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.
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.
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