WHAT DOES THE CONCEPT SAY?

In terms of strategy for the creation and rollout of the pilot project for legal access to cannabis for non-medical purposes, the policy approach is to proceed in stages and to develop a specific approach to cannabis for non-medical purposes.

The first stage, bill No. 8033 amending the amended Act of 19 February 1973 on the sale of medicinal substances and the fight against drug addiction, was introduced on 22 June 2022. The legislative process is currently in progress.

With its risk reduction and crime prevention approach, the bill has a dual objective:

On the one hand, any person of legal age will be allowed to grow up to four cannabis plants, at home, per household, for personal use, exclusively from seed. It is worth noting that plants must be kept out of public view. Personal use in private will be allowed. If the place of cultivation is non-compliant or if the number of plants grown at home is exceeded, criminal penalties will apply.

On the other hand, there are plans to abolish criminal penalties for small quantities of cannabis (< 3 grams) in public. Less complex and swifter criminal proceedings will be introduced for adults in public possession of, or transporting and acquiring, no more than 3 grams of cannabis, or its derivatives (including mixed products). The bill reduces the range of fines to between €25 and €500 with the option for the Grand Ducal Police to issue a warning with a €145 fine. Use in public is still banned.

It is worth noting that this legalisation of self-cultivation and private use is a first step, pending finalisation of the overall concept to counteract the black market and regulate the illegal trade in cannabis. As appropriate, this first step will need to be reviewed and adapted, depending on the final system selected.

When drafting the bill implementing this concept note, the system introduced by bill No. 8033 will, therefore, be reassessed to ensure consistency between the two systems, particularly with regard to the issue of possession of cannabis in public.

To ensure the quality of cannabis and prevent the emergence of an unregulated parallel market for products of uncertain quality, regulations on the packaging and physical sale of cannabis seeds with a future THC content of more than 0.3% for private and personal use, will be put in place.[2]

[1] Bill No. 8033: https://www.chd.lu/fr/dossier/8033

[2] Draft grand-ducal regulation amending the amended grand-ducal regulation of 26 March 1974 setting out a list of narcotics.

At a later stage, the transition to legal access to cannabis for non-medical purposes will be ensured [1] and the following minimum criteria and conditions will have to be met:

• Be domiciled in Luxembourg: Actual residence in the Grand-Duchy of Luxembourg . This provision is intended to prevent “cannabis tourism”, to limit the potential disturbance caused by an increased influx of customers from all sides, and to increase acceptance, or even reduce fear, resistance and criticism from neighbouring countries[2];
• Age criterion: Minimum legal age, i.e. 18 years of age;

[1] As stated in the 2018 coalition agreement described in chapter I.1.

[2] In line with the decision of the European Union Court of Justice ruling on the compliance with EU law of a decision of the Mayor of Maastricht prohibiting coffee-shop owners from admitting to their establishments persons who are not actually resident in the Netherlands (Josemans, Case C-137/09).

For use in private only: The ban on taking cannabis and cannabis-derived products will apply to premises open to and/or serving the public, and to any places in which the ban on smoking (tobacco and e-cigarettes) applies. This measured is intended to limit public nuisances; prevent the passive inhalation of harmful, potentially psychoactive smoke by non-users; and to counter the spread and normalisation of cannabis use, and even the perception that it is less risky, among young and not-so-young people. The same rules must also apply to all other cannabis-based products smoked or vaped, in particular those with a THC content of less than 0.3%.

Maximum monthly and daily quantities: Given the domestic context, it is recommended that the monthly threshold should not exceed 30 grams of dried cannabis per customer. In addition, dispensaries will have to ensure, by means of a computer system common to all outlets, that the maximum quantity of 5 grams per day, per purchase and per customer, is not exceeded. These quantities purchased must be exclusively for personal use.

In order to make it easier to detect violations of the pilot project and ultimately ensure that it can be applied on a permanent basis, the working group believes that a distinction should be made between cannabis of legal, and illegal, origin. Relevant biomarker methods will have to be identified in order to determine, if necessary, the origin of the cannabis, bearing in mind the need for safety for the end-user and the importance of the price of legally available products remaining competitive with those for sale on the black market.

All relevant policies relating to smoking or drinking alcohol in the workplace should be adapted to incorporate the consumption of cannabis for non-medical purposes. In addition, a zero-tolerance rule should be applied to certain professions when carrying out their professional activity, such as pilots, police officers, surgeons, prison staff, professional drivers etc.

The working group recommends that the pilot project be accompanied by a scientific evaluation consisting of a pre- and post-implementation analysis based on validated scientific indicators. This scientific evaluation will be carried out in close collaboration with the EMCDDA and its National Focal Point, and with various public health research institutions. In addition, and as part of a general evaluation, these research institutions, with the support of the Luxembourg National Focal Point of the EMCDDA, will publish a final report on the first seven years after legal access to cannabis for non-medical purposes was introduced. Within this context, it is recommended that the scientific evaluation should also be supported by an independent and neutral committee of experts from different disciplines. The final research evaluation report should, therefore, include the conclusions of the evaluation exercise and, where appropriate, recommendations to be made to the government. It remains to be seen how long the committee will have to complete its evaluation and submit its report to the government before the scheduled end of the pilot project

After receiving the final evaluation report, the government will have a set amount of time, which is still to be determined, to form an opinion on the report and how it wishes to follow up the results and conclusions of the evaluation.

The aim of such an evaluation will be to see whether the approach taken can improve public health protection nationally, in particular, by controlling the quality of products taken by large numbers of the general public, and whether the new prevention strategies can limit use, stem revenue flows and the growth of organised crime, free up capacities and resources for reducing supply and combating organised crime, and reduce the contact between users and criminal circles that has, until now, been unavoidable. In fact, the current situation is not satisfactory for the reasons set out above and it would, therefore, seem fair, and indeed necessary, for the government to work towards finding solutions that are more likely to achieve the desired goals, based on scientifically valid data.

The scientific evaluation will be based on a baseline analysis of the current situation, during the period prior to the implementation of the national pilot project. The baseline data will then be supplemented by periodic analyses for the post-implementation period, in close collaboration with interdisciplinary experts, in order to 1) determine whether the national pilot project scheme is in line with its indicators and targets, 2) monitor emerging trends and their impact on public health, including changes in cannabis use and use-related behaviour, and 3) acquire new evidence-based knowledge.

In order to evaluate and monitor the impact of the national pilot project, six core targets with first, second and third priority indicators for evaluation and monitoring were selected. These were identified mainly by the working group through an extensive literature search and in collaboration with the EMCDDA in order to assess the drug situation and the potential impact of different legal and regulatory changes.

Each indicator associated with one of the six targets was assessed to see to what extent national data and information sources are currently available, the need for international data (EMCDDA, UNODC, etc.), as well as the timeframe for data collection (short, medium or long term) and its relevance in terms of achieving the future regulation’s objectives. The following non-exhaustive list of key epidemiological indicators is proposed:

• Identifying and monitoring factors associated with cannabis use, including psychosocial motivations and determinants e.g. risk perception, social attitudes and norms, socio-economic factors and mental health disorders
• Identifying and monitoring the prevalence of cannabis use and patterns of use among the general population, including vulnerable populations (e.g. groups with low socio-economic status, young people, those experiencing discrimination as a result of their gender, individuals with psychiatric co-morbidity (especially psychotic), etc.)
• Monitoring the prevalence of high-risk cannabis users
• Monitoring treatment provision and the proportion of high-risk cannabis users (cannabis as the main product) entering treatment, both in terms of access and treatment outcomes
• Identifying and monitoring changes in usage and possible impacts (including negative impacts) associated with the prevalence of use of other controlled and regulated psychoactive substances (including alcohol, tobacco, medicines and illicit drugs such as opioids)
• Assessing and monitoring morbidity and adverse effects associated directly and indirectly with cannabis use
• Collecting data and monitoring healthcare use directly and indirectly related to cannabis use (e.g. number of medical emergency episodes and hospital admissions related to cannabis use)
• Identifying and monitoring the social (family, professional, legal) and economic (loss of productivity, employment, school drop-outs, etc.) consequences of cannabis use
• Identifying and monitoring the consequences of the redeployment of policing activity

These indicators, in line with the objectives of the pilot project, will help to provide objective and reliable informationon cannabis use, its determinants and consequences in order to assess trends and developments in the supply and demand for cannabis. This work will make it possible to conduct a needs analysis to facilitate the development of targeted policy measures, including public health and public order intervention programmes.

The scientific evaluation will require one or more national mixed-method studies to collect data relating to the selected epidemiological indicators. For example, a general population survey (GPS) specifically dedicated to drug use and perceptions should be set up. The data currently available do not allow for a sufficiently nuanced assessment of the behaviours and perceptions associated with drug use prior to any change in the current regulatory framework, nor do they allow for measurement of the resulting effect on these indicators.

A general population survey could, therefore, cover and assess a large number of indicators. One example is the indicator of prevalence of cannabis use in the general population, for which measuring different rates of prevalence of cannabis use, including lifetime prevalence, past year prevalence and last month prevalence, is recommended. Analysis of non-use, past use and current use will make it possible to identify “new users”. The impact of usage will be one of the key indicators for steering and adjusting the planned policy. Other variables to be considered are socio-demographic factors, age at which cannabis use starts, frequency of use, psychosocial factors, etc. The general population survey should be supplemented by targeted studies that provide more detailed data on current cannabis users and (future) growers, e.g. cannabis users’ habits, quantities taken, usage patterns (including methods of taking cannabis), type of product taken (CBD-dominant/THC-dominant), intentions to grow cannabis plants at home, sources of cannabis acquisition (legal versus black market).

Establishing a representative general population survey supplemented by targeted studies will boost the availability of national data and statistics on the drug situation. The information gathered will facilitate study of the drug phenomenon, understanding of the impact of drug-related policy changes, identification of priorities and better planning of responses. Lastly, the general population survey will support the EMCDDA’s key indicator on prevalence and patterns of drug use, which makes it possible to collect and interpret harmonised and high quality European data.

This survey will require a nationally representative probability sample of people aged 15-64 and residing in Luxembourg. EMCDDA guidelines and European model questionnaires will be used to develop the questionnaire.

The evaluation studies will help to establish a baseline of specific indicators that are relevant in the context of the yet-to-be-implemented cannabis regulations. For example, it will be necessary to estimate consumption patterns and habits, motivations, attitudes and perceptions of risk, supply behaviour, and the prevalence of cannabis-related addictive disorders.

In addition, it is important to monitor trends in supply reduction indicators and the market for illegal psychoactive substances, including the number of cannabis seizures, quantities seized, street prices, types of cannabis products seized, THC concentration and contaminants in cannabis products seized in Luxembourg.[1] In addition, judicial and penal measures will be monitored, including the number of summons (arrests and charges) for cannabis-related offences. The number of fatal and non-fatal road accidents and cannabis driving offences will also be assessed.

Wastewater analysis can provide an additional source of data to qualify, or even validate, the survey data.

In addition to analysing the impact on public health, assessing the impact, before and after the pilot project, from an economic perspective is recommended. The economic impact assessment will focus on health economics approaches and a cost-of-illness study. This study will include, among other things, the costs to the health sector (direct costs), the value of lost productivity (indirect costs), and intangible costs.

Finally, a process evaluation of the national pilot project for legal access to cannabis for non-medical purposes should be considered. This evaluation will determine whether the different components of the pilot project were carried out as planned (fidelity) and whether its objectives were achieved. The process evaluation will generally review stakeholders’ experiences and help to determine which elements of the new pilot project are working well in practice, how well the pilot project is achieving its objectives, and which elements should be modified for improvement.

Evaluation of all aspects of the situation before, and after, the implementation of the pilot project will provide new scientific, theoretical and practical knowledge about cannabis use and regulation. The pilot project and its outcomes should be subject to ongoing monitoring and interim evaluations.

This evaluation process should be accompanied by a national research strategy, possibly in conjunction with international partners. In this way, Luxembourg will contribute to the international scientific community’s efforts to advance knowledge of all aspects of cannabis and to expand the scientific literature on the subject, which is still lacking. This approach will help to develop intervention programmes (preventive, educational, behavioural, psychological) based on scientific protocols and evidence.

[1] N.B. Seizures are not a particularly useful measure of the size of the black market. They are likely to be, above all, a measure of policing activity rather than market size, and the lessons to be learned from them may be distorted by a small number of significant seizures over a period of time.

The importing of cannabis is currently not a viable option. It will therefore be necessary to, right from the outset, plan for the establishment of a national production and marketing chain; given the current lack within Luxembourg of infrastructure for and experience of cannabis cultivation and production within a legal and controlled framework and environment, this looks likely, at the moment, to be a long-term undertaking.

It is recommended that a national control agency for that production and marketing chain be made responsible for oversight of the country’s production and producers and for the purchase of domestically produced cannabis. That option seems the wisest choice with a view to preventing companies’ profit-seeking from conflicting with the primary public health goal of reducing the negative side effects of cannabis use among the population at large. This national agency must be able to ensure the production of enough varieties of cannabis to prevent users from turning or returning to the black market.

During the establishment of the legal framework regulating production, it will be important to conduct a market analysis and determine whether the offering will meet users’ needs, in order to avoid over-/underproduction, or even a negative impact on changes to the ways in which the drug is taken. This goal could be achieved by limiting the number of production permits issued and/or a producer’s total permitted output. In addition, such a measure will contribute to mitigating the risk that legally produced cannabis could be diverted onto the black market.

On the basis of these considerations, it is proposed that producer companies be granted a maximum of two production permits and be able to acquire no more than one permit for a single production site. In order to be able to apply, companies will have to meet the quality requirements laid down by the authorities and the eligibility conditions set out in the specification. The permits will authorise the growing, processing and distribution, under certain conditions, of cannabis for non-medical purposes.

In view of the estimated number of potential users and of the small size of Luxembourg territory, it is estimated that two production sites will be able to meet domestic needs. Since the sustainable and guaranteed production and supply of cannabis for non-medical purposes is a key element of the later stage of the pilot project, this stage must not start until the legal framework regulating the production of cannabis for medical purposes is in place.

The production of cannabis for medical purposes is particularly important as part of a holistic and proactive approach, since the related legal framework being in place will therefore be a precondition for starting the subsequent stages described in the pilot project of legal access to cannabis for non-medical purposes.

The legal framework regulating production of cannabis for medical purposes will therefore serve, subsequently and after the related legal framework is in place, as the regulatory, administrative and logistical basis for establishing the production of cannabis for non-medical purposes.

2.5.1 Varieties of product 

It is important to offer a varied range of products on the legal market, in order to meet users’ demand. The varieties of product that may be sold should be set out in the specification for a public tendering procedure relating to the allocation of production permits.

The products to be included must be decided on the basis of what is currently available on the black market and of the risks associated with using different varieties of cannabis. Those risks are closely linked to THC and CBD concentrations, and strongly influenced by the method used to take the drug and the amount taken.

Initially, a range of cannabis flowering-tops and resin products is being considered. Nevertheless, it seems appropriate to supply dispensaries with a range of cannabis varieties (several THC/CBD ratios and terpene profiles) and of appropriate THC and CBD concentrations, in order to ensure the lowest possible probability that users, unable to find the desired variety for sale legally, will turn or return to the black market.

In addition, since certain hybridisation and extraction techniques now make it possible to produce plant varieties or derived products containing very high THC concentrations (e.g. butane hash oil), the varieties and resins supplied by producers must meet the criteria laid down in the specification. The production and sale of pre-rolled cigarettes (joints), containing either tobacco and cannabis or just cannabis, must be prohibited.

2.5.2 General requirements for the producer to meet 

It is recommended that producers should meet the following minimum criteria (non-exhaustive list):

• The producer must draw up a project proposal covering growing operations, post-harvest facilities, quality checks, quality-management system and the cannabis varieties (e.g. THC/CBD ratio and terpene profile) that it wishes to grow.
• The producer must guarantee the product quality standards – which have yet to be set out – throughout the production chain (growing, packaging, storage, etc.).
• The producer is responsible for security measures, in particular the completely secure storage of the cannabis, and must ensure a safe and healthy work environment.
• The producer must undertake to use exclusively the tracing software provided by the control agency, as defined in item 7, enabling the route taken by each finished product to be traced, so that the closed cannabis production chain can be properly monitored.
• Cultivation, drying and packaging of the product must take place on the same site, in order to avoid any unnecessary transportation.
• The producer must undertake to make every effort to prevent criminal involvement in the cannabis production and marketing chain and to cultivate no cannabis other than that which is to be sold at the dispensaries authorised under the national pilot project.
• The producer will not be permitted to sell online or deliver to customers’ homes.
• Every available resource is to be brought to bear to prevent the exporting of cannabis for non-medical purposes.
• The producer must meet stringent reliability requirements: the operator, manager and staff must exhibit a high degree of integrity, which will be checked in cooperation with the competent authorities; the THC and CBDcontent allowances of the dry weight – at a given percentage, to be determined – must be clearly marked and observed.
• The production of cannabis-derived products whose THC content deviates in a significant way – which has yet to be defined – from the level stated or required in the regulations should be considered a serious breach of the conditions for granting of the permit.
• Producers must demonstrate that measures are in place to make it possible to proactively avoid producing surpluses and to enable secure storage of surpluses in a way that safeguards their quality, for instance by means of refrigeration. These measures are necessary in order to appropriately respond to the ebb and flow of the Luxembourg market, which is intrinsically limited.
• Producers must, upon the national control agency’s request, grant inspectors access to representative samples of a batch of cannabis, so that it can be sent to an independent and state-approved laboratory for testing.
• Producers must, using specific methods yet to be determined, destroy:
  • a) The compounds or derived products from a batch of cannabis or those resulting from a batch that does not meet the quality control requirements
  • b) Stock remaining unsold once an expiry date has passed

• Producers must meet certain requirements favouring production sites that will adequately meet the climate goals in respect of renewable energy sources set out in the 2018-2023 coalition agreement. Thus, the specification will lay down as-yet undetermined requirements in respect of self-sufficiency in renewable energy, and energy-efficiency and emission-reduction measures.
• The conditions under which producers operate and set up business must be agreed with the competent authorities (environmental impact, water supply, wastewater disposal, etc.).
• Producers must be registered with the appropriate trade association.

2.5.3 Storage and quality checks

The working group considers it important to put safeguards in place to ensure both the quality (of refrigerated cannabis stockpiles, for instance) and the security of the product while it is being stored.

Before the pilot project is up and running, it is proposed that each production site ensure that it has a back-up supplyequivalent to one production cycle for all varieties cultivated. Provision will need to be made for an initial stage and a market-maturity stage to adapt suitable back-up supplies.

In addition to the quality requirements for growing, independent quality checks and cannabis analyses should also be organised. This makes it possible to conduct checks on whether the product meets the quality (contaminants, pollutants, plant protection products, plant growth regulators, etc.) and concentration (THC and CBD) requirements. It is important that, in order to prevent any conflicts of interest, a certified independent body be made responsible for these quality checks. In parallel, it will also be necessary to guarantee that the relevant agricultural best practice is observed.

2.5.4 Product quality standards 

The quality of cannabis for non-medical purposes to be produced by the selected producers should meet the quality standards, which will be laid down in a grand-ducal regulation.

It is proposed that producers be required to produce cannabis of quality compatible with public health goals and with the objective of gradually eroding the black market. One of the results of this requirement is that quality will be uniformly beyond reproach and that there will be no consumer-protection disputes consisting of criticisms that products are of inferior quality to those found on the black market.

Production and quality standards should be drafted to incorporate the following points (non-exhaustive list):

• Clearly defined government standards setting upper limits, or undetectable levels, of plant protection products, contaminants and pollutants:
  • Prohibition against using any plant-protection products (pesticides, fungicides, etc.) and plant growth regulators: It is proposed to prohibit the use of these producers and, if necessary, to require producers to use organic methods. Certification that meets the requirements for organic farming standards is recommended.
• Production that meets the requirements of the food industries’ quality assurance systems, where that proves beneficial for producing cannabis for non-medical purposes:
  • Consider the possibility of partially or fully applying good agricultural and collection practices (GACP). They contain regulations on food safety, packaging, and working environment and conditions;
  • Set out a quality management.

2.5.5 Container and packaging

The producer should ensure that the container meets the following requirements and has the following characteristics (non-exhaustive list):

• Being airtight
• Having a childproof catch
• Not looking attractive to children
• Ensuring that the product is properly preserved
• Being sealed once the product is ready to be dispatched to the dispensary
• Being sealed in such a way that it cannot be opened without damaging the seal but that it can be closed again
• Being uniform and containing an amount weighing the same as one of the measures in which cannabis is normally sold (1, 3 or 5 grams)

All packaging should be identical and the “plain packaging” principle must be applied and respected.

The container label should also display the following information (non-exhaustive list):

• Product name
• Product type
• Producer’s name and contact details
• Quantity in grams
• THC and CBD content and ratio: the THC and CBD content allowances and the ratio of the two substances must be stated on the products sold, accompanied by a risk score represented by a colour code
• Universal THC symbol
• Batch number
• Use-by/expiry date
• Storage recommendations
• Unique code for the monitoring and tracking system
• QR code with practical information for users (e.g. analysis results, detailed information on, for instance, the presence of terpenes and the cultivation method)
• Quality label proving that the product has been checked by an official body
• Made in Luxembourg label

The container should also bear the following warnings, on a rotational basis (non-exhaustive list):

• “Contains cannabis”
• “Keep out of the reach of children”
• “Smoking cannabis is the most harmful way to take it”
• “Do not drive a motor vehicle or use machinery while under the influence of cannabis”

Instructions, in French, German, English and Portuguese, should be enclosed with the container, including the following information (non-exhaustive list):

• Recommended method(s) of administration
• Contra-indications
• Adverse effects
• Precautions for use
• Drug safety monitoring contact details
• Information on accessing treatment services
• The following warnings:
  • “Do not smoke cannabis, pure or with tobacco.”
  • “There may be a delay of two hours or more before intoxicating effects occur.”
  • “Women who are pregnant, breastfeeding or intending to become pregnant are particularly at risk from this product.” Possibly add a pictogram of a pregnant woman in an interdictory circle.
  • “Cannabis use can lead to substance abuse and addiction.”

It is recommended that the packaging developed and marketed in accordance with the above requirements also comply with the principles of the circular economy. The specific criteria to meet should be laid down in the specification for the production permit.

The distribution chain, from producers to dispensaries, should be organised by the producers and be transparent, so that it can be monitored and so that no cannabis can end up in criminal hands. The eligibility criteria for hauliers will be specified in the regulations.

The number of stops during transportation must be kept to an absolute minimum, in order to reduce all risk that cannabis will disappear from the closed distribution chain.

It is proposed to incline towards a public body for operation of distributors of cannabis for non-medical purposes. The intention is to avoid the risk that the marketing of cannabis products will, even with strict legal controls, bring companies’ profit-seeking into conflict with the primary public health goal of reducing the negative side effects of cannabis use among the population at large.

The working group takes the view that publicly owned dispensaries are more likely to comply with other regulatory limitations imposed by the state and are best placed to ensure both sales and qualified staff who will, to the best of their ability, strive for the achievement of the goals being pursued as part of the pilot project.

Publicly owned dispensaries have a number of advantages:

• Independent, strategic identification of the dispensaries’ specific locations
• Dispensaries’ swift, harmonised and simultaneous adaptation in the event of potential changes being made during the pilot project
• Ease of implementation of recommendations pertaining to, among other things, prevention and health promotion
• Lack of commercial pressures and their negative side effects
• Lack of competition between dispensaries
• Easier price setting and adaptation in response to the reactions and commercial strategies from the black market

It is therefore proposed that 14 dispensaries be established, at least during the initial stage. Item (a) of this chapter sets out the exact distribution of these dispensaries, on the basis of resident population per canton. In order to prevent “cannabis tourism” for non-medical purposes within Luxembourg, that distribution will have to be fairly even, in terms of both geography and population. To a certain extent, the locations of the 14 dispensaries will also be partly determined on the basis of population densities by workplace and of commuting routes.

The dispensaries must be used exclusively to sell cannabis for non-medical purposes. The state, or companies duly licensed by it, will be the exclusive suppliers of the dispensaries, at a price set by the state. That price will include packaging and secure transportation to the dispensaries. No other suppliers of cannabis for non-medical purposes will be tolerated; should other suppliers be used, civil and/or criminal proceedings will be brought without delay.

The only people eligible to buy cannabis for non-medical purposes will be residents 18 years of age or older. Customers’ right to buy will be verified using an information system provided by the Luxembourg Government IT Centre (CTIE). This system will consist of a secure terminal, a system for scanning the bar-codes included on the packaging and the related systems, such as the secure link to the National Register of Natural Persons (RNPP), the specific software application for entering the quantities bought by the customers and for checking, in real time, whether the monthly volume per resident of legal age has been exceeded. No other information system or software may be used on the terminal provided by the CTIE. The CTIE will perform preventive and corrective maintenance and any operational error must be reported to it as swiftly as possible. Telephone and remote support will be available during the dispensary’s business hours. In order to minimise the risk of computer system intrusion, the selected economic operators must have secure telephone and Internet connections. The state, through the CTIE or one of its specialist suppliers, reserves the right to conduct penetration tests, scheduled or unannounced, in order to check the security of telephone lines and Internet connections. These tests will take place before the above-mentioned terminal is installed and at least once per year.

Customers must be kept safe in the dispensaries and the property that the points of sale contain must be kept secure. At the least, a guard must be present in the dispensary during its business hours and at its closing time. The goods must be placed in strongrooms, with appropriate hygrometry- and temperature-control systems. Customers will be able to pay for their purchases by any legally permitted means. The dispensaries must, consequently, make provision for a cash-in-transit service, in order to prevent the accumulation of large sums of cash that, combined with the value of the stock of cannabis for non-medical purposes, could make the dispensary a target for criminals, including organised crime groups. In that connection, the specification will set out minimum and maximum levels of stock of cannabis for non-medical purposes. In the specification, the state will establish the type of premises that may house dispensaries of cannabis for non-medical purposes and all the details relating to making those dispensaries secure. Dispensaries should be open from 12.00 to 20.00 Monday to Saturday, excluding public holidays.

A dispensary may only be officially opened once it has been fully checked by the competent state services. Such checks, unannounced or regular, will also be conducted on the subcontractors of the selected economic operators, such as security or cleaning firms. In addition, other unannounced checks will be conducted on, for instance, premises security systems, the quality of storage for cannabis for non-medical purposes and compliance with dispensaries’ obligations.

There will be checks on the presence of a sufficient number of prevention and awareness-raising documents. In that connection, the state, or an authorised organisation, will provide the selected dispensaries with all the materials necessary for carrying out indispensable prevention and awareness-raising assignments. The employees of the selected concessionaires will, before the dispensary is opened, be duly trained on the best way to carry out those assignments. A dispensary will need to be staffed by at least three people at all hours of the day, in order for all prevention, awareness-raising, sales and administrative assignments to be carried out.

2.7.1 Geographic distribution of dispensaries 

The geographic distribution of dispensaries is to be settled by a competent institution on the basis of criteria; both the institution and the criteria are yet to be determined. In general, it is recommended to limit the number, density (geographic and population) and type of the dispensaries.

In the context of the national pilot project, it is proposed to establish one dispensaries in each of the following cantons, in order to ensure national coverage representative of the population density.

• 1 dispensary in the Canton of Diekirch
• 1 dispensary in the Canton of Grevenmacher
• 1 dispensary in the Canton of Capellen
• 4 dispensaries in the Canton of Luxembourg
• 4 dispensaries in the Canton of Esch-sur-Alzette
• 1 dispensary in the Canton of Mersch
• 1 dispensary in the Canton of Remich
• 1 dispensary in the Canton of Redange

Following the national pilot project, it will be possible to adapt the number of dispensaries to demand.

As regards the distribution of dispensaries, it will also be necessary to consider the fact that many people are able or obliged to make purchases in the canton where they work, not necessarily their canton of residence.

In relation to the location of dispensaries in the selected cantons, consideration must be given to laying down some requirements in respect of the conditions for setting up a dispensary (for instance, required distances from educational establishments, care model, easy access for people with reduced mobility, etc.).

2.7.2 Obligations that dispensaries must meet 

It is recommended to rule out the options of online sales and home deliveries.

All dispensaries should meet the following requirements (non-exhaustive list):

• The products offered must be bought exclusively from domestic producers approved by the public authorities.
• The dispensary must not hold more than the permitted stock on hand.
• Each dispensary should assess its stock on hand on the basis of need.
• The dispensary must meet its obligations as regards information on the product and on prevention.
• The dispensary may only sell the permitted cannabis products. Dispensaries must check whether they are entitled to sell cannabis accessories.
• The sale of alcohol is strictly prohibited.
• The dispensary is responsible for storing products in a way that preserves their quality, i.e. in a temperature- and humidity-controlled environment.
• The dispensary must ensure that its customers can use cash or bank cards to buy cannabis products.
• The dispensary must ensure secure storage of its products and guarantee a safe and healthy working environment.
• The dispensary must meet the sales-quality requirements.
• The dispensary must meet stringent reliability requirements.
• The dispensary must register all customers and check their entitlement to buy cannabis.
• The dispensary must ensure that the maximum quantities delivered every month are not exceeded. Taking into account the national situation, a monthly limit of 30 grams of dried cannabis per customer is recommended.
• The dispensary must ensure, by means of a joint computer system, that the daily limit of 5 grams per customer is not exceeded.
• The dispensary must ensure that no cannabis is used on its premises.
• The dispensary must do everything in its power to ensure that its activities do not cause problems (noise, litter, etc.) in its vicinity.
• The dispensary must respect the perimeter established in the specification in respect of proximity to schools, youth clubs, care homes, nursing homes, etc.
• The dispensary must undertake not to market or offer pre-rolled cannabis cigarettes (joints). The sale of tobacco, including tobacco-related accessories, will be prohibited.
• Customers must be encouraged to give preference to inhaling cannabis vapours by means of vaporisers and to cut back on smoking cannabis (pure or mixed with tobacco). Dispensaries should therefore be authorised to sell vaporisers.
• The dispensary’s staff may not process or handle the products intended for sale in any way. This prohibition does not apply to the presentation of samples of no more than 20 grams, made available by producers so that clients can evaluate the products for sale.
• The dispensary must ensure that no one opens a product’s packaging on the premises.
• Non-residents and people under 18 years of age will be prohibited from accessing dispensaries.
• Dispensaries must have limited business hours and days. It is recommended that dispensaries be open Monday to Saturday, 12.00 to 20.00, excluding public holidays.
• Dispensaries must not display advertisements promoting or encouraging cannabis use. Economic operators must not participate in any activities promoting and advertising cannabis for non-medical purposes, including the sponsoring of events and participation in events, conventions, trade fairs, etc. relating to promoting cannabis and products derived from it. The purpose of a dispensary must not be apparent from the outside, in other words they should not display any advertising that could encourage cannabis use.

• The dispensary may, however, very visibly display on its premises materials provided by the state or an authorised organisation, such as health warnings, educational literature and the contact details of consultation and therapy services.
• The dispensary is required to clearly explain, on its premises, how and why customers’ personal that is recorded will be processed, in accordance with the data protection legislation in force.

2.7.3 Stock management in the dispensaries 

• Each dispensary is responsible for recording, by means of the allocated unique code, all products received.
• The dispensary is not entitled to hold more than the permitted stock. The stock of cannabis necessary depends on the average quantity sold; it should be borne in mind that these averages can vary depending on the dispensary and, in particular, on its location. It is recommended to set the maximum stock level for each dispensary at such a level that the cannabis must not be delivered more than once per day; in other words, the stock should be sufficient for at least one day and no more than six given business days.
• The security conditions (strongroom with monitored entrance) are to be determined.

2.7.4 Role of sale price 

It is as difficult as it is crucial to set a fair price for the varieties and products sold by legal dispensaries. The goal is to make black market products less attractive, but without encouraging members of the public to use or even to start using legally sold cannabis. Discussions with representatives of other countries where there is experience of this should help a solution to this problem to be found, although the unique situation of Luxembourg (e.g. purchasing power, current prices on the national black market) should be borne in mind.

The national control agency should set the price, which should be neither too high nor too low. Too high a price could encourage users to buy cheaper products on the black market. As far as possible, the price should be guided by the black-market price. A regular evaluation will be necessary. The mechanism for setting prices should offer the flexibility necessary for it to be adjusted in line with changes on the black market.

In-depth analysis of the applicable taxes must be carried out. Where applicable, the taxes will be guided by EU legislation and the Belgium-Luxembourg Economic Union Convention. The taxation level is a variable relevant in terms of public health policy and should be the one that will enable achievement, to the greatest extent possible, of the goals being pursued (see chapter I.3).

As set out in the coalition agreement, the working group recommends that “In the investment of the revenue generated by cannabis sales, priority should be given to prevention, awareness-raising and treatment in respect of the huge numbers of addicted people”. Nevertheless, public health interventions, administrative work, enforcement action and research must be funded according to need, rather than being dependent on sales.

A lower price could initially help to avoid the repeating of experiences observed in some other countries, where the high price and scarcity of legal products benefitted the existing black market.

The price strategy must enable the competent authorities to discourage the use of cannabis with high THC content, which represents an increased health risk. Therefore, the option of a progressive and variable price that increases with THC content should be considered.

Maximisation of tax revenues must not be considered a goal in itself. Tax revenues must ultimately be considered an additional benefit that makes a positive contribution to investment in public health.

[1]Kugener, T., Berndt, N. & Seixas, R. (manuscript in preparation). Enquête Européen sur les Drogues au G.D. de Luxembourg 2021. Luxembourg National Focal Point of the EMCDDA, Department of Epidemiology and Statistics at the Directorate of Health: Luxembourg.

2.8.1 National control agency 

Under Articles 23 and 28 of the United Nations Single Convention on Narcotic Drugs of 1961, as amended by the 1972 Protocol, of which Luxembourg is a signatory, any party to the Convention that permits the cultivation of the cannabis plant for the production of cannabis or cannabis resin for industrial purposes (fibre and seed), is required to establish and maintain “one or more government agencies” to apply the system of controls as provided for in article 23 of the Convention in respect of control of the opium poppy.

Therefore, the establishment of a competent government agency is required under international law. It will be necessary to clearly define the ministry to which the national control agency reports, along with the agency’s make-up and duties, and to establish the legal basis required for its setting-up and operations.

2.8.2 Governance 

It will have to be decided which public bodies will be jointly performing the role of national control agency for the cannabis production and marketing chain. Additional resources will have to be allocated, if the various tasks involved in these control and regulatory duties are to be adequately performed. A monitoring committee should be established, in order to support and supervise development and to ensure that the goals being pursued, as described in chapter I.3, are achieved.

2.8.3 Distribution and duties 

The national control agency’s duties might be distributed between several public bodies, which will be determined gradually in due course.

It is proposed to develop a computing platform[2] that will enable the whole journey of a cannabis-derived product from producer to user, via the dispensary, to be monitored. By recording every stage in the journey and the product’s status, this system will make it possible to trace the origin of every cannabis product and the route it has taken, so that the closed cannabis production and marketing chain can be properly monitored. Products will be assigned a unique code, so that the batch can be identified. In Canada and several US states, the seed-to-sale system is already in use and has proved reliable.

2.9.1 At the production level 

• Producers must register their products once they have been packaged, so that their stock can be tracked.
• Products must be registered before transportation and during delivery to the dispensary, in order to guarantee that no products disappear in transit.

2.9.2 At the dispensary level 

The working group recommends that the architecture[1] of the tracking system and of the national database make it possible to trace the product at all times and to check whether the customer is entitled to enter the dispensary and buy the product.

Dispensaries will have the role of data processor and must therefore strictly adhere to the duties set out by the data controller, which will be the national control agency.

The identification of customers in dispensaries requires vendors to register customers in the system that has been put in place and is supervised by the national control agency.

The system must have a connection in the background to the National Register of Natural Persons (RNPP), so that it can be verified whether the customer is both a Luxembourg resident and the required age to enter a dispensary andbuy the product.

In addition, the must have a second connection to the central database, in order to enable it to check whether the customer has exceeded the permitted monthly quantity.

Vendors will not have direct access to the various database mentioned above; the system will only allow them to check whether the conditions precedent have been met or not. Vendors may only go ahead with selling the product if all three conditions have been met. Vendors must therefore scan each product (packaging) sold, in order for each sale to be recorded in the national database.

All personal data will be pseudonymised and held in the national database for a maximum of two years. The national control agency will not be able, at any time, to discover the customer’s identity.

A body with the role of trusted third party must be named and will be responsible for pseudonymising all data before it is sent to the competent authority.

The following personal data will be recorded, for a maximum of two years, in the national database:

For each product:

• product name
• product type
• producer name
• quantity in grams
• batch number with use-by/expiry date
• unique code and tracking history

For each sale:

• customer’s pseudonym
• customer’s age
• product’s unique code
• customer’s sex
• canton of residence
• dispensary’s location

In terms of data protection management, it is proposed that the process of selling cannabis for non-medical purposes follow these stages:

1. Potential buyer visits dispensary.
2. Buyer presents identity document to vendor in dispensary.
3. Vendor checks that the appearance of the potential buyer matches the person shown (in the photo) in the presented identity document.
4. Once the buyer’s identity has been checked, the vendor encodes the potential buyer’s full name and date of birth in the dispensary’s software.
5. The encoded details are sent to the trusted third party via the dispensary’s terminal.
6. The trusted third party checks the received data in the RNPP and collects the data necessary for checking the eligibility criteria (age and country of residence).
7. The trusted third party generates a pseudonym for the checked person.
8. The pseudonym and the data necessary for checking eligibility criteria are sent by the trusted third party to the data processor via the dispensary’s monitor.
9. The data processor checks the information received against the eligibility criteria and sends the approval or refusal of the sale to the pseudonym in question to the dispensary’s monitor.
10. The seller receives an approval or refusal message on the dispensary’s monitor.
11. In the case of approval, the vendor completes the sale and sends the related data to the data processor via the dispensary’s terminal for recording in the customer-monitoring database.

It is recommended that the pseudonymised data be retained for two years and then be anonymised. The data will be used to conduct statistical research. The pseudonymisation may only reversed by the trusted third party and doing so will require an injunction.

[1] See Annex 2.

[2] As part of the process of drawing up this draft concept note, the Directorate of Health conducted an assessment of the data-protection impact of the processing of personal data.

2.10.1 At the production stage 

The following steps should be taken in order to prevent any cannabis from, for instance, ending up in the hands of criminals:

• Secure production sites and facilities, with particular attention on storage
• Rigorously check the plants being grown (e.g. by counting and labelling the plants, by weighing products at several points, by sealing packaging, etc.)
• As far as possible, grow, dry and package cannabis in a single place, in order to minimise stops during transportation
• Ensure that the principles laid down in Chapter II.3 (“Production”) are respected

2.10.2 At the transportation stage 

In risk management terms, this is the most vulnerable stage, owing to the risk that the vehicle will be stolen or robbed The producer is responsible for distribution and must, in order for sufficient security criteria to guarantee a closed cannabis production and marketing chain to be integrated, establish the following:

• Secure, trackable transportation in an unmarked vehicle with notice given of the delivery
• Status, equipment and training of the driver’s assistant
• Conditions of loading and unloading

2.10.3 At the sale stage 

Dispensaries must ensure a secure working environment and secure storage. The following conditions must be met:

• Storage in a restricted-access strongroom
• Presence of a security guard

2.10.4 Production and sale staff

Those employed in production and sales must meet stringent reliability requirements: the operator, manager and staff must exhibit a high degree of integrity, which will be checked in cooperation with the competent authorities.

Provision will be made for administrative and criminal penalties.

The current legislation on drugs in Luxembourg is based on the Act of 19 February 1973 on the sale of medications and the combating of drug addiction, as amended. This piece of legislation regulates the production, use, possession, delivery, sale and trafficking of controlled drugs. The Act of 27 April 2001 materially changed the legal framework in Luxembourg, by introducing, for the first time, differentiation of penalties on the basis of the types of substance involved. As such, there is cannabis-specific legislation already in place and it is partially distinct from that relating to other illegal drugs. Since 2001, there has been no provision for custodial sentences for merely using cannabis or possessing it for personal use; only criminal fines may be imposed. However, the sale of cannabis, and its importation, exportation or use, when accompanied by aggravating circumstances, are subject to severe criminal penalties.

In the criminal policy followed since then, a pragmatic approach to this matter has been adopted, with a focus on treating users, rather than punishing them. In line with that policy, therefore, those who merely use cannabis already enjoy a more favourable legal regime.

As part of current youth protection policy, a range of psychosocial and therapeutic support offerings are now made available at the national level to young people, their families and the affected institutions in cases of the use of legal and illegal psychoactive substances by someone under the age of 21. Under the Act of 1973, as amended, the public prosecutor has the right to end any proceedings against addicts who agree to undergo a drug treatment programme. In 2001, a legal framework was also introduced for substitute drug treatments for addiction; such treatments had previously been tolerated but illegal. As part of the legislative work towards implementation of this concept note, the arrangements need to be further refined, in order to duly take into account the pilot project and the reform of the criminal law in respect of minors.

The effective operation of the system to be implemented in accordance with this concept note requires a coherent package of effective, adapted, proportionate and dissuasive penalties. To that end, use will be made of both administrative penalties – such as administrative fines or the revocation of concessions and permits on the order of the national control agency – and criminal penalties handed down by the competent criminal courts.

2.11.1 Administrative penalties 

The following is a non-exhaustive list of administrative penalties:

• Administrative fines in the event of failure by producers or dispensaries to meet their obligations, for instance by holding quantities in excess of the permitted maximum; these fines could be doubled in the event that such a failure is repeated
• Closure (temporary or permanent) of a dispensary or production premises
• Revocation by the national control agency of the permit of a dispensary or production premises
• Administrative fines in the event of a person of legal age possessing quantities of cannabis in excess of the permitted maximum of 5 grams or using cannabis in public
• a ban (temporary or permanent) on accessing points of sale

2.11.2 Criminal penalties 

Given that the pilot project of access to cannabis for non-medical purposes will risk inciting criminal elements to make up, one way another, their lost profits, it is essential not to relax enforcement of the law in respect of narcotics, in particular as regards the illegal production, growing and trafficking of cannabis and other illegal drugs.

Public health and safety must be protected by means of strengthening the legislation and the actions taken to punish and respond effectively to serious cannabis-related offences, in particular selling cannabis in a way not permitted in law.

Selling on non-medicinal cannabis to minors or non-residents and sharing it with such individuals must be prohibited and subject to deterrent criminal penalties, including custodial sentences.

In the context of the bill implementing this draft concept note, all current criminal penalties will undergo a critical assessment, in particular those for breaching the prohibitions against the illegal sale, production and trafficking of cannabis (whether from the legal cannabis production and marketing chain or from elsewhere), with a view to the establishment of a coherent and appropriate set of related criminal penalties.

The government, municipalities, law enforcement agencies and competent authorities are responsible for monitoring and overseeing compliance with the rules in place and the legislation in force.

In general terms, the Act must include at least the following provisions:

• Permission for the possession, in private and public, of quantities of cannabis of up to 30 grams, exclusively in the sealed packaging of an authorised dispensary
• Permission for the possession, in private and public, of quantities of cannabis (or the equivalent) of up to 5 grams, sealed or unsealed
• Provision for the prohibition against possession of cannabis by people under the age of 18, even when it is available on the legal market; depending on the individual’s age and the seriousness of the offence, young people breaching this prohibition will be subject either to the provisions of the Youth Protection Act or to the Act establishing a criminal law regime in respect of minors
• Provision for wide-ranging inspection and seizure powers, including the right to access any premises in respect of which there are reasonable grounds to believe that an activity that could be governed by the Act is taking place, and the power seize and retain cannabis or any other item in respect of which there are reasonable grounds to consider related to breaches of the Act
• Provision for the prohibition against the use of cannabis, whether flowering tops or resin, in premises open to and/or serving the public; cannabis use will also be banned in premises where the smoking ban (tobacco or e-cigarettes) applies

For dispensaries, the intention is to impose the following obligations, failure to observe which is to be combined with appropriate administrative or criminal penalties:

• Prohibition against selling to any individual under 18 years of age
• Prohibition against selling to non-residents
• Prohibition against selling to legal entities
• Prohibition against selling amounts in excess of what is provided for in law
• Prohibition against selling illegal cannabis that is not produced domestically
• Prohibition against selling cannabis not contained in its sealed original packaging
• Prohibition against producers and authorised dispensaries from selling cannabis online

Mitigating circumstances should be considered in cases where the dispensary has taken reasonable measures to check a person’s age or place of residence, for instance, but that person presents fake or stolen documents, acts that are already criminal offences.

For users, the future legislation must prohibit commission of or intent to commit the following acts:

• Sale or giving free of charge to a non-resident by a person of legal age
• Sale or giving free of charge to a minor by a person of legal age
• Any form of inducement, by a person not permitted to buy cannabis on their own behalf, of another person to buy cannabis for them
• Sale or giving free of charge of cannabis to another person, even if that person is entitled to legally buy cannabis at an approved dispensary
• Use of cannabis in any non-private setting
• Possession in public by a person of legal age of a quantity of cannabis in excess of 5 grams that is not contained in its sealed permitted original packaging
• Crossing of the land, air or river borders of Luxembourg by a person of legal age with any quantity of cannabis

This list is not exhaustive from a legal perspective. Note that some acts are already subject to criminal penalties, such as using a fake identity document to impersonate another person.

Any person committing one of the above-mentioned acts in relation to or with a quantity of cannabis that clearly goes beyond private personal use should be considered a drug trafficker and will be subject to the applicable severe criminal penalties.

The working group considers it essential that the pilot project of legal access to cannabis for non-medical purposes go hand in hand with the development of existing measures relating to preventing the use of cannabis for non-medical purposes and reducing its potential health risks and harmful effects. The pilot project actually offers new possibilities and opportunities for developing prevention work, by making it easier to access cannabis users and facilitating the work of using prevention messages to inform them and raise their awareness.

In order to do everything possible not to make cannabis more attractive and thereby, potentially, increase smoking levels, complementary preventive measures will also have to be taken to counter the trivialisation and normalisation of cannabis and tobacco use, in particular among young people, in order to prevent undesirable effects on individual and public health.

Information and universal, selective and indicated prevention measures must start during primary education; reach children in their home and school settings and in their recreational activities; be routine and diverse; target both occasional use and the detection of high-risk use; make use of all the available tools and networks; and be specific to different age groups and other target groups.

Prevention strategy must be based on a holistic concept that goes beyond preventing and reducing risks related to the use and misuse of cannabis: it must promote general well-being and the development of skills in relation to cannabis use and of skills linked to managing the related risks.

It is essential to include young people; their parents; teachers, education staff and school management; their general practitioner; the representative of their local education authority; their tutors; and groups of their peers in prevention strategies, and to make use of all digital and other tools and media available for prevention and for offering those involved information and training.

In this regard, a crucial role is played by the National Addiction Prevention Centre (CNAPA), whose articles of association provide for, among other things, the drawing-up of a national concept note for systematic and structured prevention work and for implanting that concept note jointly with existing national and international organisations and institutions.

2.12.1 Communication and awareness-raising strategy 

The pilot project of access to cannabis for non-medical purposes might bring about changes as regards the perception of risks and hazards linked to its use.

The working group therefore recommends developing, in close consultation with the public authorities relevantfor the target groups (e.g. the Ministry of Education, Children and Youth or the Ministry of Higher Education and Research), external experts and partners on the ground active in combating addictive behaviours, a complete and well thought-through communication strategy to provide information about the pilot project before its implementation. This will contribute to adequately informing target groups and other stakeholders about the rules and legal framework in place in respect of legal access and about the ability of each individual to make an enlightened and responsible choice. This communication will mainly take the form of public campaigns using the communication channels best suited to the target groups.

The strategy must address the properties of cannabis, its potential risks for users and those around them, and the characteristics of its various types, qualities and methods of use. The messages must be balanced, respectful and convincing for the main target groups.

The communication must also address adults in direct contact with young people, in particular vulnerable young people more at risk of high-risk forms of using cannabis (parents, teachers, employees of youth justice institutions, people working in the field of care for young people with mental disabilities). People working in the system – employers, teachers, law enforcement officers, healthcare professionals, etc. – will need information adapted to their specific roles.

A multi-year communication plan must be drawn up for each of the various target groups and must state which communication tools will be appropriate. This communication plan must include an action plan, coordinated with the various partners on the ground. A multiannual budget must be established, with a view to ensuring consistent communication.

The communication strategy must also cover the labels to affix to packaging for cannabis and products containing cannabis include health warnings based on scientific evidence, contra-indications, risk-reduction messages and information on accessing support services.

2.12.3 Prevention and education strategies 

Messages for the attention of people choosing to use cannabis must be systematically disseminated, with the aim of reducing risk and potential damage.

Both before and after the pilot project of access to cannabis for non-medical purposes comes into force, it is essential to develop, in close consultation with external experts and services specialising in the field of addiction, even more prevention programmes based on and guided by scientific evidence.

The main challenge will consist of adapting these different strategies to target groups and contexts and of ensuring that they have solid foundations and sufficient coverage at the national level. Too few programmes of this sort are currently available to address these new challenges.

Several types of prevention strategy need to be considered, such as those targeting society as a whole (environmental prevention) or interventions targeting at-risk people (indicated prevention):

• Environmental prevention strategies to change the cultural, social, physical and economic environments in which people choose to use cannabis
• Universal prevention strategies targeting whole schools and communities, with a view to giving young people the social skills necessary to avoid or delay starting to use cannabis
• Selective prevention strategies targeting specific groups, families or communities that are at greater risk of becoming addicted to cannabis
• Indicated prevention strategies targeting individuals identified as presenting increased risk factors in respect of addictive behaviours
• Early intervention strategies intended to delay or prevent the use of psychoactive substances

Young people should be the priority targets for these measures.

Prevention programmes should be based in the best scientific evidence available and include multidisciplinary interventions in schools, focused on social skills and refusal skills, on informed decision-making and handling certain situations and on correction of certain widely held but incorrect beliefs about drug use.

In addition, interventions at the family level and structured health interventions should take place, along with counselling sessions and motivational interviewing. Prevention programmes in several settings, involving various specialisms and combining a number of approaches seem most effective. In this context, it is recommended to put in place guidelines in schools for setting up information and prevention sessions, not just about the potential risks and harm from cannabis use, but also about addiction in general. Likewise, guidelines should be put in place on how to respond to signs of abuse and addiction.

In addition, it would be desirable for schools to be able to call on a team of specialists to take preventive and prohibitive action on addictive behaviours in the broader sense (substances, screens, gaming, new media, etc.). For the purposes of national coverage, this team should be structured in such a way that each specialist covers several schools.

It is also important to target other vulnerable groups, such as pregnant and breastfeeding women, people with a personal or family history of mental health or people with a history of problems resulting from substance abuse.

In order to ensure the implementation of prevention strategies, training should be provided for the major players at the various levels of addiction prevention, in particular cannabis-addiction prevention. This training should be offered to stakeholders working with adolescents and other vulnerable groups (e.g. specialists involved in youth clubs, schoolteachers’ representatives, municipal administrators, etc.). This training should include subjects such as protection of minors, communication about cannabis use, addiction prevention, early detection of cannabis addiction, treatment options, etc.

Strategies intended to increase resilience, responsible and well thought-through risk management, (pycho)social skills and decision-making skills and other personal resources have proved to have beneficial effects.^{[1],[2],[3],[4]}Supplementary studies examining the relevance and relative effectiveness of interventions intended to prevent and reduce cannabis use. Prevention interventions should be adapted to the stage of development of adolescents or of the target group and should involve the parents/family and peer groups, but also social networks.

2.12.4 Sales practices 

It is important to incorporate preventing cannabis use, in particular among young people of legal age, into the stage when cannabis is being sold in dispensaries. Appropriately trained staff should be responsible for discharging this duty.

This training should be carried out by the national control agency or by its appointees. It must be conducted regularly, at least every two years, in order to keep staff’s skills up to date.

• Dispensaries’ staff must receive tailored training to enable them to advise and inform customers appropriately about how to use cannabis in the most responsible way that best minimises risk and harm.
• Dispensaries’ staff must have advanced knowledge of the health effects and risks of cannabis and must adequately inform customers about those effects and risks.
• Staff must be able to recognise the signs of abuse and addiction.
• Where a customer shows signs of high-risk usage, staff must be able to refer to appropriate information or services, such as an online platform where it is possible to interact in real time with addiction-care professionals.
• Dispensaries’ staff should be required to recommend or propose that users initially buy cannabis products with lower THC content and with a balanced THC/CBD content ratio, which has yet to be determined.
• Staff must be able to propose and explain the information materials that are available and clearly displayed in dispensaries.
• Staff must be able to suggest to customers they conduct tests on themselves, with a view to assessing their own usage level and its associated risks.

2.12.5 Customer information 

It is important that all the information labels affixed to packaging for cannabis and products containing cannabis include evidence-based health warnings, contra-indications, messages on reducing potential and risks and harms, and information on accessing prevention and treatment services.

Some key messages should be communicated to users in parallel with those included in the instructions (non-exhaustive list):

• Rather than smoking cannabis, vape it.
• When using cannabis, do not mix it with tobacco.
• Do not use cannabis if you have a family history of mental illness.
• Do not use cannabis products with high THC content and low CBD content, since the latter seems to be able to partially counteract the psychoactive effects primarily derived from the THC contained in cannabis products. Try to choose cannabis products with high CBD content and low THC content.
• Only use cannabis in your free time and when you are felling well.
• Limit the frequency of your cannabis use.
• Do not use cannabis while pregnant.
• Do not use cannabis at the same time as other psychoactive substances, such as alcohol.
• Do not drive while under the influence of cannabis.

2.12.6 Prohibition of promotion, advertising and marketing 

It is recommended to prohibit all activities promoting and advertising cannabis for non-medical purposes, including the sponsoring of events and participation in events, conventions, trade fairs, etc. relating to promoting cannabis and products derived from it. Any failure to respect this principle that there should be no promotion could lead to the immediate withdrawal of the permit and concession, and to claims for damages.

[1] European Monitoring Centre for Drugs and Drug Addiction (2019) Developments in the European cannabis market. EMCDDA Papers. Luxembourg: Publications Office of the European Union. Available at: http://www.emcdda.europa.eu/system/files/publications/11391/TDAU19001ENN.pdf

[2] Gates, P. J., Sabioni, P., Copeland, J., Le Foll, B., Gowing, L. (2016). Psychosocial interventions for cannabis use disorder. Cochrane Database of Systematic Reviews, 5 (CD005336). DOI: 10.1002/14651858.CD005336.pub4.

[3] Hoch, E., Preuss, U.W., Ferri, M., Simon, R. (2016). Digital Interventions for Problematic Cannabis Users in Non-Clinical Settings: Findings from a Systematic Review and Meta-Analysis. Eur. Addict. Res., 22:233-42.

[4] Tirado-Muñoz, J., Mestre-Pintó, J. I., Farré, M., Fonseca, F., Torrens, M. (2018) Comprehensive interventions for reducing cannabis use. Current Opinion in Psychiatry, 31(4):315–23. DOI: 10.1097/YCO.0000000000000430.

The existing monitoring and care system for potential problems linked to cannabis use should be expanded, with the following as its central elements:

• Monitoring of high-risk or potentially problematic use
• Evaluation of the form and intensity of use, accompanied by a diagnostic assessment
• Evaluation of the user’s needs, motivation and individual resources
• Proposal of tailored interventions and, where necessary, guidance towards specialist offerings
• Coordinated monitoring of patients following treatment
• Optimisation of access to consultation and help offerings, in particular by means of regionalising the extant offering

It seems essential to make customer-facing staff aware of the potential risks of cannabis use, of tools for monitoring and evaluating the form and severity of usage (e.g. approved questionnaires, such as the Cannabis Abuse Screening Test (CAST) and of existing care options. The involvement of general practitioners, emergency departments, schools and employers seems essential because they are often the first to encounter the various cognitive, mental or physical disorders, subsequently well documented, that could point to either use or misuse of cannabis.

In addition, particular attention should be paid to higher-risk groups (e.g. young people who are underperforming at school, facing troubled family situations or displaying signs of a mental disorder).

At the moment, no specific pharmacotherapies for cannabis-use disorders exist (Nielsen, 2019).^[1] In the medium term, a full range of care offerings will have to be adopted at the national level, including out- and inpatient care for younger and older people, with and without prescribed medications, adapted in line with developments in the field; solution-focused brief therapy interventions for individuals, families and groups (see the Impuls service offered by Solina); online consultations; where necessary, residential rehabilitation stays at specialist facilities in- and outside Luxembourg; and follow-up care after treatment.

In addition to longer-term consultation and treatment options, the range of care offerings should include solution-focused brief therapy interventions for families, interventions based on cognitive behavioural therapy and motivational interviewing.

Good use will also have to be made of online consultations and of care for young people and their families.^[2]

The above-mentioned interventions should be offered to beneficiaries according to their relevance, established on the basis of the individual monitoring and assessment stage. Lastly, patient follow-up should be ensured by means of sustained cooperation and coordination between the various specialists and non-specialists involved.

[1] Nielsen, S., Gowing, L., Sabioni, P., Le Foll, B. (2019) Pharmacotherapies for cannabis dependence. Cochrane Database of Systematic Reviews, 1 (CD008940). DOI: 10.1002/14651858.CD008940.pub3

Summary of the systematic literature review: The data are incomplete for all the pharmacotherapies examined and, on the basis of numerous evaluation criteria, the quality of the evidence was poor or very poor. The results show that SSRIs, SNRIs, bupropion, buspirone and atomoxetine are probably of little use for treating cannabis addiction. In view of the limited efficacy evidence, THC preparations must be considered to still be experimental, with some positive effects on withdrawal symptoms and syndrome. Little evidence is available on the anticonvulsant gabapentin, oxytocin and N-acetyl cysteine, but these medications merit further study.

[2] Examples: www.quit-the-shit.net, www.realize-it.org

The working group takes the view that some aspects of the pilot project of access to cannabis for non-medical purposes should be re-evaluated at regular intervals. This will make it possible either to address challenges with practical implementation of the pilot project and of its goals, as set out in chapter I.3, or to take account of new data resulting from scientific evaluations or developments at the international level.

In that regard, it will be necessary to ensure that legislation and regulations are up to date in response to black-market and technological developments, not least because new ranges of cannabis preparation could emerge and methods of cannabis use could change.

It will be possible to introduce any changes that might be required into the national pilot project. It is therefore recommended to draw up a specific schedule, assessment criteria and an assessment process incorporated into the legislation.

Cannabis for non-medical purposes / non-medicinal cannabis

“Cannabis” means plants from the Cannabaceae family. The cannabis plant contains hundreds of chemicals, including more than 100 cannabinoids, along with flavonoids and aromatic terpenes. The effects of cannabis result from its cannabinoids acting on biological “targets”, a system of particular molecules and receptors found throughout the human body that, taken together, are called the endocannabinoid system. To date, two cannabinoids have been the subject of most of the scientific interest in the subject. Delta-9-tetrahydrocannabinol (THC) is the main psychoactive ingredient. When THC enters the bloodstream, it acts on the endocannabinoid receptors in the brain. THC acts in a dose-response relationship; high levels entering the bloodstream are more closely associated with negative health impacts. Cannabidiol (CBD) is the second cannabinoid that has been the subject of research. In Luxembourg, the cannabis available on the black market takes two main forms:

• flowering tops (dried)
• “hashish”, which is produced from cannabis plant resin

Regulation

Regulation is intended to enable, by means of the most appropriate policy and legal measures, individuals and society to limit the harm related to substance use; while there is no attempt to eradicate those substances, very restrictive measures are not ruled out, where applicable. It is, therefore, an approach intended to make a pragmatic contribution to controlling the relationship between people and drugs (or other types of product), with no argument being made for either the “war on drugs” or a putative future liberalisation.

Pilot project

A pilot project is a series of elements contributing to the achievement of a goal. It is scientific, temporary and limited in scope. A pilot project is intended to contribute to establishing evidence-based scientific foundations for decisions on potential later changes or future courses of action. The evidence obtained from a scientific assessment (see II.3) must be methodologically robust and lead to scientifically valid knowledge.

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