Wherever you fall on the cannabis-use continuum, unless you're living under a rock, you know that since Oct. 17, cannabis has been as legal and accessible in Canada as alcohol and cigarettes.
Maybe you used marijuana in university, or had friends who did. Of course, back then it was illegal. Not for today's U of A students. Noting that permission and promotion are two different things, the university has become one of few in Canada to allow cannabis consumption on campus grounds (see Cannabis Policy on Campuses sidebar).
It's up to each person to weigh the pros and cons of using marijuana or not, says Charl Els, a U of A psychiatry clinical professor and addictions expert. That could include talking to a doctor or other health professional beforehand. Much remains unknown, he adds. In the end, "the decision about whether to use a legal compound should be made by the adult individual, and no one else. It should be an informed decision."
We've called on Els and other U of A experts to answer some common questions.
Can I toke and drive?
No. It's a dangerous myth to suggest that it's safe to use marijuana and drive. Drivers who use cannabis are twice as likely to be involved in a fatal collision, yet 39 per cent of users admit to operating a vehicle within two hours of use, Els says.
Els and 13 other physicians in Alberta and British Columbia - members of the Occupational and Environmental Medical Association of Canada (OEMAC) - have released a position paper advising cannabis users to wait at least 24 hours before driving. OEMAC advises people in "safety-sensitive jobs" to follow the same 24-hour rule before work. (Some employers have released stricter guidelines.) The paper was cited in Alberta Health Services' recently released position statement on cannabis in the workplace.
"In the interest of safety, we're taking a conservative approach to this," Els says. "We're not telling people what to do, but we are suggesting there are risks associated with using cannabis when working in these settings."
Can I get addicted to marijuana?
Yes. "We know that cannabis is an addictive compound," says Els. The Diagnostic and Statistical Manual of Mental Disorders - or DSM-5, used by mental health professionals - draws from the best available science and lists it as such.
The chemical properties of cannabis make it less addictive than some other recreational drugs, such as opioids or crystal meth, says Els. A user's predisposition to addiction is also a factor. "Some people may try a certain drug and never become addicted; others may use a much lower-addictive drug, e.g. cannabis, and then become addicted."
The U of A is one of few universities in Canada to allow cannabis consumption on campus. Four locations on North Campus have been designated for smoking or vaping - three near student residences and one at the Students' Union Building - and evaluations are underway for additional sites at Campus Saint-Jean and Augustana.
Since it's private property, the university can be more restrictive than Edmonton bylaws, says Andrew Leitch, '86 BA, co-chair of the campus cannabis working group. The group wanted both to accommodate students living on campus and respect the wishes of those who don't want to be around weed.
Keeping it in the open also allows discussions about health and safety.
"People should be aware of the risks and able to make their own decisions," Leitch told the Edmonton Journal. "Ultimately though, this is about permitting. We're not here to promote cannabis."
I'm curious about marijuana - how does it work?
The marijuana plant contains tetrahydrocannabinolic acid (THC acid) and cannabidiolic acid (CBD acid), says pharmacy professor Raimar Löbenberg, director of the university's Drug Development and Innovation Centre. Of the two compounds, only the THC acid is psychoactive, and only when it is heated. Heat causes a reaction called decarboxylation: a C02 molecule is removed, leaving THC and CBD.
When THC and CBD molecules enter the bloodstream, they connect with receptors found on cell surfaces all over the body. The receptors, which make up the endocannabinoid system, are like locks, and cannabis molecules are like keys that slide in. The endocannabinoid system helps control pain, memory and appetite, all of which can be affected when a new "key" is introduced.
THC produces a feeling of intoxication, the high that is what most recreational users are seeking.
Löbenberg's research focuses on CBD, which acts as an anti-inflammatory and could, he believes, have great medical potential. "People who have pain get good relief from the CBD," he says. He hopes that, with more research, CBD painkillers can become a safer and more effective alternative to opioids.
How do I know how much to use?
For medical use, physicians recommend patients use just enough cannabis to get pain relief without feeling high, says Martin Davies, a pharmacology professor. He points to an article published in Canadian Family Physician journal, which suggests treating pain with one inhalation per day of cannabis cigarettes with nine per cent THC, up to a suggested maximum of four inhalations per day.
Recreational users will have to experiment and find what feels comfortable for them. "Novices and experienced smokers will experience the effects of THC differently, and some people are more sensitive to the effects," says Davies. "There are no hard and fast rules for dosing when it comes to recreational use."
What are the dangers?
Dying from an overdose is highly unlikely, says Els, though intoxication can contribute to injury or death through an accident. Marijuana can also have uncomfortable and even dangerous side effects. Red eyes and a faster heartbeat are common, as are anxiety and paranoia. It can cause hallucinations and even psychosis - the latter means the user has trouble telling the difference between what is real and what is imagined.
"We view acute psychosis as a medical emergency that requires immediate medical attention," Els says. Symptoms of psychosis can also mimic other life-threatening conditions, such as a state of confusion (delirium), severe head injury or a diabetic emergency. That's why he says it's important to get a medical professional involved.
Who shouldn't use marijuana?
"In young people, chronic heavy use can interfere with brain development," says Els. Studies of marijuana users in their teens and early 20s show poorer education outcomes compared to non-users. Some studies show that some impairment in cannabis users persists, even after several weeks without using.
Cannabis use among people with schizophrenia and other psychotic disorders has been noted. There isn't conclusive evidence that cannabis causes schizophrenia if there are no other risk factors present, but studies have shown there is an overrepresentation of heavy cannabis users among new cases of persons with schizophrenia. It's possible that teens suffering social isolation related to symptoms of schizophrenia self-medicate with cannabis. But Els says people with a history of this or other mental illness may want to take extra precautions. "I would be exceedingly careful and suggest abstinence," he says, "as well as having a discussion with a health professional about the risks of using."
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