Professor Patricia Erickson | Professor Andrew Hathaway – Cannabis Use: The New Normal?

As more countries begin to decriminalise and legalise cannabis, understanding attitudes towards its use will be essential in anticipating the risks and benefits of these legislative changes. Professor Patricia Erickson of the University of Toronto and Professor Andrew Hathaway of the University of Guelph provide new insights into the attitudes and practices of both cannabis users and non-users in order to better understand the ongoing normalisation of cannabis use.

Cannabis: Friend or Foe?

Cannabis is the most widely used illicit drug worldwide by a wide margin. The United Nations Office on Drugs and Crime estimate that approximately 4% of the world’s population use cannabis on an annual basis. Recent years have seen a growing body of literature concerning the health effects of cannabis, both positive and negative. Studies have linked smoking cannabis to lung conditions and the worsening of pre-existing mental health conditions; conversely, cannabis has been investigated and used as a treatment for chronic pain, loss of appetite caused by chemotherapy, and a host of other health issues. Considerable research is underway to obtain a more precise picture of effects.

The prevalence of cannabis use in society and the volume of contemporary studies into its potential medical benefits have led to the widespread reform of cannabis laws in recent years. Some countries, such as the UK, have approved the use of cannabis as a treatment for specific medical conditions. A number of countries around the world have gone on to decriminalise the possession of cannabis, while very few have legalised its production and sale; in Canada, where statistics for use have consistently been among the highest in the world, cannabis has been legally available for medicinal purposes since 2001, and for recreational access to adults since 2018. However, individual attitudes vary greatly on the acceptability of its use according to age, location and social context.

Professor Patricia Erickson from the Department of Sociology and the Centre for Crime and Socio-legal Studies at the University of Toronto, and Professor Andrew Hathaway at the University of Guelph, have published prolifically regarding harm reduction policies and the normalisation of attitudes towards cannabis in Canada. They aim to understand the perspective of young people regarding cannabis use, particularly the stigma associated with the use of cannabis and the shift in attitudes towards regarding cannabis use as a ‘normal’ activity.

What’s the Harm?

Harm reduction measures aim to reduce the negative impact of drug use, whether controlled, recreational forms or more problematic dependencies. Examples of harm reduction measures include needle exchange programs, used to reduce the risks of blood-borne infections for intravenous heroin users, and safer consumption sites to prevent overdoses. A number of studies have argued that an increase in the incidence of high-strength strains of cannabis means that appropriate harm reduction approaches are now needed to mitigate their possible negative health effects, particularly to protect youthful consumers.

In a 2003 review, Professors Erickson and Hathaway called this approach into question and argued that there is little evidence that cannabis smokers experience greater toxicity from more potent strains. They argued that most evidence shows that the harms associated with cannabis use tend to be minor compared to those associated with the criminalisation process. Of course, current forms of consumption such as edibles and concentrates pose additional concerns to consider in relation to health and safety effects.

Professors Erickson and Hathaway argued that in addition to being harmful, prohibition was also not an effective deterrent. The origins of global prohibition were based on misconceptions or misinformation, exaggerating the harms and addictive potential of illicit drugs overall.

Social Stigma

In a 2011 study, Professors Hathaway and Erickson surveyed a large cohort of frequent, adult cannabis smokers in four cities in different provinces in order to obtain meaningful data regarding attitudes towards cannabis use and gauge the effectiveness of the prohibition laws in Canada at that time. Their data showed that although some frequent users were somewhat worried by a threat of criminal punishment, others were concerned with the social stigma associated with their cannabis use being ‘outed’ to employers or family; however, most felt little disapproval among their friends and colleagues.

The perception of many of those interviewed was that use of the drug, in the larger society, was still seen to be associated with ‘deviant’ behaviour, including the use of other drugs and criminal activity. Most were sensitive to the importance of restricting use to social situations where others would not be bothered by use, such as avoiding use around children, for example. These findings supported their previous conclusion that criminal threats were not necessarily the most effective deterrent towards the use of cannabis, and indicated that social attitudes were more likely to limit or prevent use and channel where and how the drug was consumed.

In a subsequent study in 2015, Professors Hathaway and Erickson and their team conducted interviews with undergraduate students, both users and non-users, from the Universities of Toronto, Alberta, and Guelph. The first analysis was mostly focused on those students who abstained from cannabis use. Questions asked by the team considered each student’s reasons for abstaining and their perceptions of responsible cannabis use, and the perceived differences between users and non-users.

The general perception of non-users was that cannabis is a relatively safe, unproblematic drug. Most students indicated that use was inappropriate when it clashed with commitments or priorities such as doing schoolwork. Non-users also indicated that a major reason for abstaining from cannabis use was due to worries regarding the possibility of arrest, and worries about it affecting future job prospects. Family and cultural issues also factored into decisions to abstain from cannabis use. Some abstainers saw cannabis smokers as less mature or foolish, or irresponsible, echoing the results of the previous studies in which cannabis smokers expressed concern about social stigma emanating from certain audiences, and hence their caution in disclosure.

Cannabis Use and Gender

Interestingly, the researchers’ findings showed a difference in attitudes towards the use of cannabis by men and women. More men use cannabis – and use it more frequently – than women according to surveys. Gender inequality and biases seemed to contribute to the attitudes of non-users towards users. The social consequences of using cannabis were perceived to be greater for women than men, men, with both men and women suggesting that women are more concerned with the potential risks of cannabis use and that they are more vulnerable to gendered social criticism (e.g., being stigmatised as sexually promiscuous, immature, or attention-seeking).

The Social Network: Cannabis Distribution in Peer Groups

In a later analysis of the campus study data in 2018, Professors Erickson and Hathaway investigated the role of social supply networks in normalising the use of cannabis by undergraduate students. The team interviewed students who were regular or occasional cannabis smokers, and asked them questions regarding how they usually acquired the cannabis that they smoked.

The team found that 44% of their respondents reported that they bought cannabis from a friend or that a friend bought it on their behalf. Like the previous study, they found a gendered difference in attitudes, noting that women were more likely to have someone purchase the cannabis for them. Use of such a ‘broker’ was seen to be beneficial through providing a safe distance between the buyer and dealer. Users saw social supply networks and the availability of free cannabis from peers as advantageous as a way of reducing consumption and keeping its use occasional and limited to social functions.

The prevalence of these social networks led Professors Erickson and Hathaway to conclude that legalisation would be unlikely to reduce the high levels of cannabis use among young people in Canada, as individuals would still be able to obtain cannabis through these social networks, and that in many cases, these illicit contacts would be desirable over legally available sources of cannabis.

Professors Erickson and Hathaway also pointed out issues with the recent legislative approaches enacted in Canada. They noted that one of the main objectives of legalisation measures is to prevent access of drugs to younger people; following legalisation, cannabis products are now age-restricted in Canada, available for purchase from the age of 18 in Alberta and 19 in other provinces.  The authors noted that this approach is unlikely to prevent the use of cannabis by youths, as legal supplies of cannabis can be diverted to the black market for distribution to younger people, much as alcohol is. Moreover, the age restrictions or high retail prices of the regulated product could drive younger users back to their already established peer networks.

These findings have very important consequences for legalisation measures. For example, overly restrictive guidelines following legalisation could lead to users finding alternative routes to save money or get better access to cannabis. The authors concluded that formal drug policies, no matter whether they may favour legalisation or prohibition, tend to be less effective at curtailing or moderating use than the informal control of cannabis use practised by the users themselves.

Legalisation and the Future

The work of Professors Erickson and Hathaway has provided a nuanced insight into the use of cannabis. Their rigorous studies have helped them recommend more effective harm reduction and legislative measures. It is not yet clear how legalisation will impact the views and social preconceptions of users and non-users alike. Normalisation has been accompanied by the reduction of stigma, but it has not been eliminated. Understanding attitudes towards cannabis both before and after legalisation will be especially important as other countries around the world begin to reconsider their policies on cannabis use and legal availability.