White Coat, Black Art

What Icelanders think of Canada's impending legalization of marijuana

Looking to the tiny European nation for feedback on Canada's impending legalization. Spoiler alert: they've got serious concerns.
Inga Dóra Sigfúsdóttir, director of the Icelandic Centre for Social Research and Analysis at Reykjavik University, describes Canada's foray into legal weed as a 'really big social experiment' with plenty of pitfalls. (Brian Goldman/CBC)

On Oct. 17, 2018, Canada becomes the second country in the world to permit the sale and possession of marijuana across the nation.

The law was passed despite the lack of consensus on legalization, with users as well as entrepreneurs in favour, and many parents and doctor groups like the Canadian Medical Association then calling on the government to take a public health approach to cannabis use instead.*

But one nation with a seemingly unified opinion on legalized cannabis in Canada? Iceland.   

Every person in the tiny island nation whose opinion I asked — parents, doctors, police officers and even teens — gave Bill C-45 the thumbs down, citing worries about what the impact on young people could be.   

"What a crazy idea," said Inga Dóra Sigfúsdóttir, Director of the Icelandic Centre for Social Research and Analysis (ICSRA) a non-profit research institute at Reykjavik University. "I'm certainly not in favour of that."

Coming from almost any other country, I might have shrugged it off as fear mongering. But it came from Iceland, a country that managed to pull off one of the greatest public health turnarounds in modern history.

Turning the tide on teen drinking

In 1998, 42 per cent of Icelandic teens had gotten intoxicated with alcohol within the past thirty days, which at the time was the highest rate of any other European nation. Today, it's down to just five per cent, one of the lowest rates of teen drinking in the world.

The success in Iceland can be chalked up to Planet Youth — an innovative program based on research conducted by ICSRA that's the subject of our season debut of White Coat, Black Art.  

The signature parts of the program include community involvement, parents spending more time with their kids and heavy subsidies for after school programs. Those came from studies conducted by ICSRA that identified factors that led to teen substance use in Iceland.

Soccer fields like this one are used nonstop most days of the week. The government heavily subsidizes afterschool programs as part of Planet Youth. (Brian Goldman/CBC )

Sigfúsdóttir calls that an upstream intervention. She sees Canada's legalization of marijuana as a downstream approach — a tacit acknowledgement that marijuana use in young people is inevitable.

The Canadian government set the minimum age for purchasing pot at 18, with the option for provinces to increase that age. But Sigfúsdóttir worries that legalization will normalize using marijuana for all age groups.

"Why would they need to use substances?" she asked rhetorically.  "Why do you even need to have it as an option?

Mental health impacts

The doctors I spoke with agree with Sigfúsdóttir.

"I don't think we should copy the policies of Canada [and parts of the U.S.] and legalize marijuana," said Dr. Hjalti Már Björnsson, an ER physician at Landspitali, Iceland's national university hospital in Reykjavik.

Björnsson said he and his colleagues are concerned that teens who try cannabis are at risk of experiencing a psychotic break.

"We have seen that," said Björnsson. "We think it's been shown very well that the use of cannabis in a younger individual significantly increases the risk of psychosis later on."

Parents such as Heiðar Ásberg Atlason don't like the idea of legal marijuana one bit either.

"To be honest, I think it's a bad idea," said Ásberg Atlason, a corporate lawyer and big believer in Planet Youth.

For the past nine years, Atlason has gone on foot patrols every Friday evening looking for teens who stayed out past the country's 10 p.m. curfew.

"We take a lot of notice of the experts say," he added. "And the experts are telling us it's a bad idea."

Marijuana use up in Iceland

Karl Steinar Valsson, chief superintendent of the Icelandic police in Reykjavik, is on the same page, believing that legalized marijuana would only increase the use of the drug and sap police resources.  

"It will increase the cost of health care," he went on. "Some countries have provided for that, and others haven't."

But despite laws prohibiting it, Valsson says cannabis use in Iceland is on the rise due to smuggling and a thriving market for illegal marijuana grown in local greenhouses.

Karl Steinar Valsson is Chief Superintendent of the Icelandic police in Reykjavik. Valsson was a front line police officer when teen drinking rates were 42 per cent. (Brian Goldman/CBC)

"We are seeing more people that we are stopping because of driving under the influence of marijuana than under the influence of alcohol," he said.  

Politicians also have objections to legal pot, especially Skúli Helgason, a former member of the Icelandic parliament and current city councilor.  

"I can understand the sentiment and the political program behind it," said Helgason, who currently chairs the education and youth committee for the City of Reykjavik.

"I don't think we have to increase the access to substances by teenagers," he said. "Every step we take that sends the message to our kids and teenagers that it's okay to use substances is a mistake."

Young people against pot

I wasn't completely surprised that adults from all walks of life are opposed to Canada's move to legalize marijuana. I was somewhat surprised to hear that young people agree.

"It's not a good idea to legalize marijuana," said  Erla Simonardóttir, a 22-year-old who has just started medical school at Reykjavik University. She also happens to be the daughter of Planet Youth creator Inga Dóra Sigfúsdóttir.

"If it's there, and you have access to it, chances are you're going to try it."

As chair of the education and youth committee for the City of Reykjavik, Skúli Helgason oversees the city's subsidy program that pays all parents 50,000 Icelandic Krona ($650 Canadian) per child per year to attend after school programs. (Brian Goldman/CBC)

She said that young people Iceland don't grow up believing drug use is a normal part of growing up.

"We've always been taught how wrong and dangerous drugs are," she added. "Anybody who tries drugs is generally considered a troubled teenager or a troubled person."

The idea that drug use indicates a troubled teenager was shared by most other young people I spoke with in Iceland.  

A warning to Canada

Since I've returned from Reykjavik, I've thought a lot about what Icelanders had to say about Canada's plan to legalize cannabis.

There are some obvious differences between our two countries. Iceland has a much smaller population, which makes keeping tabs on young people at risk a lot easier. As a small island nation, Iceland is far more vigilant than Canada at preventing the smuggling of illegal substances into the country.  

But most of all, the two countries are at two different points along the continuum of drug and alcohol use. In Canada, a significant percentage of young people already use marijuana. The federal government's stated reasons for legalizing it are that prohibition doesn't prevent young people from using it and that too many Canadians end up with criminal records for possession.

None of those arguments swayed Inga Dóra Sigfúsdóttir, Planet Youth's director. She described legal marijuana as "a really, really big social experiment."

Her advice is to learn from Iceland's example. That means doing research on young people to learn and address the factors in their lives that increase substance use. In other words, to use the same upstream approach that has been so successful over there.

"The kids who are going to be here in 10 years have a right to a happy and healthy life," she said. "To never have to use substances."

Given the many unanswered questions about legal marijuana, that seems like sound advice.

* Corrected on September 11, 2018. While the Canadian Medical Association recently began contemplating policy action to phase out medical marijuana, their submission to the Federal Government's task force on legalization did not declare its opposition to legalization.


Dr. Brian Goldman is a veteran ER physician and an award-winning medical reporter. As host of CBC Radio’s White Coat, Black Art, he uses his proven knack for making sense of medical bafflegab to show listeners what really goes on at hospitals and clinics. He is the author of The Night Shift and The Power of Kindness: Why Empathy is Essential in Everyday Life.


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