White Coat Black Art26:30The toll of cannabis-induced psychosis
When Kalpit Sharma started smoking cannabis, he thought it was just part of “living his life” as a university student. After all, he had been told that the drug was relatively harmless.
That all changed in the summer of 2021, when he started hearing voices in his head.
“I would bike around, and the chain of the bike, it came off. And I thought that I could speak to birds, and birds were telling me how to put the chain back on,” said Sharma, who was studying at York University in Toronto at the time.
Those voices are known as auditory hallucinations — a hallmark of psychosis. When they became more frequent and insistent, he went to the Centre for Addiction and Mental Health for an assessment.
Sharma was shocked when he was told that he had been exhibiting signs of psychosis — and eventually he was diagnosed with schizophrenia.
“The ground slipped beneath my feet,” he told White Coat, Black Art host Dr. Brian Goldman. “I’m going to be looked at differently. I’m going to be separated from society. I’m not going to be my parents’ Kalpit ever again.”
Sharma, who is now 23, said that after consulting with physicians, he believes his heavy smoking of high-THC cannabis contributed to his psychosis and schizophrenia. Now he urges consumers to educate themselves as increasingly potent cannabis products become commercially available in Canada.
Researchers are also sounding the alarm that, while casual cannabis use isn’t harmful for most people, possible connections are being found between using cannabis products with high-potency THC (tetrahydrocannabinol, the main psychoactive ingredient in cannabis) and harmful health effects, particularly among young men.
“I think that people remain unaware of this connection between cannabis use and potential risk of chronic psychotic disorders,” said Dr. Daniel Myran, a researcher with the Ottawa Hospital Research Institute and a family physician.
Dr. Daniel Myran, a researcher with the Ottawa Hospital Research Institute and a family physician, has been involved in studies examining the connection between cannabis and psychosis. (Todd Langille)
According to Health Canada’s 2023 Cannabis Survey, 21 per cent of 16-to-19-year-olds who use cannabis use it daily or almost daily. In the 20-to-24-year-old group, that number goes up to 23 per cent.
In 2023, Myran co-authored two studies looking into the connection between cannabis and psychosis. They found a 220 per cent increase in emergency room visits in Ontario for cannabis-induced psychosis between 2014 and 2021 — with the number rising from about 400 people to about 1,400 over that seven-year period.
“For men aged 14 to 24, the risk of developing schizophrenia rises to over 40 per cent within three years” of showing up in an ER for cannabis-induced psychosis, he said.
Myran was also lead author of a separate study released in early February that found 27.5 per cent of people who visited an emergency room for cannabis use developed an anxiety disorder for the first time within three years.
Not your grandfather’s weed
Starting in 2020, Sharma’s cannabis consumption “skyrocketed” — when he and everyone else were inside because of pandemic lockdowns. But it was also shortly after more, and stronger, products became available in Ontario’s cannabis shops.
“I was doing, let’s say, half of a joint in 2018. That bumped up to, like, three or four joints in a day in 2020, 2021,” he said.
In 2018, the same year the sale of cannabis became legal in Canada, licensed cannabis stores in Ontario could sell only dried flower, cannabis seeds and some oils, Myran said. In 2020, the number of stores allowed to open expanded, and newer products like gummies — some with much higher THC content — hit store shelves.
According to Health Canada’s 2023 Cannabis Survey, 21 per cent of 16-to-19-year-olds who use cannabis use it daily or almost daily. In the 20-to-24-year-old group, that number goes up to 23 per cent. Five years earlier, the sale of cannabis became legal in Canada. (Joe Mahoney/The Canadian Press)
“The cannabis industry calls it cannabis 2.0. What these products are is just increasingly processed cannabis,” Myran said.
Even without getting into edibles, nearly all cannabis today is much stronger than it was even a decade ago.
“It’s been around for centuries. True enough. But the product that we’re using today that’s available to our youth and young adults into the population today is completely different than even what it was 10, 15 years ago,” said Dr. Philip Tibbo, a professor and director of research in the department of psychiatry at Dalhousie University in Halifax.
LISTEN | What do I need to know about high-potency cannabis?:
The Dose23:16What do I need to know about high-potency cannabis?
Naturally occurring cannabis plants contain one to two per cent THC; genetically modified plants are cultivated to boost the percentage. From the 1960s to the ’80s, you might encounter cannabis with anywhere from one to five per cent THC.
Today, the amount in plants is much higher, and commercially available processed products can contain 20 per cent THC or more.
Those higher-THC products enticed Sharma as he smoked more products to chase higher highs. He was also drawn to products with humorous names, like a strain called Black Widow, since it reminded him of the Marvel character.
After his diagnosis, Sharma initially tried cognitive behavioural therapy, but he declined an anti-psychotic medication, Abilify, recommended by doctors out of fear of the stigma.
Soon after he had his worst psychotic episode, at a family wedding in India.
“I didn’t follow through with it, but I was close to self-harm,” he said.
WATCH | Cannabis use, hospitalizations up 5 years after legalization, researchers say:
Cannabis use and hospitalizations up 5 years after legalization, researchers say
4 months ago
Duration 2:11
The number of Canadians using cannabis has increased by 25 per cent since it was legalized five years ago, a new commentary in the Canadian Medical Association Journal stated. But hospitalizations are also on the rise, prompting some doctors to say more information and better policies are needed to better mitigate negative outcomes.
When cannabis was first legalized, some labels on packages included warnings that regular use “can increase the risk of psychosis and schizophrenia.” They were phased out in April 2019.
Health Canada told CBC News that the labels were changed to “refresh messaging to make it more reflective of population-level guidance,” and included consultations with scientific experts and the public.
Ottawa researcher Myran said it was a mistake to do so and that those warnings should be put back. “I think Canadians have a right to know about this association, about this link,” he said.
What to know about high-THC cannabis
Today, Sharma is working on managing his psychosis with therapy, medication — and laughter, when he performs onstage as a standup comedian.
“I was confused what to do with my life. So people told me to listen to my inner voice. And now I have schizophrenia,” he begins his routine.
He’s also working as a strategic adviser for the Cannabis and Psychosis Project, an online resource created by the Schizophrenia Society of Canada.
Gummies and other edibles often have a much higher THC content than cannabis in plant form. Edibles take longer to kick in, so if people want an immediate high, they risk eating too many too fast and getting hit harder. (Travis Dolynny/CBC)
Sharma said he hopes his story can encourage people to take the time to research cannabis instead of lighting up and possibly putting themselves at risk — and to always start with something with a low amount of THC.
Like any other product, Dalhousie University’s Tibbo said, it’s always better to be an informed consumer.
He said it’s important to understand that today’s cannabis products are often stronger and act differently than a joint passed around in a basement in the ’70s.
Edibles take longer to kick in, for example. So if people want an immediate high, they risk eating too many too fast and getting hit harder.
If you’re the parent of a youth who’s thinking of trying cannabis for the first time, it’s also important to know how to broach the topic, Tibbo said.
“Although difficult for parents, sometimes, [you should] be able to know how to ask those questions in kind of a non-judgmental way that will allow you to have a conversation with your child — versus that child, you know, kind of putting up the wall and not having that conversation.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
