Canadian Nurses Association suggests harm reduction guidelines for cannabis users

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Courtesy of Lift Magazine

It can be said as a universal truth that if you find something you like, there’s probably a catch. It’s an admission many advocates and activists are reluctant to make about cannabis, but with legalization on the way, the Canadian Nurses Association has published a document warning of the potential health risks that have been linked to non-medical cannabis use. The document also presents a list of simple recommendations Canadians can follow to reduce those risks.

The list of health risks in the CNA’s document primarily fall into the categories of respiratory effects, cannabis use disorder, mental health issues, impaired driving, and accidental overdose.

The document cites three separate studies associating cannabis smoking with respiratory issues including coughing, wheezing, shortness of breath on exertion and episodes of chronic bronchitis. Cannabis use disorder is defined in the document as, “a problematic pattern of cannabis use leading to clinically significant impairment or distress,” with roughly 9 percent of cannabis users developing such a dependence.

Mental health issues of chief concern for the CNA are depression, anxiety, and suicidal behaviours. Accidental overdose refers mostly to cases wherein a user experiences intense effects from high dosages of edibles or inhaled smoke, but also includes more serious cases in pediatric applications wherein overdoses can result in respiratory distress in children.

Harm-reduction tips

Delay use until early adulthood

The CNA document cites studies that have found the risk of forming a dependence disorder is higher when use begins at an earlier age.

Minimize frequency of use

The Nurse’s Association suggests avoiding frequent, daily or near-daily use.

Try to stop when use becomes hard to control

Frequent non-medical users who begin to have trouble controlling their use are advised by the CNA to attempt to stop—with professional help if necessary. Minimize respiratory complications

The document recommends users avoid smoking cannabis with tobacco, refrain from deep inhalation and breath-holding, and consider using a vaporizer rather than smoking.

Avoid using amounts that are large or highly concentrated

The recommendations caution against excessive use, both ongoing and in single-sitting use. The CNA also warns of excessive dosages when smoking or vaping concentrates.

Refrain from using non-medical cannabis with alcohol

The document states that mixing cannabis with alcohol can increase impairment exponentially, and can also cause anxiety, nausea, vomiting or fainting.

Avoid driving while high

The Nurse’s Association recommends waiting 6 hours before driving after smoking or vaping cannabis, or longer if consuming edibles or concentrates.

Share with care

Users are recommended to minimize lip contact with joints and smoking or vaping implements to reduce the risk of transmitting infections such as meningitis, influenza and other pathogens.

Vulnerable groups should abstain from use

The CNA document warns of an increased risk for cannabis-related problems among high-risk groups, including pregnant women and individuals with a personal or family history of psychosis. These groups, the document states, should avoid use altogether.

Use caution when ingesting cannabis

To avoid accidental overdose with cannabis edibles, the Nurse’s Association recommends a “start low and go slow”

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