David Poon, BSc. Immunology and Infection, PharmD Student
Controversial Cannabis in Canada
Oh dear. What have I gotten myself into here. For those who don’t know, cannabis is now legal in Canada as of yesterday. This CBC article does a good job summarizing what you need to know now that cannabis is legal1. Whether you are pro cannabis or anti-cannabis, that is your rightful opinion. From a medical perspective I think the legalization of cannabis will open the new doors for the medical research field. On the other hand, the long term harms of cannabis remains unclear.
The Wonderful and Happy World of Cannabis
I think there are appropriate uses of cannabis to treat certain medical conditions. It may help with symptoms of multiple sclerosis, neuropathic pain and refractory seizure disorders in children2. For patients suffering from these debilitating conditions, the use of cannabis may be a blessing to them. Can cannabis treat other medical conditions? For sure! There have been small studies using cannabis in patients with chemotherapy induced nausea and vomiting and fibromyalgia for example. How effective cannabis is compared to traditional pharmaceutical options remain unknown.
By legalizing cannabis, it offers researchers the opportunity to clarify the muddy waters of the benefits and harms of cannabis use. I truly do hope that we can find more uses of cannabis because there are definitely people in the world that can benefit from it. Will I be recommending it to my patients to try cannabis over studied pharmaceutical drug options? Probably not. If someone came up to you and asked you what you recommend for insomnia. Would you recommend alcohol? Alcohol can be very sedating and it can knock you out. What I’m trying to get at is, don’t think of cannabis as a miracle drug just yet.
The Risk of Cannabis
I often hear from patients that natural health products are safer than pharmaceutical drugs. That’s not necessarily true. St. John’s Wort is a natural health product known to cause a plethora of drug interactions. On the flip side, some drugs are derived from nature. Take aspirin for example. Ancient Egyptians used willow bark to reduce pain and inflammation, but in large quantities it can cause nausea, vomiting and even comas3. What I’m saying is that nothing is safe, regardless if it is found naturally in nature (like cannabis). Immediate use of cannabis can cause euphoria, confusion, paranoia, increased heart rate, red eyes and yes, the munchies2. Similar to alcohol, there is a risk of tolerance and addiction. Before you all raise your arms and scream bloody murder, I’m not saying that cannabis is a gateway drug. Would you consider alcohol or cigarette smoking a gateway drug? Maybe, maybe not.
Now what about the long-term effects of cannabis use? I think the answer at this point is that it’s too early to tell because the studies just aren’t there. Smoking cannabis has the same risks as cigarette smoking. Yes seriously. You’re still burning the cannabis, turning it into various harmful molecules and inhaling that into your lungs. In terms of vaping it, I think the evidence is still unclear, but it may be a better option than smoking it directly. If you got to use cannabis, the College of Family Physicians of Canada recommends vaporizing or ingesting it. It’ll be interesting to see if the rates of lung cancer will increase because of more people smoking/vaping cannabis. Also, if the rates of neurological diseases will increase, such as dementia or Parkinson’s. Only time will tell.
The Bottom Line
Hate it or love it, cannabis is now legal and I don’t foresee that changing anytime soon. I think only future research will tell us if legalizing it was the best decision of the century or the mistake of a lifetime. From the medical professionals I’ve talked to so far, their opinion remains divided on cannabis. Depending on your healthcare professional, some may be more open minded than others. Regardless, I think it’s important to disclose all medications and natural health products used to your primary healthcare provider because it may affect your treatment. My recommendation for now? For those who partake, just enjoy it (in moderation of course), unless told otherwise by your healthcare professional.
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1. Butler, P. (2018, October 17). Legal pot is here: What you need to know | CBC News. Retrieved from https://www.cbc.ca/news/canada/marijuana-faq-legalization-need-to-know-1.4862207
2. Landau, E. (2010, December 22). From a tree, a ‘miracle’ called aspirin. Retrieved from http://www.cnn.com/2010/HEALTH/12/22/aspirin.history/index.html
3. Cannabis. (2018). RxTx.