Quebec’s public not-for-profit distribution system

François Gagnon, Ph.D.January 29th, 2019

North American Cannabis Summit, Los Angeles

Québec, Canada?

INSPQ’s mandate: expert support to the Ministère de la santé et des services sociaux du Québec and the regional public health authorities

Une équipe multidisciplinaire:

Réal Morin (project coordinator)

Maude ChapadosGeneviève LapointeSébastien Tessier

Nicole AprilRichard Fachehoun

Onil SamuelAnnie Montreuil

Pierre-André DubéKarine Souffez

François Gagnon

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Prologue

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Source: https://www.fastcompany.com/40428568/what-if-the-pot-industry-was-like-just-a-big-nonprofit-man

Outline

Une équipe multidisciplinaire:2. Quebec’s public not-for-profit

distribution system and public health

Une équipe multidisciplinaire:1. Mass commercialization

of cannabis and public health

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Public health logic

Global consumption reduction

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Road trauma

Addictions

Mental health

Etc.

Acute intoxications

Respitory diseases

Frequent and intense consumption reduction

Other high-risk consumptions reductions(products, situations, sub-groups)

1. Mass commercialization and public health

Netherlands: no link between legal status and use, but link between commercialization and use

(MacCoun 2011)

Europe: no link between consumption and penalty regime (EMCCDA 2011)

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1. Mass commercialization and public health

Systems based on profit growth generate more users, higher riskuses, and harmful cost reduction strategies

For-profit actors can become counter-forces to public health regulation

Alcohol, tobacco, medications

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1. Mass commercialization and public health

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1. Mass commercialization and public health

2009: mass commercialization of cannabis in Colorado (Colorado

Public Heath 2017)

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1. Mass commercialization and public health

Source: NSDUH (2015)

0

5

10

15

20

25

30

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Cannabis user rates (last month) in Colorado 2002-2014

12 years + 12 to 17 18 to 25 26 +

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1. Mass commercialization and public health

Source: NSDUH (2015)

02468

1012141618

Daily or near-daily cannabis use rates amongstdeclared users (last month) in Colorado 2002-2014

12 years + 12 to 17 18 to 25 26 +

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1. Mass commercialization and public health

0

1

2

3

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5

6

7

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2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

Daily or near-daily cannabis use rates amongstdeclared users (last month): Colorado – United-States 2002-2014

Colorado United-States

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1. Mass commercialization and public health

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Higher THC concentration in the USA (ElSohly et al. 2016)

1. Mass commercialization and public health

Emergency admissions and hospitalisations possibly linked to cannabis in Colorado(Colorado Public Health - 2017)

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1. Mass commercialization and public health

Poison centre calls linked to cannabis in Colorado(Colorado Public Health - 2017)

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1. Mass commercialization and public health

2. The public not-for-profit distribution system in Québec

Société Québécoise du

Cannabis (SQDC)

Purchase and retail monopoly

Health Canada licensing of producers

(private for profit)

On-Line-sales

Retailers

12 SQDC (t1) -up to 300

Types and potency of products

Qualitycontrol

Model and controls

appropriate?

Prevention and harm reduction

practices?

Sustainable?

Personalproduction (at home or in a

coop): prohibited in

Québec

Constitutional? Applicable? Fair

application?Direct users to

public retailor or to clandestine

market?

« Medical » system

Illegaldistributors

What lawenforcment?What

commercial pressure on

SQDC?

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Mandate: access withoutincreased consumption

Final thoughts : Monitoring, research and evaluation

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2021: Quebec’s and Federal law review

2023: Federal medical law review

Uses and health consequences patterns

Production, distribution and use regulation

Useful for other jurisdictions?

Contact Information

François Gagnon

francois.gagnon@inspq.qc.ca

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Auteur: Jean Gagnon