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This paper considers the findings of the Beckley Foundation's Global Cannabis Commission Report (Room et al, 2008), an overview of the scientific literature on cannabis, detailing its potential harms and those caused by its prohibition. It moves on to consider the various strategies that different jurisdictions have adopted to deal with cannabis use, before moving beyond the Conventions, arguing that countries should have more autonomy to develop policy best suited to their individual circumstances.Cannabis was incorporated into the global prohibitive regime via the Single Convention on Narcotic Drugs 1961 (United Nations Office of Drugs and Crime, 1961), and is further affected by two later drug Conventions, the Convention on Psychotropic Substances 1972 (United Nations Office on Drugs and Crime, 1972) and the Convention against Illicit Traffic in Narcotic Drugs and Psychoactive Substances 1988 (United Nations Office of Drugs and Crime, 1988). Together, these require that all signatories make production, commerce and possession of cannabis criminal offences under domestic law: in the UK, this expectation is effected via the inclusion of cannabis in Schedule 2 of the Misuse of Drugs Act 1971 (HM Government, 1971). In the half century since the initial Convention was drafted, patterns of cannabis consumption have altered fundamentally; smoking cannabis has transformed from a relatively rare behaviour confined to a scattering of countries and cultures, to almost a rite of passage among young people in many nations. The United Nations Office on Drugs and Crime (2009) estimates that there is a global population of 190 million cannabis users, rendering it by far the most widely used illicit drug, yet, paradoxically, one that is rarely mentioned in international drug control policy discussions.

This chapter looks at the past, present and future of international cannabis control required by the UN drug control conventions in the post-2016 United Nations General Assembly Special Session era with an eye on the next High Level Ministerial Segment (HLMS) at the UN Commission on Narcotic Drugs in 2019, and beyond. From a policy analysis perspective, the author meanders through the increasing tendency to legally regulate recreational cannabis markets notwithstanding the obligation enshrined in the UN drug control conventions to limit cannabis exclusively for ‘medical and scientific’ purposes. Taking into account relevant national and international developments, the chapter describes how the growing discomfort with the status of cannabis and the prohibitive and punitive approach stemming from the international drug control regime went through a process from soft to hard defections of the treaty obligations. The case of the Netherlands demonstrates the difficulty faced by reform-minded states in reconciling their wish for a different cannabis control mechanism with their obligations under international law, resulting in an incomplete regulation of its coffee-shop system, where small amounts of cannabis are tolerated for sale, but where the illicit supply to the shops remained unregulated. Subsequent more wide-ranging reforms to regulate cannabis from seed to sale in Uruguay, several US States and – in 2018 – in Canada, are clearly violating the obligations of the UN drug control conventions. Nevertheless, the HLMS will likely leave the elephant in the room untouched. The emerging paradigm shift regarding cannabis shows that a modernisation of the UN drug control regime is long overdue. This chapter discusses some of the options available.

The COVID-19 pandemic likely impacted cannabis distribution, access and usage worldwide. This study aims to describe self-reported changes in cannabis use and related outcomes following COVID-19-related restrictions among an international sample of people who use drugs.

Using data from the Global Drug Survey COVID-19 Special Edition, the authors identified 20,417 respondents from 13 countries who reported whether the number of THC-containing cannabis usage days changed compared with February 2020 (before COVID-19 restrictions). Using descriptive statistics and a multinomial multivariable logistic regression, the authors investigated the impact of changes in cannabis use on respondents’ mental health, physical health, relationships, finances, work/study performance and cannabis-related pleasure/enjoyment.

Similar proportions of respondents reported that their cannabis use had stayed the same (38.2%) or increased (38.3%) compared with February 2020, while 21.9% of respondents reported a decrease. The most common reason for increased use was having more time (68.4%), while decreased use was associated with having less contact with people they use cannabis with (58.4%). The likelihood of reporting worse mental and physical health, finances, and work/study performance following COVID-19 restrictions was highest among those who reported increased cannabis use.

These findings provide a unique understanding of the short-term international impact of initial COVID-19 restrictions on cannabis use, and highlight the need for policy to address the ongoing and improved provision of evidence-based mental health and other support for people who frequently use cannabis.

To the best of the authors’ knowledge, this is the world’s largest international study exploring the impacts of these changes in cannabis use following initial COVID-19 restrictions on individuals’ mental health, physical health, relationships, finances, work/study performance and cannabis-related pleasure. This study is also unique in comparing these changes across multiple continents.

This chapter provides a critical exploration of the European Union’s impact on the 2016 United Nations General Assembly Special Session (UNGASS) proceedings and Outcome document. It demonstrates that the ability to produce a European ‘common position’ ahead of the UNGASS debates represents a significant step forward in the ability to ‘speak with one voice’ in the global illicit drug policy arena, and has played an important role in ensuring key issues such as human rights and public health remain on the agenda. In highlights, however, a European failure to engage with issues such as the continuing suitability of the international drug conventions to preside over the current climate of drug policy innovation and experimentation, and the unintended consequences of a ‘war on drugs’ approach. Ultimately, therefore, it argues that these failures will hamper the development of a more progressive and effective global drug policy.

“Cannabis” and “cannabis resin” are derived from the Cannabis plant, used as herbal medications, in traditional medicine and as active pharmaceutical ingredients. Since 1961, they have been listed in Schedule IV, the most restrictive category of the single convention on narcotic drugs. The process to scientifically review and reschedule them was launched by the World Health Organisation (WHO) on 2 December 2016; it survived a number of hindrances until finally being submitted to a delayed and sui generis vote by the UN Commission on Narcotic Drugs on 2 December 2020, withdrawing “cannabis” and “cannabis resin” from Schedule IV.

To evaluate WHO’s scheduling recommendations, the process leading to the Commission vote and subsequent implications at global, national and patient/clinician levels. Narrative account of the four-year proceedings; review of the practical implications of both rejected and accepted recommendations.

The process was historically unprecedented, of political relevance to both medical Cannabis and evidence-based scheduling generally. Procedural barriers hampered the appropriate involvement of civil society stakeholders. The landscape resulting from accepted and rejected recommendations allow countries to continue creating decentralised, non-uniform systems for access to and availability of “cannabis” and “cannabis resin” for medical purposes.

Perspective of accredited observers; highlight of institutional issues and the lay of the land; contrast of stakeholders’ interpretations and engagement.

This chapter explores the relationship between the global drug policy agenda and the United Nations Sustainable Development Goals (SDGs). Development is one of the key pillars of the UN's charter; however, sustainable development and drug policy have existed in separate policy spaces for decades. During 2015 and 2016, two parallel processes took place at the UN – the adoption of the 2015 SDGs, superseding the Millennium Development Goals, and the 2016 UN Special Session on the world drug problem (UNGASS), a global convening of countries to create a way forward to address illicit drugs. This chapter explores how a group of reform-oriented countries, UN agencies and civil society stakeholders used the UNGASS to advocate for better policy alignment with development principles. While some headway was made, tensions remain about allowing a development approach into the drug policy realm. This chapter argues that given strong pushback to maintain a law enforcement-driven agenda by many countries, better alignment will not happen without more clarity on what sustainable development–driven drug policy is and without champions to push these ideas in the drug policy arena.

The purpose of this paper is to inform readers of developments in drug policy debate in Australia following the publication of the Global Commission Report. To explain the activities, discussions and findings of events organised by the Australian NGO Australia21. To provide some key contextual information and references.

Overview of international situation following publication of Global Commission Report. Summary of current Australian national policy and its origins. Summary of recent national reports and their impact on policy. Account of NGO reports and recommendations.

Civil society agencies have entered national debate on drug policy and recommended an abandonment of prohibition-based approaches, using the Global Commission Report as a catalyst. First steps have been taken to introduce this debate into the Australian parliament.

Incomplete knowledge of relevant national documentation.

Probable delay in government developing debate and acting on recommendations in an election year.

Case study of developments and debate in one jurisdiction resulting from Global Commission Report. Aligns with similar debate and moves in other nations. Adds to knowledge of developments which challenge existing international policy debate and practical approaches which reject prohibition.