Public health proactive in cannabis education

By Sharon McLeay Times Contributor

Representatives from Alberta Health Services (AHS) are getting a jump on public health and addiction education about cannabis use, prior to the legalized sale of cannabis expected later this summer.
Jason Cabaj, AHS medical officer of health for the Calgary zone, addressed Wheatland County council on May 1, with interesting health facts about the use of cannabis.
“It is a very complex process for this legalization, as you probably know, and there are lots of issues for each level of jurisdiction to be thinking about,” said Cabaj
Legalization will cover leaves, flowers and oils, and selling these in edible products that will fall under a separate phase of legalization. The purpose of legalizing cannabis is intended to reduce youth access, deter young people from usage, curtail criminal activity, regulate the products, protect and enhance public health, and provide education.
“We have a system right now that is failing,” said Prime Minister Justin Trudeau in a CBC news video on Feb 1. “The current system has the highest rate of underage use of marijuana in the world … here in Canada. So we are failing our kids now, today, with a policy that is not working to protect our kids and we are delivering over $6 billion a year into the pockets of organized crime.”
Cabaj said about 50 per cent of adults in Alberta have already used cannabis some time in their lives; of that percentage there is significant use by 10 to 24-year-olds.
“Cannabis is one of the most commonly used illicit drugs in Canada,” said Cabaj. “There is a particular focus on youth and their current rates of use with it being illegal.”
He added it remains unknown how much consumption will increase with legalization, and that recent substance use by Alberta youth in Grades 7 to 12 has actually decreased in the last few years. He said health norms and public education have helped decrease current substance abuse.
Legislation in Alberta has set minimum age for cannabis use at 18. Sales will be administered under the Alberta Gaming and Liquor Control board and retailers will be required to check ID.
It is expected ticketing and confiscation will occur if a person under 18 is found with cannabis in their possession.
AHS recognizes cannabis is different from tobacco and alcohol and that legislation doesn’t eliminate all social harm, but through restrictions and public education the health impact will be minimized.
Studies have not conclusively determined what health impacts cannabis has, as the parameters of current studies vary and methodology is more observational, without scientific trials.
A gathering of information over the long term will lead to better conclusions. Cabaj said new types of cannabis and the more potent varieties developed in the last few years indicate additional studies will be required to get a full picture of health risks.
AHS has used reviews from the University of Calgary health and technology department and the National Academy of Science and Medicine that ranked 10,000 studies on a scale to determine what may currently be substantial risks.
While it was acknowledged that cannabis use can have positive effects for some users, overall they considered some of the substantive risks with long-term use. They included some mental health changes, particularly in those persons with genetic/biological precursors for schizophrenia and psychosis, increased motor vehicle accidents under the influence, low birth rates with use by pregnant women, dependency and respiratory problems. There was some evidence around brain changes and neuro-cognitive changes especially in use under the age of 25, effects on vision, increased testicular cancer risks and problems with drug interactions.
Second-hand cannabis smoke is more toxic than tobacco, and impairment was evident for anyone exposed for 15 minutes in an unventilated space.
AHS is recommending the best way to avoid risks is not to use cannabis, but if used, some precautions to consider would be to delay use until older, find safer ways of using cannabis (vape, edibles), investigate the product in use, avoid synthetic or burnt cannabis, limit the amount and duration of use, avoid using while driving or operating machinery, and intake moderate inhalation of the product.
“Surveys have shown people do underestimate the effects of cannabis from a health perspective,” said Cabaj. “If we certainly think about cannabis impacts in relation to public health perspectives on all substance use, we have the unique opportunity with cannabis use in regards to legislation to get some things right that we didn’t with alcohol and tobacco.”