Black and white thinking is a logical fallacy where the brain basically chooses a side and sticks with it. Our brains like black or white thinking because it’s easier to navigate and requires less attention to nuance. For example, if I decide that I don’t like country music, then my brain can place all country music in the “don’t like” category, which prevents me from having to listen to every country music song I come across to decide all over again if I like it. Food is the same. My dad and partner dislike beets. If a dish comes along with beets in it, even if they like the other ingredients or the beets are prepared in a way that is new to them, or everyone around them talks about how delicious the dish is, they reject it because, well, they don’t like beets. Usually these kinds of cognitive shortcuts are harmless. Sure, I might miss out on a country music song that I actually like, and they may pass up a dish with beets that they may find delicious, but the brain wants to make decisions quickly and easily, and black or white thinking allows for that.
So, what does this have to do with cannabis and harm reduction? A while back I published an article about the black or white thinking that has plagued the cannabis space. Due to decades of propaganda followed by decades of activism, the messaging around cannabis was that it is either all good, or all bad. Of course the truth is somewhere in the middle, and that is where harm reduction comes in. Cannabis use and the related market has both potential benefits and potential harms, and forcing our brains to examine and accept these nuances not only leads to a better consumption experience, it can help avoid some of the unwanted outcomes associated with cannabis use. In part one of this series, we reviewed the values underneath the concept of harm reduction. In part two, we will examine how some of these values come into play when reducing the potential harms that can come from cannabis use. The goal of this article is not to sound an alarm or feed into prohibitionist rhetoric, quite the opposite. The goal is to challenge black or white thinking and to recognize that, when it comes to cannabis, there is a spectrum of safety, and we can aspire to move the needle towards safer use.
Cannabis has been around for thousands of years. It was always naive of the government to think that making it illegal was going to make it go away. However, harm reduction isn’t just about the harms of products, but also those caused by prohibition itself. There are some potential harms with obtaining products from the illicit market. Manufactured products like edibles may be of unknown potency. I remember the early medical cannabis days. Edibles at dispensaries looked like bake sale items and you never quite knew how strong the effect would be. They were accompanied by instructions like “eat a piece the size of your fingernail”. Additionally, vape pens and the oil inside them may contain solvents or other chemicals that pose a health risk.
Just like alcohol use, cannabis use may evolve and change across the lifespan. Heavy use in adolescence or college years does not predict use at 40 or 50. Consumers should examine how cannabis best fits into their life NOW, and be prepared to change consumption habits as life circumstances and metabolism changes. Furthermore, it is important for consumers to consider the impacts of different methods of ingestion. Understanding the difference in effect between smoking, dabbing and edibles for example, can prevent overconsumption or experiencing something you don’t want such as being too intoxicated for your current environment. Finally, not all methods of consumption hold the same kind of health risk. The risk of overdose is higher with edibles, but smoking, while allowing for dose titration, can cause lung and throat irritation, gum health issues and, over time, an increased risk for bronchitis and chronic cough. Vape pens may address some of the harms of smoking, but their ease of use could be more habit forming.
Includes people who actively use drugs or who have used in the past in the conversation about how people who use drugs should be treated.
As the legal cannabis industry evolves, I am finding the voices of consumers less and less a part of the policy conversation. Business leaders, regulators and others with a financial stake in the industry are drowning out the voices of patients and others who are actually impacted by these laws. This can potentially cause harm in the form of decreased access and regulations that do not support the healthiest and most efficient ways for people to consume.
If we want to look back at cannabis reform and legalization as a net benefit for personal and community health, we must not get trapped into black or white thinking. Focusing consumption and policies within the framework of harm reduction may make more work for our brains, but, in the end, it is the best way to minimize harm and maximize benefits. In the last article in this series, I will discuss how cannabis can be used as a harm reduction tool to reduce or eliminate the use of potentially more harmful substances.
