Cannabis not benign: public health

Organization unveils plan to educate youth and other at-risk populations about potential issues

Youth will be the target of Hamilton Public Health’s first prevention campaign showcasing the risks of cannabis use as Canada’s legalization looms.

Frequent cannabis users, pregnant and breastfeeding women and people with mental health and substance issues are the other “at-risk” populations identified in Hamilton’s proposed public health strategy for nonmedical cannabis.

“Risk is a real thing when it comes to cannabis,” James MacKillop, director of the Michael G. DeGroote Centre for Medicinal Cannabis Research, told councillors at Monday’s board of health meeting.

“A lot of people are unfortunately believing legalization is essentially a recognition that it’s a relatively benign drug. That’s not necessarily the case.”

MacKillop, who emphasized he is not “pro” or “anti” cannabis but “pro” science, evidence and data, said there are acute risks, like impairment of motor coordination, and chronic risks, like “cannabis use disorder.”

“Cannabis addiction is ... a real thing,” said MacKillop, who is also director of the Peter Boris Centre for Addictions Research.

“Unfortunately a common myth out there is cannabis is not addictive, and it’s not physiologically addictive, but cannabis use disorder is a real issue, albeit in a small proportion of individuals.”

It is possible to overdose on cannabis, which can cause delirium or psychosis but will not result in a fatality, he said.

But the risks do not apply to everyone “uniformly,” he noted.

Youth are particularly at risk because their brains are still developing. Regular users have the highest risk of cannabis use disorder and bronchitis, he said.

Pregnant women are at risk because there is “too much misinformation online” about cannabis use to manage morning sickness. He added that cannabis can exacerbate symptoms for those with psychiatric disorders.

But the “prohibition” of cannabis has not succeeded in preventing use, including among youth, or deterring a contraband market, MacKillop said.

Legalization “may” be able to help limit youth access, deter crime and protect public health and safety by ensuring quality control, he added.

Dr. Elizabeth Richardson, Hamilton’s medical officer of health, said it’s not clear what will happen in terms of health impacts when cannabis becomes legal in Canada Oct. 17, but there will likely be changes when it comes to use.

According to Statistics Canada’s National Cannabis Survey, 24 per cent of current cannabis users said they planned to increase their consumption after legalization, while six per cent of Canadians who did not use cannabis in the past three months said they would likely try it.

“Hamilton tends to have higher rates of use and higher levels of harm, but we don’t know precisely what will happen here,” she said.

As legalization approaches, public health will monitor the situation to understand the health impacts and encourage a culture of safer use going forward, Richardson said.

The public health strategy proposes multiple education and awareness campaigns over the next two to three years.

The goals of the strategy include:

• To educate the public on safe, legal and responsible use of cannabis

• To prevent or delay the onset of cannabis use and to reduce the likelihood of harm from use, problematic use and/or overdose

• To promote a culture of safer use

• To increase knowledge of the impacts of consuming cannabis while parenting or pregnant

• To equip trusted adults with the knowledge and resources to “start the conversation” about cannabis use with youth