The Globe and Mail: What Canada’s doctors are concerned about with marijuana legalization

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 HEALTH REPORTER

As Justin Trudeau’s Liberal government tables its long-awaited marijuana legislation, Canada’s doctors have a message about pot: Just because it will eventually be legal, doesn’t mean it’s safe.

The Canadian Medical Association, the Canadian Psychiatric Association, the Canadian Paediatric Society and other organizations representing front-line health-care providers have been busy broadcasting their concerns about the ill effects of cannabis, especially for chronic smokers under the age of 25.

“We’re saying, ‘please keep the public-health focus front of mind as this legislation is unrolled,’ ” said Gail Beck, the clinical director of youth psychiatry at The Royal, a psychiatric hospital in Ottawa. “Lots of people think this is harmless.”

 

Explainer: Legal marijuana is coming but what does it mean for you?

The medical profession in this country has long had misgivings about medicinal marijuana – namely, that there is not enough solid evidence of pot’s efficacy in treating chronic pain and other ailments to warrant a doctor’s endorsement. But with the advent of legal recreational marijuana, doctors have a different set of worries.

 

Addiction

One top-of-mind concern: The potential for addiction to marijuana, especially among teens and young adults. “We know that 1 in 7 teenagers who start using cannabis will develop cannabis-use disorder, which is significant,” said Christina Grant, a professor of pediatrics at McMaster University in Hamilton.

Cannabis use crosses over into disorder territory when it begins to cause dysfunction in users’ day-to-day lives, derailing their commitment to school or work and sowing conflict in their families, said Dr. Grant, the lead author of the Canadian Paediatric Society’s position statement on marijuana, released last fall.

Mental illness

Cannabis has also been linked to certain mental illnesses. The drug’s relationship to depression and anxiety is still up in the air; the science has not established a causal relationship between the two. In other words, it’s not clear if people smoke pot because they are depressed and anxious or are depressed and anxious because they smoke pot.

There is stronger evidence that heavy use of cannabis can lead to psychosis, especially among people who have a family history of mental illness, Dr. Beck said. However, the vast majority of the research involved people who use cannabis daily. The scientific literature is virtually silent on the mental-health effects of smoking pot now and then.

“We don’t know the lower limit that’s safe,” Dr. Grant cautioned. “There’s no evidence to say, yeah, use it once, use it twice and nothing will happen.”

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