Cannabis is the most commonly-used illicit substance among Maltese youth. Regular cannabis use is associated with increased risk of schizophrenia, and by impacting brain maturation, may also negatively interact with depression, bipolar mood disorder and anxiety disorders.
In light of this, the Maltese Association of Psychiatrists (MAP) would like to raise the following points:
- The White Paper recommendation of decriminalization of possession of up of 7 grams cannabis is vague and needs to be elaborated to describe percentage THC content.
- Significant support is needed for public health education and resources, in collaboration with mental health stakeholder groups.
- Any educational campaign needs to be evidence-based and aimed primarily towards prevention of cannabis use for recreational purposes, thus promoting the well-being of citizens (mens sana in corpore sano).
- Prudent consideration of advertising and marketing guidelines are needed with clear markings of THC and cannabidiol content, consistent public health warning messaging and flagging of potential adverse consequences particularly during pregnancy.
- Recreational activities such as sports and performing arts should be widely promoted. Access to such sports and performing arts should be made a public health priority, indirectly reducing the demand of taxes on the health system.
- Biological and local psychosocial research initiative should be promoted to better understand the impact of cannabis and its legalization on mental health in Malta.
- As such, MAP supports the setting up of a dedicated Cannabis Authority, which needs to be established prior to any new legislation.
- Studies regarding the potential impact of any proposed legislative changes need to happen before, not after, implementation of laws.
- MAP advises caution when interpreting data from overseas, as these may not always apply within our local cultural context.
- MAP is also calling for improved support for prevention, early identification and cannabis cessation treatments (i.e., using change-based treatment models including harm reduction strategies) within the framework of mental health and addictions.
- MAP also advised that any enforcement needs to be detailed and elaborated upon.
- Provisions are to be put in place to address the needs of families with cannabis users.
- Evidence for regular use of cannabis includes – a cognitive decline, increased rates of school dropouts, employment failures, and increase in criminal behaviors. All these need to be taken into consideration and provided for by this paper.
- Mental disorders frequently start before the age of 25: age of access to cannabis should not be prior to age 25, with restrictions on quantity and THC potency.
- It is not advisable to operate motor vehicles or heavy equipment, or engage in other safety-sensitive tasks for 24 hours following cannabis consumption, or for longer if impairment persists.
- Education and training should be given to employers and employees on the occupational risks of cannabis use as well as the recognition of impairment, and the treatment options available to employees with substance use issues.
- Employers should update relevant workplace drug and alcohol policies to address the use of cannabis and the mitigation of occupational risk. This decision will need to take into account that cannabis derivatives are detectable in a person’s system for up to several weeks following use.
MAP trusts that these points are taken up by the relevant authorities, with the sole aim of ensuring that any new legislation on cannabis use takes into account its impact on the mental health of our citizens.
 The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)’s 2019 Report and the EMCDDA’s European School Survey Project on Alcohol and other Drugs (ESPAD, 2019) report cannabis as the most frequently used, most frequently seized and the most accessible drug locally.
 This is particularly relevant in targeting children, adolescents, young adults, and expectant mothers, who are identified as increasingly vuilnerable sub-populations.
 There are many studies which report the positive effect on mood, resilience to stress and self-esteem which comes from practicing regular exercise and being a part of an in-group that practice a sports or performing art.
 More research is needed to adequately study cannabis-related impairment, including methods for the detection of impairment as well as the further implications of the legalization of cannabis on the individual, the workplace, and on human resources policies and practices.