VANCOUVER — People who have never smoked marijuana could be most at risk of overdosing on cannabis-infused edibles that will soon be on store shelves across the country, warns a public health physician who says first-time users may keep noshing away while expecting a high, only to experience a racing heart, anxiety and panic attacks.
Dr. Lawrence Loh, adjunct professor at the Dalla Lana School of Public Health at the University of Toronto, said overdose from overconsumption often means a trip to the emergency room for those who are unaware that feeling the mellow effects of pot from edibles can take several hours because of the time needed to digest and absorb food into the small intestine versus quickly inhaling the drug through the lungs.
Seniors are especially at risk because of a slower metabolism, Loh said of non-lethal overdose from edibles, which federal regulations limit to an individual serving size of a 10-milligram dose of THC, the psychoactive ingredient in marijuana.
However, someone who eats an entire package of cannabis-infused product could be taking in a whopping 100 milligrams of THC and putting themselves at risk, even though regulations require products to be individually wrapped in 10-milligram serving sizes.
“I think the big thing for anyone in the public, especially cannabis-naive individuals or people who have edibles around with children at home, is to first and foremost avoid overdosing,” Loh said.
“There’s psychotic reactions so people may lose touch with reality, sometimes in the form of hallucinations or delusions and also anxiety or panic attacks along with decreased judgment.”
Loh is co-author of a commentary published Monday in the Canadian Medical Association Journal on the health risks of cannabis edibles.
Short-term effects of edibles are not the only issue of concern, he said.
“There are still those longer term, chronic risks around edibles, particularly around addiction and also the risk of exacerbation of existing mental-health issues that we might be worried about in the longer run with cannabis edibles as well as any form of cannabis,” he said.
Regulations governing edibles, beverages, vapes and topical forms of cannabis came into effect last October, a year after Canada legalized fresh or dried bud, oil, plants and seeds.
Cannabis edibles such as cookies, chocolate and gummies were available for sale starting in December in all provinces except Ontario, Quebec and Alberta, where consumers can access them in mid-January.
In Ontario, for example, edibles will be available as of this week in stores, and then online in mid-January through the provincial distributor as a part of a slow rollout over the next few months.
A University of Colorado School of Medicine study published last March in the Annals of Internal Medicine says an increase in emergency-room visits related to edibles prompted health experts to issue warnings about cardiac and psychiatric issues in the state that began selling recreational marijuana in 2014. Packaging, potency and labelling restrictions on edibles did not come into effect until a year later before being tightened to require labels to prominently display the potency of psychoactive ingredients.
Loh said there’s a lack of data on edibles in general but consumers should also beware that illicit, unregulated products still exist and could be problematic because of issues such as mould.
The Canadian Centre on Substance Use and Addiction recommended last July that anyone who has never smoked or vaped cannabis should not consume more than 2.5 milligrams of THC in a product and wait to feel the effects before taking more.
Dr. Jeff Finkler, an emergency-room physician at St. Paul’s Hospital in Vancouver, said he sees plenty of patients, mostly females in their late teens and early 20s, who come in having panic attacks or anxiety from eating too much of a cannabis-infused food and sometimes mixing it with alcohol or other substances.
“The thing that people forget is that there’s a delayed response,” he said, adding users often think the recommended dosage couldn’t possibly pack a buzz. They are sometimes given a benzodiazepine to counteract the effects of an overdose before being sent home.
“Don’t cut off more than the actual dose just because it looks so small. You don’t want to eat the whole thing. That little thing’s got eight doses or 10 doses,” he said of a package.
“It’s not like smoking. When you start to feel weird you can stop inhaling. But when you ingest it, man, it’s on board.”
While 10 milligrams of THC is the recommended dosage, the psychoactive ingredient of marijuana in a food is hard to measure, he said.
“It requires very sophisticated analytical equipment and it’s even more complicated when they use chocolate because people think it enhances the viability of the THC but chocolate interferes with the measurement of the actual amount.”
“Start low, go slow, and wait. Be patient if you’re going to take the edibles.”
This report by The Canadian Press was first published Jan. 6, 2020.
— Follow @CamilleBains1 on Twitter.
Camille Bains, The Canadian Press
Hospitals struggle as 20 European countries record highest daily number of COVID cases – ABC News
Europe’s coronavirus second wave is in full swing with 20 countries on the continent, including the UK, Italy and Switzerland, reporting record numbers of COVID-19 infections.
- At least 20 European countries have recorded their highest daily number of new COVID-19 infections
- Europe has recorded more than 5 million cases and 200,000 deaths linked to coronavirus
- Authorities are worried that hospitals will not be able to cope with the second wave
The UK topped the list with 26,668 new cases and 191 coronavirus-related deaths in the previous 24 hours, while Italy recorded an additional 15,199 infections, up from its previous record of 11,705 on Sunday.
The Czech Republic saw an increase of 11,984 cases on Wednesday, while Poland recorded 10,040 and Switzerland had 5,596 new infections.
The records are following a worrying trend in Europe which is forcing governments to reintroduce restrictions on social interaction and hospitality services throughout the continent.
According to data from the European Centre for Disease Prevention and Control (ECDC), Europe has registered more than 5 million cases and 200,000 deaths, with new cases beginning to rise sharply from the end of September.
Meanwhile, Spain has become the first western European country to reach more than 1 million confirmed cases after reporting 16,973 additional cases in the past 24 hours.
The country has 34,366 confirmed deaths.
European Union leaders will hold a video-conference next week to discuss how to better cooperate as the infections rise.
Hospitals struggle to cope
With case numbers that were brought largely under control by lockdowns in March and April now surging, authorities in countries from Poland to Portugal have expressed mounting alarm at the renewed crisis confronting their health infrastructure.
Belgium, struggling with what its health minister called a “tsunami” of infections, is postponing all non-essential hospital procedures, and similar measures are looming in other countries where case numbers have been rising relentlessly.
“If the rhythm of the past week continues, rescheduling and suspending some non-priority activities will become unavoidable,” Julio Pascual, medical director at Barcelona’s Hospital del Mar, told Reuters.
European countries boast some of the world’s best health services and doctors say that with the benefit of almost a year’s experience with coronavirus, they are much better equipped to treat individual patients clinically.
But the capacity of hospitals to handle a wave of COVID-19 patients, as well as people suffering from cancer, heart disease and other serious conditions, is still vulnerable.
Dutch health authorities said if the number of COVID patients in hospital wards continues to grow, three quarters of regular care may have to be scrapped by the end of November, and there were similar warnings from Czech authorities.
“We have hit a wall on clinical beds,” Wouter van der Horst, spokesman for the Dutch hospital association NVZ, said.
‘We couldn’t get to everyone’
As hospital admissions have spiralled, much attention has been focused on intensive care units, which came close to being overwhelmed in many areas during the first wave of the crisis.
On Wednesday authorities in Lombardy, the Italian region at the centre of the first wave of the pandemic, ordered the reopening of special temporary intensive care units set up in Milan and Bergamo that were shut down as case numbers receded.
Already, a number of regional health authorities in Germany, one of the countries that dealt with the first wave most effectively, have agreed to take in intensive care patients from other countries.
The ECDC said that some 19 per cent of patients diagnosed with COVID-19 are estimated to have ended up in hospital and eight per cent of those could require intensive care, but variations are wide both across Europe and within individual countries.
On Wednesday, Poland’s Health Minister said up to 30 per cent of new cases there could end up being hospitalised.
There has also been concern over the track and trace systems meant to keep local outbreaks of the disease under control but those systems have proven ineffective in many areas.
Authorities in Ireland, where the five-day case average has tripled since the start of October, said there were no longer enough officials to keep the system working.
Niamh O’Beirne, national lead for testing and tracing, told RTE radio that contact tracing centres had seen “unprecedented demand” with exponential growth in the number of cases, “and over the week we simply couldn’t get to everyone”.
Fraser Health names two weddings for potential coronavirus exposure | News – Daily Hive
Fraser Health is alerting the public about two weddings this month where guests could have been exposed to coronavirus.
The two weddings in the Fraser Health region both happened on October 10. The first was in Port Moody at Saint St. Grill. The exposure time applies all day from 5 am to 11 pm.
The second was in Mission at Lake Errock, again from 5 am to 11 pm.
— Fraser Health (@Fraserhealth) October 23, 2020
The alert comes on the same day that Provincial Health Officer Dr. Bonnie Henry threatened further restrictions could be enacted as social gatherings including weddings and funerals fuel the province’s second wave of coronavirus cases.
Ontario reports 841 new COVID-19 cases and another hospital outbreak
A COVID-19 outbreak at a Quebec pork-processing plant grew Thursday as Manitoba expanded its restrictions and Alberta announced a testing pilot at two international border crossings that it hopes will eventually boost its ailing travel industry.
Olymel said 62 workers at its plant southeast of Quebec City had tested positive for the novel coronavirus.
The union representing plant workers is calling for a temporary closure, but the company says it is following guidance from public health officials who have not recommended a shutdown.
One worker died following a positive test result, but it wasn’t yet determined whether the death was due to the novel coronavirus.
Quebec, the province hardest-hit by COVID-19, reported 1,033 new cases Thursday and 20 additional deaths. Five hundred and fifty-three people were in hospital, including 101 in intensive care.
Premier Francois Legault said chances are slim restaurants in Quebec’s largest cities will be allowed to reopen this month as the province continue to report daily case increases in the quadruple digits.
Montreal and Quebec City have been under a 28-day partial lockdown since Oct. 1.
“At this time, we need to reduce even the risk of contact because we cannot afford to continue having about 1,000 new cases every day,” Legault said.
Manitoba reported four COVID-19 fatalities on Thursday in its deadliest day yet.
Dr. Brent Roussin, the chief provincial public health officer, announced 147 new cases — 87 in Winnipeg, where more restrictions on restaurants, pubs and gathering sizes came into effect this week.
He said the measures will also apply to the northern health region and Churchill starting next week. Extra measures are being put in place for schools in the Winnipeg area and the north starting Monday, including cancelling field trips, banning choirs and wind instruments and requiring substitute teachers to wear medical masks.
Manitoba’s daily test positivity rate is up to 5.6 per cent.
“We have to change things. We fell back on the fundamentals,” Roussin said. “We got back to all that normalcy that we want, but we just know this is what happens when we attempt that.”
Also Thursday, the European Union’s council reimposed a travel ban on Canada, reversing a decision in June that lifted entry restrictions on a number of non-EU countries. Europe is battling a second wave of the pandemic.
In Alberta, Premier Jason Kenney announced a joint federal-provincial pilot project that will enable international travellers re-entering Canada via the Calgary International Airport or the Coutts land border crossing from Montana to avoid a full 14-day quarantine. Instead, they would only have to isolate for a matter of days.
The pilot is to begin on Nov. 2 and is open to asymptomatic travellers returning to Canada who are Canadian citizens, permanent residents or foreign nationals permitted to enter Canada.
“Though a lot of work lies ahead, we can see a return to normal travel,” said Kenney. “The results will help shape provincial and federal policy and ultimately they’ll help to find a new approach for international travel.”
Those who voluntarily participate will receive a COVID-19 test upon entry into Canada before going into quarantine. If the result is negative, they can leave, as long as they promise to get tested six or seven days later at a pharmacy.
Participants will be subject to daily symptom checks and will have to wear masks in public places and avoid visiting high-risk groups.
Anyone who chooses not to get a test will still have to quarantine for two weeks.
Kenney said the provincial tourism industry has suffered a 63 per cent drop in spending this year. He also noted that three per cent of the province’s active cases were acquired through travel.
“We must find ways to bring back safe travel if we’re ever going to get the economy firing again on all cylinders.”
Kenney made his remarks by phone as he was self-isolating at home. The premier tested negative for the novel coronavirus on Wednesday, but said he will remain in isolation for another week.
Kenney attended events with Municipal Affairs Minister Tracy Allard, who contracted COVID-19 last week.
Alberta reported 427 new infections in Thursday’s update, a new record and the second day in a row its daily case count breached the 400 mark. Its test positivity rate was at three per cent on Wednesday.
Ontario Premier Doug Ford said his government is keeping a “sharp eye” on the Alberta border pilot project.
“I’d be open to it, but I just first want to see what’s happening in Calgary,” said Ford, who noted that Pearson International Airport in Toronto gets far more volume and international traffic.
Ontario reported 841 new cases of COVID-19 on Thursday as two more Toronto hospitals declared outbreaks.
Canada’s most populous province also recorded nine more deaths and had a daily test positivity rate of 2.5 per cent.
Two hundred and seventy people were in hospital, including 74 in intensive care and 48 on ventilators.
The Scarborough Health Network said six patients were infected in one unit at its general hospital, and the University Health Network said it was dealing with an outbreak involving four patients at the Toronto Rehabilitation Institute.
St. Michael’s Hospital, St. Joseph’s Health Centre, Toronto Western Hospital and the Centre for Addiction and Mental Health have also declared outbreaks among staff or patients.
This report by The Canadian Press was first published Oct. 22, 2020.
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