New marijuana guidelines stress abstinence

CTV National News: Expert advice on smoking up Medical researchers say marijuana users should stay away from combustibles and avoid pot until after age 25. Glen Macgregor reports.

As Canada prepares to legalize marijuana next July, a panel of medical and mental health experts has released a set of guidelines to offer guidance to Canadians on how to use the drug safely.

Several health groups, including the Canadian Medical Association, Canadian Public Health Association, and the Centre for Addiction and Mental Health (CAMH), unveiled Canada’s Lower-Risk Cannabis Use Guidelines Friday, saying the recommendations represent “science-based” ways to reduce the health risks of the drug.

Among the recommendations:

ABSTINENCE

First among the guidelines is to not use cannabis at all.

“The most effective way to avoid any risks of cannabis use is to abstain from use,” the guidelines state.

AVOID IN TEEN YEARS

For those who do choose to use the drug, the guidelines advise they wait until they are older, since use of the drug before age 16 increases the risks for mental health, education or other related substance use problems.

MINIMIZE THE SMOKE

The recommendations also advise avoiding smoking the drug. Edible cannabis products eliminate lung problems, they note, but because the psychoactive effect can take longer to kick in, edibles may result in larger-than-intended doses.

For those who do smoke the drug, they are advised to avoid deep inhalation of the smoke, or breath-holding. Finally, the guidelines recommend avoiding synthetic cannabinoids, such as K2 and Spice.

AVOIDING DAILY OR FREQUENT USE

Frequent or intensive use increase the likelihood of several health problems, including brain development or functioning changes; mental health problems; and dependence, the guidelines state.

Dr. Gail Beck, clinical director of psychiatry at the Royal Ottawa Mental Health Centre, told CTV News that people who use cannabis regularly can see impairments in cognitive function as well as working memory.

“In an adult, someone who’s brain is fully developed, those symptoms reverse after a few weeks of not using. This has not shown to be true in young people. The research is very conclusive,” she said.

AVOIDING IMPAIRED DRIVING

“Cannabis impairs cognition, attention, reaction and psychomotor control — all of which are critical skills for driving,” the guidelines note, adding that the effects can persist for up to six hours.

SPECIAL RISKS

The guidelines recommend avoiding the drug during pregnancy or if there is a family history of psychosis or substance abuse.

Beck said that research shows in cases where there is a family history of mental health issues – specifically anxiety disorders, mood disorders and schizophrenia – cannabis use can make those issues emerge earlier.

“In addition to this, we know that when a person is intoxicated with marijuana it’s not unusual to see symptoms of anxiety, depression and more rarely acute psychotic episodes,” she said.

The rate of cannabis use in Canada is among the highest in the world. More than 10 per cent of adults and 25 per cent of adolescents report having used marijuana over the past year. The paper also notes that approximately one-in-five people seeking substance use treatment have cannabis-related problems.

Dr. Benedikt Fischer, a senior scientist at the Centre for Addiction and Mental Health and one of the authors of the recommendations, said it’s imperative to apply science to improve public health to prepare for the legalization of marijuana.

“It will not make cannabis use safe… but actually safer. And that’s a small but important distinction,” he told CTV News Channel Friday.

The recommendations focus on what is within the realm of choice and control of the user to make so that they are less likely to risk their own health or the public’s, said Fischer. He hopes governments, health and addictions organizations take the recommendations and promote them to the public, especially key and vulnerable groups such as young people.

Dr. Laurent Marcoux, President-Elect of the Canadian Medical Association, says because marijuana use carries “real health risks,” and mitigating those risks – particularly among young Canadians – must be a priority.

“The CMA continues to recommend a broad public health policy approach focused on preventing problematic drug use; ensuring the availability of assessment and treatment services for those who wish to stop using; and harm reduction to increase the safety for those who are using.”

Cannabis activist and co-owner of Cannabis Culture, Jodie Emery, told CTV Power Play that it’s great that the new guidelines promote sensible, safe and smart use of the marijuana. But she thinks the new recommendations give the wrong message that cannabis is “inherently harmful”.

“Cannabis is far safer than alcohol, tobacco, sugar and especially opioid pills,” she said.

In a time of a Canada wide opioid crisis, Emery believes the messaging should be “promoting cannabis as a safer choice […] for pain relief for the many people who are addicted to opioids and other pills.” She also cited U.S. research that suggests better access to marijuana is linked to fewer opioid deaths.

The full recommendations are published in the American Journal of Public Health.