Health considerations of the legalization of cannabis edibles
Jasleen Grewal | Lawrence C. Loh
3M (United States) | University of Toronto | Regional Municipality of Ottawa
Amended regulations concerning edibles limit dosing, prohibit formulations with other psychoactive substances, and require safety measures with regard to packaging and production. Physicians should openly discuss patients’ use of cannabis, including edibles, to enable counselling on safe consumption and driving, and to discourage the consumption of illicit or homemade edibles. After legalization of cannabis edibles in Colorado, the state poison control centre saw a 70% increase in calls for accidental cannabis exposure in children from 2013 to 2017, and studies of health care usage reported more children than adults being treated for ingestion incidents.3 People aged 65 years and older report the lowest rate of cannabis use overall, but use in this group has reportedly increased after legalization in Canada, mirroring a trend in the United States in which older adults increasingly report cannabis use to manage symptoms of chronic conditions amid changing social norms.2,5 Among older adults, cannabis consumption — including use of edibles — has been linked to greater cognitive impairment and a heightened risk of hypotension-related falls, arrhythmia and drug interactions.6 Youth represent another population of concern, and a survey from the World Health Organization found that 15-year-old Canadians reported lifetime and past-month cannabis use at a higher rate than peers in other high-income countries.7 A recent Canadian report highlighted a pervasive belief among youth that consuming cannabis edibles has a positive effect on mood, anxiety and sleep.8 This perception is at odds with described harms related to cannabis use among youth, particularly impaired brain development and poor mental health associated with initiation in early adolescence.7 Finally, longer-term use of edibles has also been associated with increased risks of adverse effects, such as panic attacks, psychosis and hyperemesis syndrome.1 Using the 2016 recommendations of the Canadian Task Force on Cannabis Legalization and Regulation as a guide, the amended regulation that legalizes edibles aims to address potential health risks. Risks of such products include spread of foodborne illness, overdose owing to variable THC content of products, poisoning from pesticide residues, and potential for unexpected effects given that illicit products may be contaminated with other drugs, such as narcotics.10 Physicians, patients and communities must work together to keep health and safety considerations at the forefront of ongoing review and regulation of the production, sale and consumption of edible cannabis products in Canada. Continued advocacy for effective regulation of edibles will help to control the availability of both legal and illicit products and mitigate their effects on individual and community health.
https://www.ncbi.nlm.nih.gov/pmc/articles/6944297