Farmability and pharmability: Transforming the drug market to a health-and human rights-centred approach from self-cultivation to safe supply of controlled substances

Abstract

Background

The supply chains addressing the global demand for major recreational drugs are hardly addressed due to international contracts, particularly the UN Single Convention on Narcotic Drugs. Currently applied regulatory changes have several disadvantages ranging from political tensions to the neglect of ecological aspects. The aim of this study is to show some implications associated with a transformation of the recreational drug market that is focused on self-supply of different categories of drugs. The concepts of "farmability", the feasibility to cultivate relevant plants and fungi, and "pharmability", the feasibility to refine materials to drugs by chemical synthesis, purification etc., are addressed.

Methods

68 drug experts were invited to fill out an online survey on the feasibility of self-supply of different categories of drugs. The online survey was a five-point Likert scale and had seven questions.

Results

26 experts (38.2%) responded to the online questionnaire. Cannabinoids were considered easy to cultivate/manufacture, depressants and psychedelics were ranked with moderate difficulty, opioids and stimulants were regarded as difficult to cultivate/manufacture, and empathogens/entactogens and dissociatives were ranked very difficult. The study found that some controlled substances, in particular cannabis, could be decriminalised without the need for a commercial market. However, some drug categories, such as dissociatives and empathogens/entactogens, would require the establishment of professional manufacturers. Psychedelics and depressants are ranked in between.

Conclusion

Different drugs are associated with different cultivation and/or manufacturing steps with contrasting difficulty levels. Those differences are likely to shape use prevalence to more accessible and safer drug markets which also decrease the involvement of organised crime groups. Hence, when decriminalising the possession of drugs for personal use, it is therefore recommended to allow also for personal cultivation or cultivation within social clubs. This is particularly relevant for drugs with moderate to high farmability but also if pharmability is sufficiently high.

Keywords

farmability & pharmability psychoactive substances self-cultivation harm reduction human rights

Introduction

Psychoactive substances have been used by humans for centuries (Wadley, 2016) as part of the basic cultural toolkit much like music or language (Brown, 1991; GCDP, 2017), and they continue to be part of society despite the efforts of the international community to reduce or even eliminate their use. Since the introduction of the 1961 UN Single Convention on Narcotic Drugs, the implied primary goal of drug policy for many years has been to achieve complete abstinence among the users. However, the “Just Say No” strategy that is promoted by the USA and adopted by many other countries since the 1980s has failed to show effectiveness (GCDP, 2017). In fact, it might even be counterproductive since it misses to provide information on the real harms of drug use and undermines trust between the authorities and youth population (Babor et al., 2009; Fishbein et al., 2002; Hawks et al., 2002; Rosenbaum, 2014). What was achieved after several decades of prohibition is a flourishing illegal drug market feeding criminal organisations, high expenditure of taxpayers’ money for investigations and persecutions of drug-related offences, a high number of drug-related imprisonments, a high drug-related death rate due to uncontrolled quality of the substances circulating on the illegal market, lack of access to controlled medicines, environmental pollution due to illegal drug production and disposal of dangerous chemicals, increased impoverishment of (already) marginalised groups across the world, and despite all the efforts to prevent drug use, millions of people worldwide still use them (GCDP, 2015; World Drug Report, 2017). Furthermore, the social representation of drugs as harmful and addictive was frequently reproduced in scientific research and non-critically adopted by public policies (Taylor, 2011; Taylor et al., 2016), education (McInnes & Barrett, 2007) and media (Ayres & Jewkes, 2012), which influenced and shaped people's perception on drugs (GCDP, 2017; Taylor, 2016). On the other hand, studies show that social support, education, opportunities in life, drug quality and set and setting rather than abstinence are paramount in reducing the harms associated with drug use (Alexander, 2010; Alexander et al., 1981; Altice et al. 2010; Degenhardt et al. 2010; Gowing et al., 2008; Hetzer, 2017; Huber, 1994; MacArthur et al., 2012; Waal et al., 2014; Zinberg, 1984).

The general understanding, based on the international conventions, is that certain substances are illegal because of the harm they cause to the individual's health and their supposed high abuse potential. However, the dominant reductionist drugs discourse is based on inaccurate evaluations of drug-related harms (Nutt et al., 2010; van Amsterdam et al., 2015) and on overestimated interpretations of the complex relationships between drugs and crime (Stevens, 2007). Moreover, the majority of people who use drugs is functional, self-regulated, episodic and non-problematic users (Aldridge et al., 2011; Cohen, 1999; Cruz, 2015; Grund et al., 1993; Hart, 2013; Nicholson et al., 2002; Nutt, 2012; Percy, 2008; Schlag, 2020; Soar et al., 2006). While there are potential risks involved in drug use, the risks increase if a substance is prohibited by criminal statute (Buchanan, 2009; Buchanan, 2015; GCDP, 2015; GCDP, 2016; GCDP, 2017; Kerr et al., 2005; Lenton et al., 2000; Werb et al., 2011).

Smart reforms of drug policy based on a human rights and public health would significantly decrease associated individual harms, as well as tackle other associated social harms, such as environmental pollution (Taylor et al., 2016; GCDP, 2016). We learned from countries such as Portugal or the Netherlands that a more progressive approach to drug policy will decrease problematic drug use, criminal activities and violence, as well as discrimination and stigmatisation of the users (GCDP, 2017).

Between full criminalisation and a completely unregulated free market there is a wide spectrum of policy options to control the production, supply and demand (Figure 1). In the middle of the two extremes is a health-centred approach, which is the one future global drug policy should focus on (Csete et al., 2016). Programmes such as the heroin-assisted treatment in Switzerland or Canada are a successful harm reduction strategy that tackles some of the worst possible adverse effects of opioid use: overdose, infections, and death (Strang et al., 2012; Fischer et al., 2007; Naber & Haasen, 2006; Nosyk et al., 2012; Reuter & Schnoz, 2009). Regarding cannabis, the most used controlled substance, there are also regulatory frameworks available, for example the Cannabis Social Clubs (CSC). The CSC are non-profit associations of cannabis users that cultivate the plants and supply the products to a closed circle of members (ENCOD, 2020). CSC as a regulatory model is based on safe access, social support, and a non-commercial business model that offers great promise for future cannabis policies (Belackova et al., 2016; Decorte, 2015; Obradors-Pineda et al., 2021). CSCs were first established in Spain in the 1990s and can be now found in several European countries, such as Belgium or The Netherlands, and have already been introduced and regulated on a national level in Uruguay (Belackova et al., 2016; Decorte, 2015; Decorte et al., 2017; Obradors-Pineda et al., 2021; Pardal, 2018; Pardal et al., 2020; Pardal et al., 2019). In general, drugs are often distributed in small circles of friends, which has been described as “social supply” in the literature (Werse and Bernard, 2016). As in the case of tobacco regulation, where advertising is banned and diverse harm reduction methods are in place, governments should apply a similar regulatory approach to the development of just and effective policies for some of the most prevalent controlled substances (GCDP, 2014).

Figure 1.

Degrees of regulation. Graph adapted from Dr. John Marks / Transform and the GCDP 2014 Report.

Although we witnessed a wave of progressive drug policies in the past years, including decriminalisation of people who use drugs (e.g. Portugal, Spain, Jamaica), cannabis legalisation (e.g. Uruguay, Canada, multiple US states) and the opportunity for regulation of new synthetic drugs (e.g. New Zealand), the implementation of drug policy reforms is still conducted rather reluctantly, that is only individual countries/states implement regulatory changes for single substances. There is no overarching approach to regulate drugs, however, some established regulatory tools can serve as inspiration for development of future policies.

The aim of this manuscript is to show some implications associated with a transformation of the recreational drug market that is focused on self-supply of different categories of (currently controlled) drugs. Therefore the concepts of "farmability", the feasibility to cultivate relevant plants and fungi, and "pharmability", the feasibility to refine materials to drugs by chemical synthesis, purification etc., are addressed.

The current scientific literature (or drug policy) does not differentiate between drugs with low and high farmability/pharmability. However, this is important to create supply models for such drugs without supporting organised crime groups or endangering individuals’ health. All these aspects gathered from experts and subsequently discussed are groundwork for evidence-based and human rights-centred drug policy work, particularly beyond cannabis (where there are already existing models). If there is already a regulated market for a specific drug, which is not causing significant harm to society, then alternative/social supply models (such as self-supply) could be considered as an adjunct.

This analysis is crucial for regulatory proposals rooted in human rights and public health while aiming for a non-commercial supply of different popular psychoactive substances, for example self-cultivation, social clubs and health-centred dispensaries.

The concepts of “farmability” and “pharmability”

Farmability describes the feasibility of farming plants or fungi to produce a psychoactive drug or a drug precursor. While cannabis would score high on farmability (as it can be grown indoors and outdoors in many regions with only little know-how), the farmability of methamphetamine is considered rather low as methamphetamine cannot be grown. Only precursors for chemical synthesis could be extracted from plants, such as Ephedra vulgaris.

Pharmability describes the feasibility of refinement starting with accessible plant, fungus or chemical material. The final product would be a psychoactive drug. Hence, pharmability distinguishes between single-step extractions (e.g. hash oil, ayahuasca), multi-step extractions (e.g. DMT, cocaine), single-step synthesis (e.g. methamphetamine, heroin) and multi-step synthesis (e.g. LSD, PCP). It must be pointed out that complexity of syntheses (including number of reactions and purification steps) depends very much on obtainable precursors and grades. Hence, LSD would have a significantly lower pharmability than ayahuasca. Also safety aspects can be expressed in the pharmability of a drug, for example, assigning “butane honey oil” (using an extremely flammable/explosive gas) a lower pharmability than a solvent-free cannabis extraction using heat and pressure due to less safety precautions needed.

Many drug manufactures can be described by a combination of farmability and pharmability as those drugs start with a substance from a plant/fungus, for example safrole from Sassafras albidum being used for the synthesis of ecstasy (MDMA) or lysergic acid from Claviceps purpurea being used for the synthesis of LSD. In this context it should be emphasised that incomplete synthesis or insufficient purification may cause harms to health in the consumer due to impurities.

Methodology

68 drug experts were invited to fill out an online survey on the feasibility of self-supply of different categories of drugs. Under the term “drug experts” we understand a person with an MSc or PhD in pharmacy, chemistry, agricultural sciences or a degree in sociology, anthropology, psychology, biology, or similar, together with a demonstrated understanding of the current drug landscape (demonstrated by publications, talks etc.). In general, we tried to get a broad information base. For instance, criminologists (often with a background in social sciences) may have a better understanding of clandestine drug manufacturing than a chemist working in a Good Manufacturing Practice (GMP) environment. Of course, we also aimed for opinions from forensic chemists. The experts that responded to the survey were native English, Spanish, Portuguese and German speakers.

The online survey was a five-point Likert-scale (1 = very easy to 5 = very difficult) and had seven questions (see Online Supplementary Material 1: Questionnaire FarmPharm). We also added a comment option at the end of each question to give space for clarification of the choice. Additionally, the distinction of natural and social science background was queried.

Different drugs have different effects, however some drug effects are closer to each other than others. It is more likely that someone replaces LSD with psilocybin or methamphetamine with amphetamine (e.g. due to availability) than someone replacing LSD with methamphetamine or vice versa due to quite different effects. Hence, we can roughly distinguish the desire to alter one's mind in seven common drug categories: cannabinoids, depressants, dissociatives, empathogens/entactogens, opioids, psychedelics, and stimulants. We asked our respondents to scale the seven mind-altering drug categories according to how easy they consider their self-production (cultivation, extraction, synthesis etc.) while taking into account different regions with regard to climate, use prevalence of individual drugs (e.g. alcohol being more popular than kava) and cultural competencies for drug production.

Results

26 experts (38.2%) responded to the online questionnaire on difficulty to cultivate/manufacture different drug categories for personal use. The feedback received can be split into 15 experts considering themselves as natural scientists and 10 considering themselves as social scientists (1 respondent did not make a choice), however results were quite similar between both groups, particularly when considering the low number of participants. Many experts expressed further comments which are summarised in Table 1. Also, which is most relevant for this study, the difficulty level regarding farmability/pharmability was ranked based on a scoring from very easy (1) to very difficult (5). Standard deviations are mostly around or below 1 which suggests a certain robustness (see Online Supplementary Material 2: Stats-Results-FarmPharm for detailed results).

Table 1.

Expert opinions about the difficulty to cultivate/manufacture different drug categories for personal use (scoring: very easy (1), easy (2), moderate (3), difficult (4) and very difficult (5); feedback from 26 experts with 15 considering themselves natural scientists and 10 considering themselves social scientists).

Drug category	Difficulty for private cultivation/manufacture	Comments
Cannabinoids	Easy (2.33 ± 0.99)	Most experts consider cultivation not overly challenging, although dependent on environmental conditions, space and the final product aimed for (cf. extracts using solvents).
Depressants	Moderate (3.28 ± 0.98)	Most experts refer to huge differences with regard to cultivation and manufacture (alcoholic beverages on the easier and benzodiazepine synthesis on the rather difficult side).
Dissociatives	Very difficult (4.60 ± 0.60)	Most experts suggest that manufacture of dissociatives is very difficult or impossible and point out that there are no natural substitutes.
Empathogens/ entactogens	Very difficult (4.55 ± 0.74)	Most experts consider manufacturing as very difficult or impossible but some point out that availability of precursors and a certain degree of training could facilitate.
Opioids	Difficult (3.68 ± 1.04)	Experts suggest that low potency products based on poppy and kratom could be cultivated/manufactured with a moderate difficulty level while more potent (semi-)synthetic substances would be very difficult to obtain.
Psychedelics	Moderate (3.32 ± 0.95)	Most experts distinguish between difficulty level of natural products, such as psilocybin-containing mushrooms on the easier side and synthetic substances, such as LSD, on the very difficult side.
Stimulants	Difficult (3.76 ± 1.00)	Experts refer to legal market (coffee, tea) and suggest that low potency products (ephedra, khat) could be cultivated with a moderate difficulty level while more potent (semi-)synthetic substances would be very difficult to obtain.

Different drug categories had different results regarding manufacturing difficulty (cf. farmability and pharmability). Cannabinoids were considered "easy" (2.33 ± 0.99), depressants and psychedelics were considered "moderate" (3.28 ± 0.98 and 3.32 ± 0.95 respectively), opioids and stimulants were considered "difficult" (3.68 ± 1.04 and 3.76 ± 1.00 respectively), and dissociatives and empathogens/entactogens were considered "very difficult" (4.60 ± 0.60 and 4.55 ± 0.74 respectively).

Discussion

The ranking of the individual drug categories in Table 1 suggests that some controlled substances, in particular cannabis, could be decriminalised without the need of a commercial market. However, some drug categories, such as dissociatives and empathogens/entactogens, would require the establishment of professional manufacturers. Other drug categories, such as psychedelics and depressants are ranked in between.

It must be emphasised that use prevalence is not necessarily comparable between different drug categories. In general, it is difficult to determine the demand for unregulated psychoactive substances as there are no sales data. However, prevalence data from surveys and information from seizures are an indicator, particularly for proportions of demand between drugs, for example how much demand of cocaine is there compared to the demand for cannabis. More or less recently regulated markets cannot be considered as fully established markets, therefore sales data from legalised states/countries are not yet considered as relevant source for demand. As shown by data from Canada, it may take some time to overtake the illegal market and the full potential is dependent on many factors which are not set in stone yet (Armstrong, 2021; Lamers, 2021).

Regarding seizures, the EMCDDA (2020) suggests high availability of drugs even during the Covid-19 pandemic. Data for Europe from 2018 suggests cannabis (herbal and resin) being the lion's share with approximately 70%, followed by 10% cocaine (incl. crack cocaine), 6% amphetamine, 5% heroin and 3% MDMA. These data seem to roughly correlate with the 12-month use prevalence which is 7.6% for cannabis, 1.3% for cocaine, 0.8% for MDMA and 0.6% for amphetamine. For heroin and other opioids there are approximately 1.3 million people in the European Union who are considered high-risk opioid users. On an international level, the World Drug Report paints a very similar picture regarding seizures, that is ca. 71% cannabis, 14% cocaine and diverse amphetamine derivatives to a lower extent. One main difference between the global and the European market is that prevalence of amphetamine and methamphetamine seem to be inverted. Furthermore, there are regional differences with regard to opioids with some regions also using/smuggling opium or highly potent synthetic opioids, for example fentanyl (World Drug Report, 2020).

It seems that classic psychedelics, such as LSD and psilocybin-containing mushrooms, but also psychedelic designer drugs (e.g. phenethylamines, tryptamines) and dissociatives (e.g. PCP) do not play a big role, neither on the European nor the global market. This may either have to do with their lack of farmability (with a few exceptions, such as psilocybin-containing mushrooms) and/or their low potential for substance use disorders and therefore mostly lack of repetitive consumption patterns (NIDA, 2021).

Different drug categories, and the individual drugs within, are associated with different degrees of farmability and pharmability. This has been collectively captured in Table 1. Nevertheless, certain caveats have to be expressed. The drug market has a certain volatility which can be acknowledged when digesting the following example: While for centuries opium was the opioid of choice in most regions, only in the last century/decades shifts towards morphine, heroin and fentanyl respectively were observed.

Cannabis, as the controlled substance with the highest demand, can be grown in multiple climates outdoors but also indoors using artificial light. There is a plethora of strains enabling different characteristics for the final product (e.g. THC and CBD content) but also with regard to growing conditions. One example for the latter would be the so called “autoflower” strains which are used for outdoor cultivation in regions of the Northern hemisphere with shorter summers. These strains, crossbred with Cannabis ruderalis (or Cannabis sativa var. spontanea), start flowering independent of the daylight cycle (Gloss, 2015). Furthermore, indoor cultivation using ventilated tents with LED lamps is a common way to produce recreational/medical cannabis products (Decorte, 2010). The question to what extent prohibition pushes this phenomenon is difficult to answer. Of course it is more difficult for police or nosy neighbours to spot cannabis in a small tent in the attic or a cellar than to spot cannabis on a balcony or in a garden. The products themselves, that is herbal and resin materials, may require some skills (particularly when aiming for high quality) but are overall easy to produce. Extracts may require some additional skills and/or safety precautions dependent on the method, however they currently seem not to have a demand comparable to herbal and resin products, which can be used for smoking, vaping and incorporation into edibles (cannabis-infused foods).

Other drug categories, such as depressants, dissociatives, stimulants and opioids, have quite mixed portfolios with some products being available at regular or licensed shops, some either over-the-counter or via prescription and others can be grown domestically or picked in the wild. Of course the markets for alcohol and diverse herbal products (depressants) and caffeine- and nicotine-containing products (cf. stimulants) are unlikely to be affected significantly by regulating controlled substances uncommercially. However, availability of opium (from Papaver somniferum) or kratom extracts (from Mitragyna speciosa) may influence prescription practice for pain medication. Also easier access to ketamine may reduce the abuse of dextromethorphan for its dissociative effects. In general farmability of dissociatives, empathogens/entactogens and potent stimulants is considered rather low. Many experts emphasised that pharmability is strongly dependent on the availability of precursors. However, with those substances safe supply should ideally be addressed with pharmacies/dispensaries handing out appropriate quantities and providing individual consultation (cf. safer use).

In general the market for psychoactive drugs has some volatility. It is difficult to predict if a new plant extract (e.g. Sceletium tortuosum, Salvia divinorum) or a more or less novel psychoactive substance (e.g. 2C-B, methoxetamine) will either become a niche product or gain substantial popularity with an accordingly developing market. Of course this popularity should not only be driven by cultural influences alone. Safety-related features but also other aspects of psychoactive drugs (e.g. ecological footprint, fair trade), particularly in comparison with each other, should be communicated in a non-commercial fashion. However, it is the authors’ opinion that the individual choice of a drug and its dose / pattern of use must be dominantly driven by education. Furthermore, the remark should be made that a regulated supply, either by self-cultivation or dispensing from a pharmaceutical source, must address all drug categories, focussing particularly on the ones with high demand, for example cannabinoids and stimulants. It is assumed that intra-categorical volatility is greater than inter-categorical volatility, that means for instance, that a herbal cannabis user vaporises cannabis resin/extract as an alternative, rather than inhaling laughing gas or DMT (a dissociative and an associative/classic psychedelic respectively) instead. This is likely due to the social function of a substance but also due to individual preferences, which may be inherent or acquired.

Overall, we must admit that innovation, education, further cultural influences and accessibility to precursors, plant matter etc. may impact drug use in an unforeseeable manner. Hence, the expert ranking and comments regarding the difficulty level of cultivation and manufacture of drugs (see Table 1) must be taken with a grain of salt. Nevertheless, the ranking of the difficulty level correlates negatively with farmability, that is if a drug cannot be cultivated its manufacture is considered rather difficult by experts.

Conclusion

Different drugs are associated with different cultivation and/or manufacturing steps with contrasting difficulty levels. Even within a drug category farmability and pharmability can be rather distinct, for example, growing opium poppy is perceived much easier than the synthesis of tilidine, even if both drugs have a similar potency (cf. equianalgesics). Those differences are likely to shape use prevalence to more accessible and safer drug markets which also decrease the involvement of organised crime groups. Hence, when decriminalising the possession of drugs for personal use it is therefore recommended to allow also for personal cultivation or cultivation within social clubs. This is particularly relevant for drugs with moderate to high farmability but also if pharmability is sufficiently high. The latter could be supported by education on safe extraction methods, simple syntheses (e.g. for GHB) etc.

Supply of substances associated with low pharmability, however, can still be considered a regulatory challenge. Beyond the current substitution practice (e.g. opioid substitution practice with methadone) in many countries, which should be extended, a non-commercial transformation could be achieved by limiting supply to dispensaries/clubs to agreed-upon contingents. Here, the pharmaceutical industry would be the institution to provide for pharma-grade substances with low pharmability (like in the case of opioid substitution therapy). An analysis, as conducted within this manuscript, is crucial for regulatory proposals aiming for an overarching, non-commercial drug supply, such as a combination of self-cultivation, social clubs and health-centred dispensaries.

Supplemental Material

sj-docx-1-dsp-10.1177_20503245221097797 - Supplemental material for Farmability and pharmability: Transforming the drug market to a health-and human rights-centred approach from self-cultivation to safe supply of controlled substances

Supplemental material, sj-docx-1-dsp-10.1177_20503245221097797 for Farmability and pharmability: Transforming the drug market to a health-and human rights-centred approach from self-cultivation to safe supply of controlled substances by Fabian Pitter Steinmetz and Maja Kohek in Drug Science, Policy and Law

Supplemental Material

sj-xlsx-2-dsp-10.1177_20503245221097797 - Supplemental material for Farmability and pharmability: Transforming the drug market to a health-and human rights-centred approach from self-cultivation to safe supply of controlled substances

Supplemental material, sj-xlsx-2-dsp-10.1177_20503245221097797 for Farmability and pharmability: Transforming the drug market to a health-and human rights-centred approach from self-cultivation to safe supply of controlled substances by Fabian Pitter Steinmetz and Maja Kohek in Drug Science, Policy and Law

Footnotes

Acknowledgements

The authors would like to thank all experts who participated in this study. We would also like to express our gratitude to the anonymous reviewers for their time and effort, as they helped us to considerably improve this manuscript with their critical comments and constructive suggestions.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Supplemental material

Supplemental material for this article is available online.

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