Cannabis Report of the Swiss Federal Commission For Drug Issues (EKDF)
May 1999
Swiss Federal Printing and Supplies Office No. Contact person: Ueli Minder Section for Policy and Research Telephone ++ 41 31 324 98 04

Table of Contents 

Preface and acknowledgements

1.1 Cannabis as the focus of expert opinions and political initiatives
1.2 Why reassess the position of cannabis?
1.3 Structure of the report
2.1 Prevalence of cannabis use
2.1.1 Development of cannabis use from 1970 to 1998 
2.1.2 Age at first use
2.1.3 International comparison
2.2 Availability and trade
2.2.1 Legal uses
2.2.1.1 Cannabis in agriculture
2.2.1.2 Cannabis for food products, cosmetics and consumer goods
2.2.1.3 Medical used of cannabis
2.2.2 Illegal use 
2.2.3 Hemp cultivation
2.3. Pharmacology and toxicology of cannabis
2.3.1 Introduction
2.3.2 Cannabis in the body
2.3.2.1 Absorption, metabolism and excretion.
2.3.2.2 Pharmacodynamics
2.3.3 Acute effects of cannabis on the central nervous system
2.3.4 Acute side effects and toxicity of cannabis
2.3.5 Cannabis and driving
2.3.6 Medical uses of THC and cannabis
2.3.7 Effects of chronic cannabis use
2.3.7.1 Amotivation syndrome
2.3.7.2 Dependence and tolerance
2.3.7.3 Carcinogenic effect
2.3.7.4 Genetic effects and effects on reproduction and pregnancy
2.3.7.5 Effects on the immune system
2.4 Historical and sociocultural aspects
2.5 The medical importance of cannabis
2.5.1 Introduction
2.5.2 Investigation of the therapeutic action of cannabis
2.5.3 Cannabis poisoning in medical emergency statistics
2.5.3.1 Swiss Toxicology Information Center
2.5.3.2 Clinical trials in Switzerland
2.6 The legal environment 
2.6.1 International conventions
2.6.2 The Federal Narcotics and Psychotropic Substances Act (BetmG; SR 812.121)
2.6.3 The Swiss Road Traffic Act
2.6.4 Agricultural and private cultivation
2.6.4. 1 Hemp in agriculture
2.6.4.2 Hemp in food, cosmetics and articles of daily use
2.6.4.3 Hemp in medicine
2.6.4.4 Hemp as a "dual- use crop"
2.7 Enforcement of the existing legislation
2.8 Effects of the status quo
2.8.1 General preventive effectiveness
2.8.2 Aid in crime detection
2.8.3 Higher propensity to undergo treatment
2.8.4 Prevention of consumption in public
2.8.5 Cost of policing and prosecution
2.8.6 Stigmatization of users
2.8.7 Doubts as to credibility and proportionality
2.8.8 Inequality of justice
2.8.9 Corruption
3. Ethical Implications of a liberal policy on drugs
4. Options
4.1 Clarification of terminology
4.1.1 Decriminalization under substantive and procedural law
4.1.1.1 Discretion in Swiss law
4.1.1.2 Discretion in the Dutch sense
4.1.2 Decriminalization and legalization 
4.2 Models of limited decriminalization
4.2.1 Introduction and summary
4.2.2 Removal of the substantive offence of consumption and procurement for personal use
4.2.3 Change in the severity of penalties
4.2.4 Introduction of an expediency regime for cultivation and retail along the lines of the Netherlands model
4.2.5 Conditions to be met by models for change
4.3 Models of legal availability of cannabis and THC products
4.3.1 Introduction and overview
4.3.2 Prescription of cannabis by medical doctors
4.3.2.1 Medicinal use
4.3.2.2 Non- medicinal use
4.3.2.3 Conditions for medical prescription
4.3.3 Licensing of dealing
4.3.3. 1 Limitation of the number of licensed outlets
4.3.3.2 Product requirements
4.3.3.3 Taxation and retail price maintenance
4.3.3.4 Advertising restrictions
4.3.3.5 Licensing without restrictions or taxation
4.3.3.6 Requirements for the implementation of licensing models
4.3.4 Controlled purchase
4.3.4.1 Rationing
4.3.4.2 Restriction of the right to purchase
4.3.4.3 Registration of purchasers
4.3.4.4 Purchase entitlement without rationing or registration
4.3.4.5 Prerequisites for controlled purchase
4.3.5 Free availability
4.3.5.1 Product requirements
4.3.5.2 Fiscal measures
4.3.5.3 Advertising restrictions
4.3.5.4 No restrictive regulations and no taxation
4.3.5.5 Prerequisites for the introduction of free availability
4.3.6 Cultivation
4.3.6.1 Cultivation permitted for personal consumption
4.3.6.2 Strictly regulated cultivation
5. Consequences of the options
5.1 Change in consumption propensity
5. 1. 1 Removal of the offence of consumption (see section 4. 2. 3)
5.1.2 Change in the severity of penalties (see section 4.2.4)
5.1.3 Introduction of a system based on the expediency principle (see section 4.2.5)
5.1.4 Medical prescription (see section 2. 5)
5.1.5 Licensing of suppliers (see section 4. 3. 3)
5.1.6 Controlled purchase (see section 4. 3. 4)
5.1.7 Free availability (see section 4.3.5)
5.2 Changes in consumption and consumption patterns
5.2.1 Removal of the offence of consumption (see section 4. 2. 3)
5.2.2 Change in the severity of penalties (see section 4.2.4)
5.2.3 Introduction of a system based on the expediency principle (see section 4.2.5)
5.2.4 Medical prescription (see section 2. 5)
5.2.5 Licensing of suppliers (see section 4. 3. 3)
5.2.6 Controlled purchase (see section 4. 3. 4)
5.2.7 Free availability (see section 4.3.5)
5.3 Changes in the effects of consumption
5.4 Consequences for the illegal cannabis market 
5.5 Need for new regulation
5.6 Political consequences
6.1 Grounds for removing the prohibitions of consumption and of procurement for personal consumption
6.2 Objectives of cannabis policy
6.2.1 Protection of the young
6.2.2 Consumer protection
6.2.3 Promotion of health awareness
6.2.4 Minimization of problem consumption
6.2.5 Prevention of consumption- related criminalization and stigmatization of young persons
6.2.6 Relieving the police and criminal justice system of the need to investigate and prosecute petty offences
6.2.7 Uniform enforcement of the applicable law
6.2.8 Credibility of drugs policy
6.2.9 Protection of other sections of the community
6.2.10 Eradicating the illegal cannabis markets
6.2.11 Cost effectiveness of drug policy measures
Medicinal use
6.3 Effect of the options in terms of the goals
6.4 Overall conclusions
7.1 Legal availability of cannabis
7.2 Limited decriminalization within the ambit of the Single Convention of 1961
7.3 Medicinal use of cannabis
8. Country profiles 

Preface and acknowledgements

In the course of its initial meetings, the Federal Commission for Drug Issues (EKDF) mandated by the Swiss Federal Council in early 1997 drew up an assessment of the situation regarding drugs in Switzerland and of the current need for action. Its predecessor (the Subcommission for Drug Issues attached to the Federal Narcotics Commission which was disbanded in 1996) had always assumed the view all illegal drugs were equivalent, as the basis for its discussions and reports; however, the marked changes that had taken place in the drug scene subsequently called for a more differentiated view of the questions raised by cannabis consumption. The focus on these questions led to a Decision in June 1998 to compile all the information on cannabis relevant to Switzerland in a report which would be submitted to the Federal Council together with recommendations for the future treatment of cannabis during the revision of the Swiss Narcotics Act. This decision by the Commission coincided with the interest expressed by the Federal Department of the Interior in an expert opinion on the same subject. Although a wide range of disciplines are represented on the EKDF (a list of the Commission's members appears at the end of this report), this extensive project could not have been completed without the involvement of additional experts. The Commission would like to extend special thanks to the many individuals in the Federal Administration who contributed to the specialist sections of the report, the Swiss Institute for the Prevention of Alcohol and Drug Problems (SFA/ SIPA), Lausanne), and Professors Martin Killias (Lausanne University), Jakob Tanner (Zurich University) and Ambros Uchtenhagen (Institute for Addiction Research, Zurich). They have all added aspects to the report which go beyond the scope of the usual discussions of cannabis, and have helped to place the problem in a wider context. With this in mind, the Commission also hopes that readers of the report will not focus solely on the conclusions but will also give due attention to the chapters intended more to provide background information, and will in this way contribute to a more objective approach to the discussion.

List of members of the Swiss Federal Commission for Drug Issues (EKDF) 

van der Linde, François, Dr. med. MPH, Cantonal Physician for Preventive Medicine and Head of the Health Prevention Office, St Gallen, Chairman

Cassis, Ignazio, Cantonal Physician for the Canton of Ticino, Bellinzona

Dubois- Arber, Françoise, Dr. med. Msc, University Institute of Social and Preventive Medicine, Lausanne

Egli, Dominik, Dr. rer. pol., Swiss National Bank, Zurich Bis

Huber, Christian , Dr. jur., President of the Jury (Geschworenengericht) of the Canton of Zurich, Zurich (until the end of October 1998)

Jenny, Guido, Prof. Dr. jur., Institute for Penal Law and Criminology, Berne University, Berne

Kessler, Thomas, Ing. agr., Delegate for migration and integration affairs, Department of Police and Military Affairs, Canton of Basel- Stadt, Basel

Menétrey, Anne- Catherine, psychologist, Swiss Institute for the Prevention of Alcoholism and Other Addictions (ISPA), Lausanne

Monney, Christian, Dr. med., FMH psychiatrist, Deputy Director, Psychiatric Institutions of French- speaking Valais, Martigny

Osterwalder, Josef, Dr. med. MPH, Senior Physician at the Central Emergency Admissions Unit, St. Gallen Cantonal Hospital, St. Gallen

Rechsteiner, Urs, lic. jur., Head of the Security Police, Geneva

Roelli, Claire, Social Worker, Swiss Coordination Office for In- patient Therapy in the Drug Sector (KOSTE), Berne

Schreiber, Hans Peter, Prof. Dr. phil., Ethics Office of the ETH Zurich, Zurich

Waldvogel, Rosann, HFS Social Worker, Head of Out- patient Drug Services, Zurich

Secretariat:

Swiss Federal Office of Public Health, Section for Policy and Research, Drug Policy coordination

Ueli Minder, Scientific Officer