Talking to Patients About Recreational Cannabis

Transcription

1 Talking t Patients Abut Recreatinal Cannabis With the upcming legalizatin f recreatinal cannabis, yu may find that mre patients want t talk t yu abut its use. This can be apprached similar t cnversatins abut ther cntrlled substances, like alchl and tbacc. This resurce prvides infrmatin abut sme health risks assciated with recreatinal cannabis use and cnsideratins t guide a cnversatin with patients abut recreatinal cannabis. Ontari s dctrs believe that recreatinal cannabis is an inherently harmful substance and the health risks caused by recreatinal cannabis can best be avided by abstaining frm use. There is strng evidence that demnstrates that recreatinal cannabis impacts brain develpment thrugh early adulthd. Fr that reasn, Ontari s dctrs advcate that thse under 25 years f age abstain frm recreatinal cannabis. Mre research n cannabis is required t infrm brader clinical evidence. It is imprtant t keep in mind that this resurce is intended fr discussins abut recreatinal cannabis. This dcument is nt intended t infrm discussins abut medicinal cannabis used fr therapeutic purpses. Further, health impacts frm recreatinal cannabis use can vary depending n a number f factrs including, but nt limited t: age f user, THC levels, cnsumptin methd and frequency f use.

2 Cannabis 101 What is cannabis? Cannabis is a prduct derived frm the Cannabis sativa plant. Cannabis cntains hundreds f chemical substances knwn as cannabinids. Cannabinid receptrs and the endcannabinid system prcess cannabinids. Terpenes give cannabis its distinct smell. What is the endcannabinid system? The endcannabinid system is a lipid signaling system fund in all vertebrates. This system has imprtant regulatry functins thrughut the bdy and has been linked with the fllwing physilgical and pathphysilgical prcesses: neural develpment, immune functin, inflammatin, appetite, metablism and energy hmestasis, cardivascular functin, digestin, bne develpment and bne density, synaptic plasticity and learning, pain, reprductin, psychiatric disease, psychmtr behaviur, memry, wake/sleep cycles, and the regulatin f stress and emtins. What is THC? Delta-9-tetrahydrcannabinl (THC) is the cannabinid respnsible fr hw the bdy reacts t cannabis, including intxicatin. The cncentratin f THC is usually shwn as a percentage f THC by weight f the cannabis prduct r by vlume if dealing with a cannabis il. If a cannabis prduct has less than 0.3% f THC in its flwers r leaves it is cnsidered as hemp. What is CBD? Cannabidil (CBD) is a cannabinid that des nt intxicate users r prduce a high, but it des affect in channels, receptrs and enzymes. There is sme evidence that CBD can blck r decrease the effects f THC. Cmmn effects f CBD use include: anti-inflammatry, analgesic, anti-nausea, anti-emetic, anti-psychtic, anti-ischemic, anxilytic, and anti-epileptifrm.

3 Other names fr cannabis Cmmnly used terms include recreatinal cannabis and adult use cannabis fr cannabis that is used utside f a therapeutic setting. There are several ther terms fr cannabis. Language and terminlgy may vary depending n scial grups, age, culture and cmmunities. The Gvernment f Canada lists the fllwing as additinal names fr cannabis: Marijuana Skunk Hneycmb Mary Jane (MJ) Pt Shatter Trees Purp Bud Budder Gangster Dank r dank krippy Dpe Errl Keef Weed Wax Rsin Bm Herb Ganja Cnsumptin Methds Cnsumptin Methd Smking Vaping Cannabis Oil Edibles Tinctures Dabbing r Shattering What is it? Dried flwer frm the cannabis plant is rlled t make a jint, r used in a pipe r bng Vaprizers heat rather than cmbust cannabis plant matter r its il, cannabis vapur is inhaled rather than smked Highly cncentrated cannabis extract where a slvent has been used t separate essential ils f the cannabis plant Cannabis that is ingested thrugh fd r drinks Effects can be dependent n users metablism and if cannabis has been ingested with ther fd r n an empty stmach Small amunt f this alchl-based cannabis extract is incrprated int fd r drink, r placed under tngue Cncentrated dses f cannabis made frm extracting cannabinids, users heat the cncentrate n a ht surface and inhale Hw lng until user feels effect? Felt within secnds f inhalatin Felt within secnds f inhalatin Felt within 15 minutes t 1 hur Felt within 15 minutes t tw hurs f ingestin Felt within minutes Felt immediately after inhalatin

4 Health Effects f Recreatinal Cannabis Addictin and Prblematic Use Recreatinal cannabis can be addictive. The addictin risk is 1 in 6 fr thse wh start using as a teen. Cannabis use disrder: The DSM-5 defines as a prblematic pattern f cannabis use leading t clinically significant impairment r distress. Symptms include tlerance and withdrawl. Cannabis withdrawal includes: irritability, anger r aggressin, anxiety, depressed md, restlessness, difficulty sleeping, decreased appetite, and weight lss. Adlescence is the mst cmmn time fr nset. Cannabis smke & secnd-hand smke Expsure t cannabis smke can trigger acute and chrnic health issues that include: cardivascular events, asthma, cancers, chrnic bstructive pulmnary disease, and a range f respiratry and circulatry cnditins. Cannabis smkers tend t inhale mre deeply and hld their breath fr lnger, this can push cancercausing agents t travel further int the lungs. Expsure t secnd hand cannabis smke cntains many f the same txins fund in cannabis smke that is directly inhaled, including carcingens. Cannabis and mental health Recreatinal cannabis use can trigger r heighten symptms f anxiety and r depressin. Recreatinal cannabis use in teenage years is linked t the develpment f md and anxiety disrders and an increased likelihd f develping psychiatric disrders later in life. Cannabis use and schizphrenia: Increases the risk f develping schizphrenia in yuth Increases the risk f triggering an early nset f schizphrenia fr an individual that has a genetic predispsitin (fr example, family histry) Cntinued cannabis use fr an individual with schizphrenia can heighten psychtic symptms

5 Cgnitive effects The immediate effects nrmally lessen within abut six hurs f use, althugh cgnitive impacts have been seen fr up t 3 weeks after cessatin. Mre evidence-based research n the cgnitive impacts f cannabis is required. Belw is a list f knwn acute and lng-term effects that can be caused by cannabis use. While these effects are general, the severity may be impacted by THC levels, age f the persn using, and frequency f use. Acute cgnitive effects Inattentiveness Impaired judgement Impaired decisin making Challenges in prcessing and retaining infrmatin Impaired mtr crdinatin and reactin time Lng-term cgnitive effects fr regular users Challenges with prblem slving and learning Challenges with inattentiveness Challenges with memry Challenges with prcessing cmplex infrmatin Cnsideratins t Guide a Cnversatin Prvide health infrmatin Let the patient knw that part f yur rle is t cnvey health infrmatin, including the side effects f recreatinal cannabis and hw it can impact his r her health. Encurage hnesty The patient may feel embarrassed t share infrmatin. Encurage the patient t be accurate with the infrmatin he r she prvide abut their cannabis use. There are n steretypes Recreatinal cannabis crsses all ages, cultures, genders, and sciecnmic grups. Be aware f ther medicatins Recreatinal cannabis culd interact with ther medicatins. The mst significant interactins are between cannabis and ther central nervus system drugs (sedative-hypntics r alchl).

6 Talk abut health impacts Recreatinal cannabis can have negative health impacts that include: harmful effects n mental health and addictin, cgnitive effects, respiratry and circulatry diseases and impairment. Ask the patient abut their cannabis use This can be a discussin n its wn r part f a cnversatin abut substance use when talking alchl and tbacc. Quickly screening t see if the patient plans n using recreatinal cannabis r hw ften a patient is using recreatinal cannabis can help t determine whether a mre in depth cnversatin is apprpriate. Be supprtive If yur patient lets yu knw he r she is using cannabis, try t understand why. Sme cmmn reasns might include stress management, peer pressure, r self-medicatin. Be prepared t help yur patient with additinal supprts if apprpriate. Additinal Cnsideratins fr Talking t Underage Patients Unique health risks fr yuth The health risks f using recreatinal cannabis are higher fr thse wh start using in their teens. These health risks include addictin, increased risk fr develping mental illness, and impacts n cgnitive develpment. There is strng evidence that demnstrates that recreatinal cannabis impacts brain develpment thrugh early adulthd. Ontari s dctrs cntinue t recmmend that individuals under 25 shuld abstain frm recreatinal cannabis. Reasns fr using A yung persn s desire t use r try recreatinal cannabis may be similar r different frm adults. Yuth have described a number f factrs that mtivate trying and using recreatinal cannabis, including: peer pressure; t experiment; t party r scialize; t cpe with stress; t alter their perspective. Cnsider having a cnversatin with teens that is similar t the cnversatin yu have abut alchl.

7 Cmmnly Asked Questins Abut Recreatinal Cannabis Talk abut health impacts Recreatinal cannabis can have negative health impacts that include: harmful effects n mental health and addictin, cgnitive effects, respiratry and circulatry diseases and impairment. Hw des recreatinal cannabis make yu feel? Recreatinal cannabis can affect users in very different ways. Sme users feel relaxed and happy, thers feel drwsy, panicked, cnfused, r frgetful. Sme users have delusins and altered perceptins. Is ne cnsumptin methd safer than the rest? Recreatinal cannabis is an inherently harmful substance and the health risks caused by recreatinal cannabis use can best be avided by abstaining frm use. Cannabis smke can trigger acute and chrnic health issues, including a range f respiratry cnditins, cardivascular events, asthma, cancers, and chrnic bstructive pulmnary disease. Is it safe t use recreatinal cannabis safe t use when trying t get pregnant? Individuals trying t get pregnant shuld refrain frm cnsuming cannabis and expsure t secnd-hand cannabis smke. Is it safe t use recreatinal cannabis when pregnant? Wmen wh are pregnant shuld refrain frm cnsuming recreatinal cannabis and expsure t secnd-hand smke. Cannabis use during pregnancy may increase the risk f: preterm birth, lw birth weight and and small fr gestatinal age.

8 Is it safe t use recreatinal cannabis when breastfeeding? Wmen wh are breastfeeding shuld refrain frm cnsuming recreatinal cannabis and expsure t secnd-hand cannabis smke. Is it safe t use recreatinal cannabis and drive? It is nt safe t drive when impaired by the use f recreatinal cannabis, as it negatively affects reactin times and cncentratin. Hw lng shuld a patient wait t drive after cnsuming recreatinal cannabis? The recently published Lwer-Risk Cannabis Use Guidelines, instruct individuals wh cnsume cannabis t wait befre driving fr at least six hurs. This wait time may need t be lnger, depending n the user and the prduct cnsumed. Is it safe t use recreatinal cannabis befre surgery? It is nt safe t use recreatinal cannabis prir t surgical prcedures as cannabis can interact with ther medicatins, including anesthetics.