, then the product itself ought to generate the revenue to deal with that, and that means t some form of taxation. Has there been reflection on this?

Mr. Cohen: The Australians are now working on a proposal for taxation on cannabis-type drugs. Once you take the course of normalizing the consumption of cannabis-type drugs - the view that there are types of behaviours that we want to put legal constraints around but no longer prohibit - I think that there is no reason to treat them differently from the way you treat tobacco or alcohol.

The taxation systems that various countries have on tobacco and alcohol are different. When Canada decides that cannabis is no longer prohibited, it may use as a model for the taxation of cannabis the taxation regime it uses on tobacco pharmaceutical drugs. However, there are many options.

If you want to use tax as an instrument to limit use, that is a whole different story. Up to a certain level, that may be successful, but over a certain level you invite all types of secondary distribution systems to develop, with all their costs. Taxation to a certain level would be considered normal and natural; over a certain level, the population would certainly try to dive underneath and find other supplies.

Senator Banks: Professor Cohen, you said earlier that the United States policy, which has sort of crystallized in everyone's mind as "the war on drugs," is known as the "Taliban" of drug policies. I gather that the present American system does not contain the realism which you believe ought to attend national drug policies, and that it does not abjure the use of myths as a basis for those polices. Would you expand on that for a moment? Do you think that United States drug policy, which is to a degree a hemispheric drug policy, is based on myth?

Mr. Cohen: To a large degree, it is. It is also, to a large degree, based on a particular notion of the function of the state. The application of general principles or ideas about the prohibition of drugs is varies from country to country.

The global treaties are of one text. They make it impossible for individual states to deviate in their legislation from that general set of rules. What actually happens in those countries that are signatories to those treaties is very different. Although many people in the U.K. use cannabis-type drugs, the police there insist on making a certain number of arrests for the possession of cannabis. Every year, approximately 70,000 to 80,000 arrests are made on the basis of that prohibition. In the north of Germany, such arrests are not seen at all, although they have the same legislation which is based on New York, 1961.

In the United States of America, an even more fundamentalist application of this legislation is seen. The American police will send in undercover police to provoke small dealings in cannabis-type drugs. They will send in police dressed as people of a certain culture to act as drug sellers. If a person agrees to buy, that person is then arrested. That kind of application of legislation goes further in the U.S. than in any other country I know of.

The application of the law is one thing. Big differences can exist between countries. The myth at the basis of this action is that cannabis leads to other drug use which is much more dangerous, that it leads to particular cultural behaviours that are considered undesirable, or that it leads to a particular type of personality that is not wanted. There is a whole series of so-called justifications for treating cannabis as if it were something extremely dangerous or destructive for human kind. Those justifications escape me completely, but the American powers seem to think that is the right way to go.

Senator Banks: From time to time you must have pondered why that is so. If the empirical information and even statistical information is available to disprove the myths to which you just referred, what is the constituency that resists that irrefutable logic?

Mr. Cohen: I think it is a type of moral indignation. Let us take another example, that of divorce. The Italians struggled against divorce, guided by the Papal State, well into the 1960s when in other countries divorce had been available for a long time. The Roman Catholic ideology that opposes divorce was so much part of the local Italian political system that it was very hard to escape it. All kinds of quasi-scientific objections can be made to divorce but, in the end, it is the moral conviction that makes it right or wrong. Even if you could see in Italy that many people were separated and that there were enormous costs related to the legal impossibility of a normal divorce, the power of the moral conviction that divorce is something bad was so strong that all the other were aspects dwarfed in relation to that moral conviction.

In the western world, many quasi-scientific problems exist around the legalization or even the decriminalization of drugs. It is the guise taken for what is actually a moral conviction that any drug use is wrong. In order to amplify that conviction, you can take a few observations and hold them as the general truth about drug use. They are illustrations of a basic moral conviction. One cannot discuss moral convictions on the basis of statistics. A moral conviction is a moral conviction.

The Deputy Chairman: Mr. Cohen, at the beginning you commented that the marijuana-selling coffee shops in Amsterdam are entitled to hold, at any given time, 500 grams of stock. How do they obtain their stock? What distribution system is used to stock these coffee shops?

Mr. Cohen: This is evolving. It is now different from what it was five or ten years ago. When the coffee shops started, most cannabis sold in coffee shops was imported hashish from Morocco, Lebanon, Pakistan or Afghanistan, but the quality of the hashish was so variable that some Dutch entrepreneurs started to grow marijuana. Slowly, Dutch marijuana has become the main article inside the Dutch coffee shops. There is still some imported hashish from Morocco, from Columbia or other Latin American countries, but most of the present-day stock in Dutch coffee shops is Dutch-grown marijuana with an incredible variety, as I already said, from the very mild varieties to the very high-potency varieties.

In our own research on cannabis-use careers, we find that more than half of all experienced users prefer the milder qualities of marijuana.

To answer your question, most present-day stock comes from Dutch soil. It is either grown outside or it is grown inside in very high-tech growing outfits inside houses.

The Deputy Chairman: Are growers licensed? How are they protected from prosecution? How is the transportation of the product from the growers to the coffee shops handled?

Mr. Cohen: About a year ago, 60 mayors of municipalities asked the Minister of Justice to design a system that would license growers, so that the entire growing and transportation system could also be regulated. The Minister of Justice refused to do so in spite of quite formidable support for such regulation within the country, because he refers to international treaties and also the possibility of foreign pressure on the Netherlands in this area. It is not regulated.

Once in a while growers are arrested. Transport is almost not interfered with. We know that the owners of coffee shops have stocks that are much larger than 500 grams because they must have stock of all the varieties, and they must store those in stashes that are secret. There is a kind of schizophrenia in the Dutch system that I deplore, which makes cannabis-type drugs fully and openly available in little shops. However, the provisioning of these shops is not yet regulated or caught in a system of rules that specifies which growers are licensed, under what kind of conditions, and how much they can produce. This is what the Swiss are now doing. That is why I like the Swiss proposal of law so much. It tries to find a solution for the entire area, not only distribution but also production.

The Deputy Chairman: Dr. Cohen, you said that the limit an individual could purchase is now five grams, whereas it used to be 30 grams. You indicated that the change was as a result of international pressure. Could you elaborate on that?

Mr. Cohen: In 1995-96, the mayor of Lille, a large city in the north of France, came with a complaint that youth of this city would travel to the Netherlands, buy a lot of marijuana and hashish, and then sell it in Lille. This was undeniably true. Some people would come to the Netherlands, stock up and sell it in France. In order to respond to that problem, the Dutch government said they would make it impossible for all people to do that. This applied not only to foreigners, but also to the Dutch because you cannot have different rules for foreigners. The Dutch government decided to lower the amount of cannabis-type drugs that a person can buy in a coffee shop in order to deal with the problem of people coming to coffee shops and buying so much that they would have enough to sell in their home country.

We know from our research that for most users of cannabis who are not reselling - and why would they because there is enough cannabis in the Netherlands to go to the shop every week or every month, whenever you want - five grams is a stock that lasts them for at least three to four weeks. The Dutch consumer was not really bothered by this change in regulation because he or she could still buy enough. The regulation focused on foreign buyers who would come to the coffee shops.

The Deputy Chairman: I understood that. My question was really how was the pressure applied?

Mr. Cohen: The pressure was applied through the prime ministers, the ministers of health and the ministers of finance. It was discussed in EU agreements. How do governments relate to each other? In all the institutes of communication, the French made it an issue and pressured the Dutch to change the accessibility.

The Deputy Chairman: Could you tell the committee how the police in the Netherlands react to this schizophrenia that you talked about in terms of drug policy? A drug appears to be legal in certain locations. However, it is not legal to grow, transport or possess when you have more than five grams. How do your police react to that and how do they enforce the law? What is their understanding of the law?

Mr. Cohen: This may be different in different areas. In Amsterdam a special group of police people is specially focused on guarding the rules around production and distribution. They frequently arrest people producing marijuana, or they check the coffee shops and, if the stock is higher than 500 grams, they will give the owner a warning. After three warnings, the coffee shop will be shut.

In other municipalities, the police are much more lax and easy going. When people grow cannabis in houses and they do not purify the air in those areas where it is grown, there is such an incredible stench of marijuana growing that people in the neighbourhood start to complain. Under those circumstances, the police will come and shut the outfit.

The Deputy Chairman: Would that be under a clean air act?

Mr. Cohen: No, they act on the basis of what is in the books. If there are no complaints, and if people do not make themselves conspicuous, the police in the Netherlands will not do anything. However, they are expected to suppress everything: growing, possession and transporting. This is highly impractical because access to the population is decriminalized. They see that this is schizophrenia to its max. The police, therefore, have trouble because the situation for them is unclear. I would never say that this should be repeated in other countries because it is one of the bad and illogical aspects of Dutch drug policy.

The Deputy Chairman: Is that because it is incomplete?

Mr. Cohen: Yes, it is incomplete. It is mainly incomplete because of the lack of courage and because of pressure from other countries. If the Dutch were to transgress international rules on the level of growing and transporting, the fear is that this would have repercussions beyond what the system can deal with. The official policy in the Netherlands at the moment is that we have done our share of demonstrating how you can decriminalize distribution. Let other people reach our level and then we may go somewhere together. Many politicians are sick and tired of the guiding role of the Netherlands in this area,.

The Deputy Chairman: Some might describe the Canadian policy as reducing demand and supply through prevention, education, enforcement and rehabilitation. Would you care to comment on that as an approach towards marijuana?

Mr. Cohen: That is a theoretical approach. It contains all the buzzwords that you must use, but there is no evidence at all that prevention has any impact on levels of drug use. There is also lack of clarity about what prevention actually means. What is prevention? Is it secondary prevention, primary or tertiary? What do you mean? How do you keep people from drugs by official guidelines when drug use is something that is decided amidst cultural developments that have nothing to do with what the government thinks. There is a great lack of clarity here about what it really means to prevent drug use.

However, if you take the route of harm reduction, you could try to define a certain number of harms. Such harms have to do with use, purchase, production, or other types of drug use where you deal with injection. If people continue to inject, at least try to make them inject in a sterile way. Harm reduction is easier to define than fighting drug use or preventing drug use. Those terms are, for a policy-maker, quite vague and difficult to fill in with real activity.

These words, more or less, are symbolic for a certain type of lip service to the global treaties. The content of these things is usually very low, vague and variable between the different regions of a country.

The Deputy Chairman: Thank you, Professor Cohen. Your interesting testimony has held the attention of the committee. You have given us valuable information and a perspective that the committee will find most useful. We appreciate you taking the time to come here and share your experience with us.

Last update: May 25, 2016