The use of medical cannabis has increased internationally, but is still small-scale. Medical cannabis is mainly allowed as pain treatment in certain cancers and to alleviate some symptoms of multiple sclerosis. While many other use areas have been claimed and studied, the evidence is still contradictory (EMCDDA, 2018). As our report will show, the use of medical cannabis is strictly regulated in the Nordic countries. Cannabis users in the Nordic countries are a heterogeneous group both in terms of their use and social background. According to a Finnish survey, most cannabis users use the drug a few times a year, without any major health or social consequences from the use (Hakkarainen & Karjalainen, 2017). Sporadic use – a few times a year – seems to be the most common way to use cannabis in other Nordic countries as well (Skretting et al., 2016). A typical Finnish cannabis user ‘is a young man who lives in a city and smokes marihuana that he got from friends. He uses cannabis recreationally and is a heavy user of alcohol.’ (Hakkarainen & Karjalainen, 2017, translation Yaira Obstbaum.) Many cannabis users do not use other illegal drugs, but they often use alcohol simultaneously or on different occasions. The share of cannabis users with prevalent health and social problems is higher than among non-users. Using other drugs is also more prevalent among cannabis users than among non-users of cannabis. Alcohol seems to be the most common drug, at least in Finland (Hakkarainen & Karjalainen, 2017). Cannabis is not a harmless substance. Frequent use of cannabis is connected to at least impaired cognitive ability and increased risk of psychotic symptoms. More studies are needed to clarify the effects of long-term cannabis use (WHO, 2017). A growing body of evidence points at cannabis use (and its psychosocial consequences) being a mental health risk (Nordentoft et al., 2015). Cannabis problems can also be regarded as a symptom of underlying ills, such as social problems, social exclusion, economic problems, ill health, and many other factors. Starting to use cannabis at an early age may be a sign of socioeconomic and (mental) health problems, and is connected to truancy and higher levels of school drop-out (Lemstra et al., 2008; Tims et al., 2002). Young cannabis users have a heightened risk of developing dependence (Sundhedsstyrelsen, 2017). It is safe to say that cannabis use is not decreasing in Nordic countries, and in most Nordic countries the use is increasing at least in the young adult population. Use of cannabis is thus likely to produce increasing harm – social problems, health problems, and problems of law and order – burdening not only the health and
11