With cannabis edibles, extracts and topicals legal as of last month, Sixth Estate’s Spotlight series joined the Canadian Centre on Substance Use and Addiction (CCSA) in hosting a panel of experts and stakeholders to discuss the new product classes, health risks, and lower-risk use of the products, as well as the importance of public education and best ways to reach out to youth.
Dr. Amy Porath, Director of Research with the CCSA, led the discussion. John Clare, acting director general of strategic policy with the controlled substances branch of Health Canada, said that there is strict regulation around the health claims associated with cannabis products in that nobody can make such a claim unless they have gone through drug approval process outlined in the Food & Drug Act.
“There are cannabis-based medicines that have gone through that process, but they are very few,” said Clare, who added that the access to cannabis for medical purpose system is a result of court decisions, which is an exception that falls outside of the therapeutic products process.
Clare said that Health Canada has launched a series of consultations on cannabis health products to find the evidentiary basis for products to enter the market and make health claims.
Clare also noted that sex and gender can be indicative of different patterns of use — in particular, that smoking and vaping is more prevalent among males, while ingesting edibles is more prevalent among females.
“Those [are] types of information that we can consider in crafting our public education to make sure that they’re more effective and that they’re targeted at particular behaviours in particular sub-populations,” said Clare.
David Hammond, professor in the School of Public Health and Health Systemsat the University of Waterloo, said that vaping is a phenomenon that isn’t going away, and that in the illicit market, users can select whatever THC content they want in their vaping oils, meaning that some can be as high as 70 percent, which can pose greater risks.
“How knowledgeable are we? The frightening thing is that as a field, we are somewhere between not at all knowledgeable and somewhat knowledgeable in terms of actual specific risks of these product categories,” said Hammond.
Hammond noted that the low-risk cannabis use guidelines offer suggestions like “don’t smoke,” or “don’t use high THC,” which is not what the market is offering. As well, the stories about vaping-related illnesses in the United States and Canada have created additional concerns, and researchers only have theories as to the cause being related to certain additives in illicit products.
“Can you produce THC vape oils that don’t have those? Absolutely,” said Hammond. “That’s why we need proper testing and reporting from Health Canada.”
Hammond noted that Quebec has said that for the time being, they won’t sell THC vape oils, because they can’t narrow down the specific additives on the illicit market that may have caused the illness.
“This is one of our fastest-growing categories and we don’t have our head around it, and the truth is, if I was a provincial regulator who was running the stores and selling the products, I would have some serious concerns about those,” said Hammond, adding that as a harm reduction measure, he would advocate that people not use THC vape oils until there is a better grasp on the illnesses.
Jacqueline Relihan, youth engagement facilitator with the Centre for Addiction and Mental Health, said that when it comes to youth engagement on substance use including cannabis, youth are more likely to trust a source that has been vetted by other youth using language that they understand and content that they can relate to.
“We need to think about how to do this work in a non-tokenizing and meaningful way,” said Relihan. “Some of the things to consider are having flexibility in your work, and if you’re doing engagement right, you’re going to need more time. Allow people with lived experience to have the space and to guide the conversations to the issues that are most important to them. This can bring up important ideas or concerns that you may not have thought about.”
Relihan noted that when it comes to talking to youth about substance use, it’s important for parents or authority figures to approach the conversation from a position of curiosity and interest rather than accusation and fear.
“Some experimentation is normal, but there are ways to support young people so that they feel informed in making these kinds of decisions for themselves,” said Relihan. “Ask them what their concerns about drugs and alcohol are, and let them know that they can be open and honest with you, and that you’re there to support them.”
Relihan suggested that parents try not to jump to conclusions about why youth are using substances, and to try to find an appropriate time to talk about it. “Show that you have confidence in their ability to make decisions for themselves,” said Relihan.
Relihan also said that there needs to be a focus on the intersection between mental health and substance use, as young people can start using because of other challenges affecting their mental health, and that they may use substances as a way to cope.