After alcohol, cannabis is the second most commonly used substance in Canada. There is a lot of information available on the Internet about the health impacts and potential benefits of cannabis use. Some of this information is accurate and some is inaccurate. The research section summarizes the current scientific evidence on the health impacts of cannabis, the potential medical benefits of cannabis and peoples’ perceptions of cannabis.
Health Impacts of Cannabis
While the evidence on the medical applications of cannabis is limited, there are risks associated with regular cannabis use. Ongoing research is improving what we know about both risks and benefits.
COVID-19 and Cannabis Smoking and Vaping
Since the beginning of the COVID-19 pandemic, there has been growing interest in the potential health benefits and medical application of cannabis to prevent and treat COVID-19 symptoms. There is no scientific evidence that demonstrates the benefits of either THC or CBD in preventing or treating COVID-19. Inhaling cannabis smoke can harm the lungs, which might increase susceptibility to COVID- 19 and worsen the symptoms of the disease.
The brief also includes eight tips to reduce health risks for those who smoke cannabis.
- Cannabis smoke contains chemicals (toxins, carcinogens and irritants) that are known to negatively affect lung health.
- Smoking cannabis regularly can cause coughing, wheezing and tightness in the chest. Long- term cannabis smoking can also worsen chronic bronchitis.
- Smoking cannabis may suppress the immune system, which can make you more prone to infection from viruses.
- Vaping unregulated cannabis has been linked with severe lung illnesses.
This evidence summary outlines four important facts people should know about COVID-19 and cannabis smoking or vaping.
Clearing the Smoke on Cannabis Series
The Clearing the Smoke on Cannabis series looks at how cannabis use affects mental and physical health, and discusses implications for policy and practice. Prepared and peer-reviewed by expert researchers in the field, this series addresses what we know about the health effects of cannabis use, what we don’t know and what needs further investigation.
This report provides a summary of the seven publications in the Clearing the Smoke on Cannabis series.
Edible Cannabis Products, Cannabis Extracts and Cannabis Topicals
A completely new line of cannabis products is now available for purchase in Canada. Edible cannabis products, cannabis extracts and cannabis topicals have unique health and safety risks that are different from the risks associated with dried cannabis.
With these products, it is important to know that:
- Edible cannabis products can increase the risk of over-consumption and subsequent cannabis poisoning.
- As edible cannabis products look like “normal” food and beverages, there is an increase in the risk of unintentional ingestion, especially by children.
- High-potency cannabis extracts increase the risk of cannabis poisoning, even more so than dried cannabis.
- Regular use of these products has been associated with problematic cannabis use, cannabis use disorder and mental health disorders.
- Research on cannabis topicals, including the use of CBD products you apply to the skin, is very limited. However, there is a growing interest among dermatologists and consumers in these products.
- Health impacts associated with long-term use of edible cannabis products, cannabis extracts and cannabis topicals is unknown.
Medical Use of Cannabis and Cannabinoids
Promising research indicates that cannabis and cannabinoids are effective in relieving symptoms associated with certain severe and chronic conditions. As of June 2018, over 333,000 Canadians had registered to access cannabis for medical purposes.
Vaping Linked to Serious Lung Disease
This report summarizes what is known about the recent emergence of severe lung injury associated with vaping, including probable causes and next steps for research. It incorporates the most current evidence and information available about the link between vaping and severe lung and pulmonary illnesses as of October 31, 2019.
Key findings from the report:
Regular Cannabis Use and Cognitive Functioning
Starting to smoke cannabis earlier in life — before 16 or 17 — is one of the strongest predictors of noticeable cognitive difficulties. However, the impact of regular cannabis use on cognitive functions is generally mild for most people. Many of the measurable effects on these functions disappear after sustained periods of not using cannabis.
Regular Cannabis Use and Mental Health
People who use cannabis regularly — one or more times per week over a period of months or years — could be at greater risk of developing psychosis or schizophrenia. This finding was determined through a review of the current body of research about the relationship between cannabis and a number of mental health conditions.
Additional findings of the report include:
Respiratory Effects of Smoking Cannabis
Individuals who smoke cannabis on a regular basis commonly report coughing on most days, as well as wheezing, shortness of breath after exercise, chest tightness at night, sounds in their chest, early morning phlegm and bronchitis. Abstinence can reverse some of the negative respiratory symptoms experienced by those who smoke cannabis.
Research on the respiratory effects of smoking cannabis provides the following observations:
Cannabis Use during Pregnancy
An estimated 16.9% of individuals of childbearing age (15–44 years) reported past-year use of cannabis in 2015 and 2% to 5% of pregnant individuals reported using cannabis during pregnancy. There is little evidence to suggest an association between cannabis use during pregnancy and increased risk of premature birth, miscarriage or major physical abnormalities. However, frequent cannabis use during pregnancy is associated with:
New Cannabis Products
On October 17, 2019, the federal government made it legal to purchase and consume edible cannabis products, cannabis extracts and cannabis topicals.
What are these products? In the simplest terms, they are defined as follows:
These new cannabis products carry with them unique health and safety risks that are not associated with consuming dried cannabis. It is important to be aware and informed of these risks before choosing to use edible cannabis products, cannabis extracts or cannabis topicals in order to minimize adverse health outcomes.
In the months leading up to legalization, CCSA released a series of public education resources about the new cannabis products. The resources include information about the associated health and safety risks, how to lower the risks or adverse health outcomes, the differences between ingesting and inhaling cannabis products, and how to safely store your cannabis products.
Edible Cannabis Products, Cannabis Extracts and Cannabis Topicals: What You Need to Know
Each of these types of cannabis product has its own attributes and uses.
Edible cannabis can come in a range of products that are meant to be consumed by eating or drinking. Although some edible cannabis products might look like normal food items, they are not. These products provide no nutritional value.
Cannabis extracts can be in solid form (hash or hashish) or in liquid form (oil intended for vaping). These products can be vaped, smoked or ingested. Cannabis extracts can vary widely in their THC and CBD concentrations. Some extracts, such as cannabis oil distillates and shatter, can have up to 99% THC, whereas others can be mostly CBD with little THC. High-strength extracts can increase the risk of over-intoxication, especially among those who are new to cannabis.
Cannabis topicals are for application directly to the skin, hair or nails. The risk of intoxication and impairment following the application of cannabis topicals is believed to be low, although there has yet to be thorough research evaluating these potential effects.
Our primer provides a brief overview of each of these different type of cannabis products and their associated properties.
Inhaling vs Ingesting: What Is the Difference?
Inhaling and ingesting are the two most popular ways to consume cannabis. People need to know how each method can affect their health.
The way we consume cannabis determines how it enters the body. One method passes through the lungs and the other through the stomach. The differences between inhaling and ingesting have a great impact on:
Edible Cannabis: Tips for Lowering Your Risk
Consuming edible cannabis is an alternative method to smoking cannabis. When edible cannabis becomes legal this fall, many Canadians might be interested in trying the variety of options that become available. Before they do so, they need to be aware of the risks.
Eating or drinking cannabis affects the body differently than smoking or vaping it. People who choose to use edible cannabis products must educate themselves on how to do so in a lower-risk manner.
7 Things You Need To Know about Edible Cannabis provides guidance on what these products are and how to lower your risk. The topics covered include:
Cannabis Extracts: What You Should Know
Cannabis extracts are products containing cannabinoids extracted from the cannabis plant. THC (tetrahydrocannabinol) and CBD (cannabidiol) are the most common cannabinoids, but they have different effects. THC makes people intoxicated or high, while CBD is non-intoxicating and might provide therapeutic benefits.
Cannabis extracts vary widely in their THC and CBD concentrations. Some extracts can contain up to 99% THC, whereas others can contain mostly CBD with little THC.
Extracts can be solid (hash or hashish) or liquid (oil intended for vaping). Certain types are named after their appearance or texture including shatter, wax, honeycomb and budder.
You can consume cannabis extracts through:
7 Things You Need to Know about Cannabis Extracts provides information you should know about cannabis extracts and how to lower your risk when using them. The topics covered include:
Always Read the Label Before Consuming Edible Cannabis
Edible cannabis comes in a wide range of products including cookies, chocolates and beverages. The amount of THC in edible cannabis products can vary. However, in Canada, packages containing edible cannabis products are legally limited to a maximum of 10 mg of THC.
To reduce your risk of over-consumption, read the label before consuming an edible cannabis product. People who are new to cannabis should start low — no more than 2.5 mg of THC — and go slow!
This infographic highlights what people should know before they consume an edible cannabis product, including:
Costs of Cannabis Use
Cannabis is one of the most commonly used substances in Canada. According to the 2018 National Cannabis Survey, 15.6% of all Canadians reported using cannabis in the past three months. While the non-medical use of cannabis can result in numerous health impacts, it also contributes to the overall cost of substance use. The greatest impact is in the criminal justice sector, and other sectors impacted include healthcare, business and industry, as well as other areas such as research and prevention, damage to property and motor vehicles, and workplace costs not covered in lost productivity.
For more information, see the full report:
Canadian Perceptions and Trends
Demographic Trends for Cannabis Use
Cannabis use in Canada is slowly on the rise: past-year use among the general population (aged 15 years and over) increased from 10.6% in 2012 to 12.3% in 2014. In addition, Canadian youth were more than twice as likely to report past-year cannabis use compared to adults, with the use rates among individuals aged 15–24 years and individuals aged 25 years and older being 25.5% and 9.9% respectively.
Canadian Perceptions on Cannabis
Since the Cannabis Act was passed in October 2018, Canadians have been voicing their concerns and perspectives about the health and safety impacts of cannabis. In 2018, CCSA commissioned a Nanos poll wherein 1,000 Canadians were asked a series of questions about their thoughts on cannabis use. Some of the results include:
Perceptions of Cannabis by Canadians Aged 16 Years and Older
According to Health Canada’s Canadian Cannabis Survey summary report (2017), Canadians aged 16 years and older held the following opinions about cannabis:
For more information, see the full report: Canadian Cannabis Survey 2017 - Summary.
Perceptions of Cannabis by Canadian Youth
In addition, a small sample of Canadian youth aged 15–19 held the following opinions about cannabis:
Cannabis Use and Driving
Cannabis Use and Driving
Cannabis impairs the cognitive and motor abilities necessary to safely operate a motor vehicle and doubles the risk of crash involvement. Current data supports the following conclusions:
For more information about cannabis and impaired driving, please see Driving Under the Influence of Cannabis.
Youth and Cannabis
Youth and Cannabis
With the legalization of cannabis, youth are seeking credible information from individuals they know and trust on the benefits and harms of cannabis use. They want to know the whole story. Young people are ready to have the conversation, but many who interact with them are not well prepared for it.
CCSA developed a communication guide to help educate youth allies on how to have safe, unbiased and non-judgmental conversations with young people about cannabis. By taking a harm reduction approach and providing a basis for communicating accurate information about cannabis, youth allies will be able to better support young people in making informed decisions about their cannabis use.
Cannabis Use during Adolescence
The Effects of Cannabis Use during Adolescence, a report in the Substance Use in Canada series, reviews the evidence on what we do and do not know about how cannabis affects adolescents. The report addresses several important questions and key issues, including:
- What are the brain and behavioural effects of cannabis use in youth?
- Is there a link between cannabis and mental health?
- Is cannabis addictive?
- What interventions are available for cannabis use disorders?
The report concludes with A Call to Action. It gives parents, teachers, healthcare providers and policy makers the opportunity to develop and employ more effective youth drug use prevention and intervention programs.
For an online learning experience based on the report, see Online Learning for the Effects of Cannabis Use during Adolescence.