As cannabis is legalized in Canada, we know you have questions—and we know there’s a lot of misinformation out there. We sat down with two doctors to chat about cannabis usage.
Since the 1960s and 1970s, cannabis has had a negative stigma attached to it—coinciding with North America’s “war on drugs.” But, a relatively new understanding on the benefits of the plant is making people curious about just how good (or bad) cannabis can be, especially now that it will be legalized in Canada this October. We sat down with Dr. Caroline MacCallum of the Vancouver General Hospital and the Greenleaf Medical Clinic and Dr. Biljana Kostovic, a pain specialist based in Toronto, to clear up some of the myths and misconceptions about the use and associated effects of cannabis.
CAN CANNABIS SMOKE BE WORSE THAN SMOKING TOBACCO?
We know that smoking cigarettes can cause lung cancer, but what about smoking cannabis? While THC (the euphoria-causing cannabinoid in the plant) is a relatively safe drug, smoking cannabis can be hazardous, as confirmed in a study by the British Lung Foundation. Dr. MacCallum believes that smoking anything can be harmful—thanks to the production of carbon monoxide. The best way for patients to protect their lungs while still consuming cannabis products is via a vaporizer, which heats cannabis at a lower temperature without smoke. Dr. MacCallum says that many studies have shown that there's little-to-no carbon monoxide produced when using a vaporizer.
WHY DO SOME PEOPLE GET ANXIOUS WHEN THEY CONSUME CANNABIS AND OTHERS ARE MORE RELAXED?
When people feel anxious it usually has to do with the particular strain they are consuming and the percentage of THC in that strain. “People want to go out and try cannabis, but they don't even know where to begin,” says Dr. Kostovic, which results in choosing or being diagnosed a strain that isn’t tailored to a person’s particular desires. She recommends having a conversation with your doctor, who can then recommend who you should speak to in a specialized clinic that deals specifically with cannabis. You can also educate yourself about the effects of THC and CBD (a more relaxing and pain-relief-specific cannabinoid in the plant) and decide which ratio of actives is right for you. One great resource is Lift & Co’s website which has a list of clinics and reviews. A good rule of thumb is that if you’re after more of a “high” or are treating appetite loss, cannabis strains with higher THC and lower CBD are where you want to start. Whereas if you’re managing pain, anxiety and want to relax, higher CBD strains are a better option.
CAN CANNABIS AFFECT YOUR BRAIN DEVELOPMENT?
A number of studies have been released that indicate that exposure to cannabis in still-developing brains could have an impact on development. The College of Family Physicians of Canada, have said that cannabis should not be used in those 25 years of age and under, though the studies are often conducted on recreational use instead of medical. Dr. MacCallum notes that usage tends to be higher in recreational users, and this could also contribute to the overall effects. “Brain development is particularly important because it's thought that it really goes on until the age of 25,” says Dr. MacCallum. “But there's no hard and fast rule that on a specific day your brain stops developing.” Bottom line? “These studies deal with large amounts of THC and with that, developmental and cognitive dysfunction can occur,” says Dr. MacCallum, “I can’t say it's all reversible or it's permanent, but I also believe there are a lot of variables, unfortunately.” At this time we just don’t have enough evidence to say anything one way or the other. Your best bet is always to speak with your own personal physician.
IS IT POSSIBLE TO OVERDOSE ON CANNABIS?
The short answer is no, you can’t overdose on cannabis. There have been a few calculations about how much cannabis you’d have to take to overdose or die, and the amount leans towards the absurd—especially when you consider how quickly you’d have to consume it. If you have felt weak, out of it, increasingly anxious or too high, there’s a good chance you have consumed too much—but the danger of overdosing is so slim so as to be almost impossible. These symptoms are often conversationally referred to by users as “greening out,” and the term describes a situation where a person feels sick after smoking or ingesting too much cannabis. Symptoms often include going pale or turning green, starting to sweat, feeling dizzy and nauseous. Dr. MacCallum reports that while there have been no reported deaths due to overdose or toxicity of cannabis, she admits that these issues and side effects are not always the wanted or desired effect, and may turn some people off.
CAN YOU BECOME ADDICTED TO CANNABIS?
Despite popular belief, yes, it is possible to become dependent on cannabis. Approximately 9 per cent of people who use marijuana will become dependent on it. Marijuana use disorders are often associated with increased dependence, which is often a proxy for addiction—though you can be dependent without being addicted, even though the terms are often used interchangeably. But if you feel withdrawal symptoms (irritability, physical discomfort, cravings) when not using marijuana, it’s possible you have a marijuana use disorder. Dr. MacCallum notes that for these patients, it’s important to talk to a physician and feel empowered when and if they are trying to limit their use or stop using cannabis completely.
August 17, 2018 as seen in Canadian Living.