Cannabis and Canada’s children and youth

Question 1

What percentage of Canadians have tried cannabis at least once by age 15yo?

Answer 1

1/3

Question 2

Which country ranked first for Cannabis use in youth in 2010?

Answer 2

Canada

Question 3

How does cannabis work?

Answer 3

Delta-9-tetrahydrocannabinol (delta-9-THC) stimulates cannibinoid receptors –> modulates secretion of GABA and glutamate within the CNS and affects endocannabinoid system involved in maturation of dopamine

Question 4

What are the effects of cannabinoids on adolescent brain?

Answer 4

1. Lower brain volume
2. Different folding patterns
3. Thinning of cortex
4. Less neural connectivity
5. Lower white matter integrity

Question 5

What are the effects of intoxication?

Answer 5

1. Euphoria
2. Distorted perception
3. Relaxation
4. Extreme anxiety
5. Short term memory impairment
6. Impaired performance of complex mental tasks
7. Impaired attention
8. Impaired judgment

Question 6

What percentage of students in grade 10-12 admitted to driving after using cannabis?

Answer 6

9.8%

Question 7

What percentage of adolescents who use cannabis will meet criteria for dependence?

Answer 7

1 in 6

Question 8

What is cannabis use disorder?

Answer 8

{roblematic pattern of cannabis use leading to clinically significant impairment in areas of function or distress within a 12-month period
Areas of functional impairment:
1. Reduced academic performance
2. Truancy
3. Reduced participation and interest in extracurricular activities
4. Withdrawal from usual peer groups
5. Conflict with family

Question 9

What is the 12 month prevalence of cannabis use disorder in N. American adolescents?

Answer 9

3%

Question 10

What is cannabis withdrawal syndrome?

Answer 10

At least 2 of 5 psychological symptoms:
1. Irritability
2. Anxiety
3. Depressed mood
4. Sleep disturbance
5. Appetite change
At least 1 of 6 physical symptoms:
1. Abdominal pain
2. Shaking
3. Fever
4. Chills
5. Headache
6. Diaphoresis
Within 24-72h of cessation of heavy cannabis use and may persist for 1-2 weeks
Sleep disturbance may last for up to 1m
Heavy use is daily or near daily use for at least a few months

Question 11

What percentage of young cannabis users also smoke tobacco?

Answer 11

80%

Question 12

What other drugs is cannabis use related to?

Answer 12

1. Alcohol
2. Ecstasy (6 fold increase)
3. K2 or spice

Question 13

What is the association between cannabis, depression and anxiety?

Answer 13

1. Depression association (?3 fold higher risk)
2. Anxiety disorders
3. Social anxiety disorder risk factor for problem cannabis use patterns
4. PTSD is a risk factors for problem cannabis use patterns

Question 14

What is the risk of developing a psychotic outcome of any nature in individuals with cannabis use during their lifetime?

Answer 14

40% increase

Question 15

What can cannabis produce acutely in teens?

Answer 15

Acute/transient psychosis

Question 16

What is the schizophrenia risk in heavy cannabis users?

Answer 16

2% (doubled)

Question 17

What is the research on association between IQ and cannabis?

Answer 17

Equivocal but some evidence cognitive decline

Question 18

What is the association between cannabis use and educational attainment?

Answer 18

Association but unclear is causation

Question 19

What does the CPS recommend governments should do?

Answer 19

1. Prohibit sales of all cannabis products to children and youth under the legal age for buying tobacco products and alcohol (18 or 19 years, depending on location).
2. Consider limiting the concentration of THC in cannabis that 18- to 25-year-olds can purchase legally.
3. Enact and rigorously enforce regulations on the cannabis industry to limit the availability and marketing of cannabis to minors. These regulations must:

a) prohibit dispensaries from being located close to elementary, middle and high schools, licensed child care centres, community centres, residential neighbourhoods and youth facilities.
b) prohibit the sale of cannabis products by means of self-service displays or dispensing devices.
c) mandate strict labelling standards for all cannabis products, including a complete and accurate list of ingredients and an exact measure of cannabis concentration.
d) mandate package warnings for all cannabis products, including known and potential harmful effects of exposure (e.g., to young children and the fetus during pregnancy), similar to messaging on cigarette packaging.
e) mandate and enforce strict marketing and promotional standards, including a ban on all cannabis industry-related advertising and on the sponsorship of events, activities or permanent facilities by the cannabis industry.
f) mandate and enforce a ban on the marketing of cannabis-related products using strategies or venues that attract children and youth, including (but not limited to) ‘candy-like’ edibles, ‘giveaways’ and promotion through social media.
g) restrict the online sales of all cannabis and related products only to individuals identified as being older than the legal drinking age in the province or territory where they reside.

4. Extend and align existing anti-tobacco legislation at all government levels to include cannabis (i.e., prohibiting smoking in public venues, smoking in cars where a child is present).
5. Fund public education campaigns to reinforce that cannabis is not safe for children and youth by raising awareness of the harms associated with cannabis use and dependence. These campaigns should be developed in collaboration with youth leaders and should include messages from young opinion-leaders.
6. Invest in the development and implementation of programs for routine roadside detection of cannabinoids and determine suitable consequences for youth who are found to be under the influence.
7. Increase funding for the research, prevention and treatment of substance use in adolescents and young adults.
8. Increase funding for mental health promotion and for treating mental illness in this age group.
9. Consult with Indigenous communities on adapting legislation, preventative measures and/or interventions to meet local conditions and cultural requirements.
10. Actively monitor the impacts on youth of changes to cannabis legislation.

Question 20

What are the CPS statements recommendations for health care providors?

Answer 20

1. Be aware of and communicate the health risks related to cannabis use.
2. Screen all children and youth for cannabis exposure and/or use and educate adolescents and families on the health risks and harms associated with cannabis.
3. Provide anticipatory guidance to parents and older children on the potential health risks of cannabis use.