When commercial cannabis sales go online on July 19, Uruguay will mark a major milestone, becoming the first country to establish a legal domestic market for non-medical cannabis. It’s hard to overstate just how important this moment is to the ongoing shift in the global drug policy paradigm: more than 50 years since the 1961 UN Single Convention on Narcotic Drugs banned cannabis for all but medical or scientific purposes, adult residents of Uruguay will be able to purchase cannabis in pharmacies for non-medical use across the country.
Uruguay’s cannabis reform law has been at once audacious and cautious. The government took the bold step of going first when the law was passed in December 2013, but has implemented its new system at a deliberate pace, while managing international treaty questions, coping with ongoing domestic political concerns, and addressing the myriad logistical issues involved in launching an unprecedented regulatory regime. As the first such national system in the world, the ultimate measure of success will be whether or not Uruguay’s approach is sustainable over time, which will doubtless involve revisions along the way.
Uruguay Cannabis Sales: a Cautious Rollout
According to the Institute for the Regulation of Cannabis (IRCCA), the law’s main regulatory agency, as of July 16, there were 4,959 Uruguayans signed up to begin purchasing cannabis. Meanwhile, 6,948 Uruguayans have registered to grow up to six flowering cannabis plants in their homes (with the understanding that their annual yield should not exceed 480 grams), and 63 “cannabis clubs” have begun operating across the country. Each of these clubs, according to the law, can have between 15 and 45 members that can grow up to 99 plants in the same space, but cannot dispense more than 480 gram annual limit to each member. Any surplus yield must be turned over to the IRCCA.
Selling to foreign tourists is also against the law. While some enterprising Uruguayans have attempted to get around this ban by offering “cannabis tours” that permit participants the opportunity to sample cannabis while on a paid tour, authorities have begun to enforce against these initiatives.
While the government is still hammering out the details of distribution with pharmacies (selected as sales points because of their experience in handling controlled substances), authorities have laid out the initial blueprints for cannabis sales. The IRCCA has said that it will initially make available two varieties of cannabis, each with Tetrahydrocannabinol (THC) levels at 2 percent, to be sold in five-gram containers at the price of 187.04 Uruguayan pesos each (about US$1.20 per gram), a price that is intended to undercut the illicit market. Registered buyers will be allowed to purchase up to 40 grams per month—10 grams per week.
In this early phase of sales, the government is taking an incremental approach. Cannabis will only be sold in 16 pharmacies across Montevideo—home to roughly half the country’s population—and the Uruguayan interior. While the locations of the participating pharmacies has not yet been made public, an initial concentration in the capital city of Montevideo would be understandable, especially considering the latest government-sponsored household survey of substance use, which showed that the prevalence of cannabis use is twice as high in Montevideo (30.3 percent reporting any use in the previous year) as in the rest of the country (15.4 percent).
Depending on how the market unfolds, all of these variables are subject to change in the months ahead. Every six months at least, the IRCCA intends to readjust the price of legal cannabis in order to keep up with shifts in market dynamics. Another two varieties, reportedly with THC levels of 4 percent (still well below the legal limit of 15 percent THC) will be made available to the IRCCA soon, and larger packaging units are up for consideration as well. Additionally, officials are still in talks with corporate chains around the country to potentially broaden the number of participating pharmacies.
A Public Health Focus, But Medical Sales Absent
Uruguay’s cannabis law was envisioned with an emphasis on public health and harm reduction. The very first article of the law’s text declares that it is in the public interest for the government to “promote and improve the public health of the population through a policy aimed at minimizing the risks and reducing the harms of cannabis use.” For this reason, the law bans all forms of advertisement or any promotion of cannabis use. Smoking cannabis in restaurants, bars, or anywhere else where people are already banned from smoking tobacco is prohibited as well.
This public health-oriented approach to cannabis policy has been a hallmark of its implementation. When the IRCCA announced the opening of the registry for commercial sales on May 5, the National Drug Council (JND) also launched a publicity campaign aimed at educating the public on the general risks of cannabis use. The JND has also carried out a previous, more targeted campaign on cannabis, with a specific focus on preventing use by minors, pregnant women, and those driving motor vehicles (the law expressly forbids driving with any detectable level of THC in one’s body).
The commercial cannabis that will soon be on the market will be sold in packaging containing clear warning labels to similar effects. Purchasers will be advised not to consume cannabis if they are pregnant or nursing, to refrain from using it in the company of minors or storing it in places to which minors have access, and that resale of cannabis is illegal. They will also be encouraged to consume cannabis using vaporizers, as opposed to smoking it, due to the health risks of combustion.
Despite Uruguay’s focus on public health in the implementation process, the government has not made significant progress on medical marijuana. The previous government of President Jose Mujica signed a set of regulations in 2015 that provided a legal framework for doctors to prescribe cannabis and cannabis products to patients, but there is a persistent gap between these regulations and reality. Uruguay’s Ministry of Public Health (MSP) has not yet authorized the development or sale of cannabis-based medication in Uruguay, meaning that patients seeking access to promising treatments for things like chronic pain or epilepsy have to seek special permission from authorities to import medicine from abroad, often at significant expense. As a result, investigators at the Cannabis Monitor of the University of the Republic (UdelaR), a specialized research team focused on studying the law’s impact, have found that 93 percent of Uruguayans who use cannabis for medical reasons do so without a doctor’s prescription.
The Importance of Monitoring and Evaluation
Because Uruguayan authorities are still ironing out certain aspects of the law, and will undoubtedly continue to make adjustments moving forward, it is important for the government to focus on monitoring and evaluation efforts. Since taking office in March 2015, President Tabare Vazquez has repeatedly promised a robust monitoring effort, and the government has taken several steps to do so. A “Scientific Advisory Committee” established by the JND has recommended that officials pay close attention to a range of citizen security, economic, and social indicators moving forward, and a special research unit in the MSP has been tasked with submitting annual reports on the law’s impact to Congress.
While these efforts represent an important start, there is more that the government could be doing to benefit from a close look at how the law is playing out. The MSP’s research unit, for instance, has so far declined to make its work public, hampering civil society and academic efforts to contribute to monitoring and evaluation. Researchers have complained of not only a lack of access to official data, but also that the IRCCA has been slow to approve and facilitate research on cannabis.
Now that commercial sales are beginning and all three facets of the non-medical regime are up and running (home grows, clubs, and pharmacy sales), the Vazquez administration should ensure that the government’s own monitoring efforts are robust and well-resourced, and to facilitate the efforts of independent researchers, including the UdelaR team as well as researchers at the Catholic University of Uruguay and other institutions. In order for the law to fulfill its potential in promoting public health and reducing the black market, robust and independent scientific evaluation will be essential.