NEW CANNABIS PRODUCTS BRING NEED FOR MORE EDUCATION

On October 17, 2019 cannabis edibles, extracts, and topicals became legal in Canada. With a 60-day notice to Health Canada required prior to the sale of these products, we are only now beginning to see these products for sale in Canada.

In the 1960s and ‘70s, cannabis contained approximately one to three percent THC (the active constituent of cannabis that is responsible for the intoxicating and impairing effects). With the legalization of extracts, very high potency THC (or concentrates) will begin to fill the shelves. Some of these products contain up to 99 percent THC, producing significantly greater intoxication and prolonged impairing effects.

The expectation is that we will also begin to see more and more baked products, snacks, drinks and food containing varying amounts of THC. The edible market is expected to be large.

The increasing availability of these new products has sparked some new concerns for employers who work in safety-sensitive industries as they continue to navigate through the potential impacts of the legalization of recreational cannabis.

EDIBLE VS. INHALED CANNABIS

Employers need to understand the newly legal products such as edibles, and how they differ from smoked cannabis. Ingested cannabis (edible cannabis) is broken down by our body differently in comparison to smoked or vaporized cannabis. With the use of edible cannabis, it takes longer to feel the effects, these effects last significantly longer and may result in a different type of euphoria or “high.” 

After ingestion of edible cannabis, the active component of cannabis — delta-9-tetrahydrocannabinol (THC) — may take between 30 minutes and two hours or more before reaching the bloodstream and brain, which means that the individual may not feel any effect for one to two hours or longer. 

The effects and impairment from the use of edibles can last significantly longer than smoked or vaporized cannabis. The initial euphoria (or “high”) may last for 12-24 hours or more.

In contrast to this, the effects of smoked or vaporized cannabis are felt within minutes. This allows the individual to titrate the amount they inhale to produce the effects they are looking for. For edibles, the prolonged and unpredictable time between ingestion and effect leads some to overconsume cannabis, resulting in unwanted effects that can last for hours to days.

It is not uncommon for individuals who use cannabis with high THC levels to experience nausea, sweats, vomiting, dizziness and a feeling of being generally quite unwell (often referred to as “greening out”). This can occur with overconsumption of edibles. It is possible as well to experience temporary symptoms such as hallucinations, delusions, severe anxiety and paranoia.

Workplaces can begin by educating their employees about the differences the new legal cannabis products present and their impact in the workplace, especially in safety-sensitive workplaces. Policies should be reviewed and updated to reflect expectations regarding the newly legal products and substance use in the workplace in general. It is important to note that these products may result in acute intoxication lasting significantly longer than smoked or vaporized cannabis (24 hours for some). Residual effects of cannabis can last even longer (days to weeks).

With edible cannabis and higher concentrations of THC come new challenges as these products result in prolonged cognitive effects.  It is important to ensure all employees who work in safety-sensitive workplaces are aware that what they do on their own time may indeed affect safety in their workplace. Prolonged impairment of edibles means usage on their own time can most certainly spill over to the workday. The same is true for very highly concentrated THC.

Dr. Melissa Snider-Adler, M.D., C.C.F.P.(AM), M.R.O. (AAMRO),D,A.B.A.M. 

Chief Medical Review Officer, DriverCheck Inc.

Physician, Addiction Medicine

Dr. Snider-Adler is the Chief Medical Review Officer for DriverCheck and is a Board-Certified Addiction Medicine Physician with a Certificate of Added Competence in Addiction Medicine. Dr. Snider-Adler currently practices addiction medicine in Oshawa, Ontario and is an Assistant Professor at Queen's University Department of Family Medicine. She works as a Peer Assessor for the College of Physicians and Surgeons of Ontario. Dr. Snider-Adler is considered an expert in the field of substance use in the workplace as well alcohol and drug testing for safety sensitive workplaces. As such, she is often asked to provide expert opinions, reports and testimony for arbitrations, hearings and court cases across Canada. Dr. Snider-Adler travels across Canada and the U.S. speaking to workplaces and at various conferences regarding the impact of recreational cannabis, cannabis for medical purposes, workplace substance use, and addiction prevention and treatment.