The three betrayals of the medical cannabis growing activist: From multiple victimhood to reconstruction, redemption and activism.

While cannabis has been widely used in the UK for over 50 years, it is only in recent decades that domestic cultivation has become established. Public concern, media reporting and policing policy has emphasised the role of profit motivated criminal organisations often working on a large scale and with coerced labour. However, increasingly, another population are growing for medical reasons, to help themselves and others treat or manage difficult, poorly understood, or incurable conditions. Our study sought to further understand the motives, techniques and interactions of cannabis cultivators through interviews with 48 growers and supplementary ethnographic work. As well as those motivated to grow for personal use, social and commercial supply purposes we identified a cohort growing to provide themselves and others with cannabis used for therapeutic purposes. This paper draws primarily on interviews with a sub-group of sixteen medically-motivated growers who were not only involved in treatment, but also embraced the label "activist". Rather than develop techniques of deception they were organising to effect a change in legislation. Rejecting the image of criminal perpetrators, they presented themselves as victims of unjust government policy, an indifferent medical establishment, and brutal and immoral criminal markets. Through cultivation, association, self-healing and apomedication, they have found voice and are shifting the debate over the status of growers and of cannabis itself. The ambiguity of their position as both producers and patients challenges the assumptions underlying legal distinctions between suppliers and users, with potentially profound implications for policy.

Lessons from conducting trans-national Internet-mediated participatory research with hidden populations of cannabis cultivators.

BACKGROUND: Internet-mediated research methods are increasingly used to access hidden populations. The International Cannabis Cultivation Questionnaire (ICCQ) is an online survey designed to facilitate international comparisons into the relatively under-researched but increasingly significant phenomenon of domestic cannabis cultivation. The Global Cannabis Cultivation Research Consortium has used the ICCQ to survey over 6000 cannabis cultivators across 11 countries. In this paper, we describe and reflect upon our methodological approach, focusing on the digital and traditional recruitment methods used to access this hidden population and the challenges of working across multiple countries, cultures and languages. METHODS: Descriptive statistics showing eligibility and completion rates and recruitment source by country of residence. RESULTS: Over three quarters of eligible respondents who were presented with the survey were included in the final sample of n=6528. English-speaking countries expended more effort to recruit participants than non-English-speaking countries. The most effective recruitment modes were cannabis websites/groups (33%), Facebook (14%) and news articles (11%). While respondents recruited through news articles were older, growing practice variables were strikingly similar between these main recruitment modes. CONCLUSION: Through this process, we learnt that there are trade-offs between hosting multiple surveys in each country vs. using one integrated database. We also found that although perceived anonymity is routinely assumed to be a benefit of using digital research methodologies, there are significant limits to research participant anonymity in the current era of mass digital surveillance, especially when the target group is particularly concerned about evading law enforcement. Finally, we list a number of specific recommendations for future researchers utilising Internet-mediated approaches to researching hidden populations.

Global patterns of domestic cannabis cultivation: sample characteristics and patterns of growing across eleven countries.

BACKGROUND: This article aims to provide an overview of: demographic characteristics; experiences with growing cannabis; methods and scale of growing operations; reasons for growing; personal use of cannabis and other drugs; participation in cannabis and other drug markets; contacts with the criminal justice system for respondents to an online survey about cannabis cultivation drawn from eleven countries (N=6530). Important similarities and differences between the national samples recruited will be discussed. METHODS: This paper utilizes data from the online web survey of predominantly 'small-scale' cannabis cultivators in eleven countries conducted by the Global Cannabis Cultivation Research Consortium (GCCRC). Here we focus primarily on descriptive statistics to highlight key similarities and differences across the different national samples. RESULTS: Overall there was a great deal of similarity across countries in terms of: demographic characteristics; experiences with growing cannabis; methods and scale of growing operations; reasons for growing; use of cannabis and other drugs; participation in cannabis and other drug markets, and; contacts with the criminal justice system. In particular, we can recognise that a clear majority of those small-scale cannabis cultivators who responded to our survey are primarily motivated for reasons other than making money from cannabis supply and have minimal involvement in drug dealing or other criminal activities. CONCLUSIONS: These growers generally come from 'normal' rather than 'deviant' backgrounds. Some differences do exist between the samples drawn from different countries suggesting that local factors (political, geographical, cultural, etc.) may have some influence on how small-scale cultivators operate, although differences in recruitment strategies in different countries may also account for some differences observed.

Reaching out and reaching up - developing a low cost drug treatment system in Cambodia.

Cambodia, confronted by the spread of drug misuse among young people, requested support from international agencies to develop a drug treatment programme in 2000. The initial plan developed by the United Nations Office on Drugs and Crime was to set up a number of conventional drug treatment centres in urban areas. During the planning phase, however, the project was redesigned as a community based outreach programme. Ten Community Counselling Teams have been formed and trained in pilot areas, and within the first year of operation 462 drug and alcohol users contacted. Comprising former drug users, family members affected by drug use and health care staff, they have drug scene credibility, local knowledge and connectivity, and a rudimentary level of medical competence. Crucially, they enjoy the support of village elders, who are involved in the planning and reporting stages. While the Community Counselling Teams with their basic training in addiction counselling are in no position as yet to either provide or refer clients to treatment, they can provide brief interventions, organise self help groups, and most importantly provide an alternative to law enforcement. By taking a development centred approach, with emphasis on community, empowerment and inclusion, it provides a constructive and inclusive alternative to medical approaches and the compulsory drug treatment centres. The paper is based on an evaluation involving interviews with a range of stakeholders and a review of project documents.

A good chew or good riddance--how to move forward in the regulation of khat consumption.

AIMS: To review the status of khat, the most recent plant based psychoactive substance to reach a global market, and consider policy making processes in general and the framework of drug control in particular. MATERIALS AND METHODS: Desk review of literature on khat and wider drug policy processes. RESULTS: The risk assessment and classification of psychoactive drugs is a contested arena where political, economic and moral agendas collide, leaving countries that have banned khat, with significant social costs. To best manage the risks arising from the increasing availability of khat it is therefore suggested to draft a regulatory framework with clear objectives and guiding principles. CONCLUSIONS: Given that medical risks of khat use are modest, the objective of the regulatory framework should be the protection of consumers and community. This is best achieved by establishing processes for the quality control of khat imports, and by regulating access and availability. It should therefore not be considered as a drug to be controlled but as a licit substance that needs to be regulated.

Regulating khat--dilemmas and opportunities for the international drug control system.

BACKGROUND: The regulation of khat, one of the most recent psychoactive drugs to become a globally traded commodity, remains hotly contested within different producer and consumer countries. As regimes vary, it has been possible to compare khat policies in Africa, Europe and North America from different disciplinary perspectives. METHODS: Field research was conducted in East Africa and Europe, using a combination of semistructured interviews, participant observation and the analysis of trade statistics. RESULTS: The research established the significance of khat for rural producers, regional economies, as a tax base and source of foreign exchange. At the same time, khat as a psychoactive substance is associated with health and public safety problems that in turn are met with often ill-informed legislative responses. Bans have in turn lead to the criminalisation of users and sellers and illegal drug markets. CONCLUSION: The empirical work from Africa provides a strong argument for promoting evidence-based approaches to khat regulation, harnessing the positive aspects of the khat economy to develop a control model that incorporates the voices and respects the needs of rural producers. Ultimately, the framework for khat may provide both a model and an opportunity for revising the international treaties governing the control of other plant psychoactive-based substances.

Khat in the neighbourhood--local government responses to khat use in a London community.

There is increasing fear among the general public about khat, its use and users, and associated crime. In many English cities, neighborhoods with growing Somali populations and emerging khat-using scenes and markets have to find ways of managing the impact of the negative image of khat. This case study describes and analyzes how a local municipal authority can respond constructively by generating an evidence base, engaging in consultation, and endeavoring to identify the actual relationship between reported criminality and public nuisance and the alleged patterns of use and distribution of khat. It is argued that it is important to frame the khat in the community not as a "drug problem" but as a wider public health issue, for which appropriate solutions can be developed.