depression, anxiety, insomnia, and
loss of appetite.
There are many ways to use
cannabis; most common are
inhalation and ingestion. Inhaling
the drug by smoking or vaporizing
has an onset of just a few minutes,
and lasts three to four hours
depending on dose. Smoking and
vaporizing are not risk-free — they
can cause irritation to the lungs.
Smoking marijuana is associated
with cough, chronic bronchitis, low
blood oxygen, and chronic lung
disease, similar to the eff ects of
tobacco smoke, even in the short
term. Vaporizing is thought to be
safer as the marijuana is heated to
lower temperatures and therefore
does not release combustion
materials into the lungs. However,
there is little evidence in this regard.
Other forms of cannabis include
extracts, edibles, and topical
solutions. Topical solutions can
relieve pain to areas on which they
are applied and are accessible only
with a prescription. It is advised
to take very little if trying edibles
for the fi rst time, as the onset is
anywhere from one to fi ve hours,
and lasts up to eight hours. Capsules
or pills are similar in their onset
and duration.
The forms of cannabis that are
available for legal purchase in
Canada are fresh or dried fl owers,
oil, plants, and seeds. Dried fl owers
are most often smoked or vaporized.
Oils are another common way for
people to use cannabis, without risk
to the lungs. Oil droplets are placed
under the tongue to let the blood
vessels absorb the drug. The eff ects
tend to be less immediate, at thirty
minutes to two hours, and can last
six or more hours.
Cannabis use causes symptoms
that may mimic alcohol intoxication:
impaired motor skills, reaction time,
decision-making, and concentration.
People may feel euphoric and have
lowered inhibitions. Hallucinations
and confusion can occur. Using too
much cannabis can cause symptoms
like rapid heart rate, nausea,
vomiting, dizziness, muscle spasms,
seizures, excessive sleepiness,
anxiety, panic, and confusion.
Overdose most often occurs with
the ingestion of cannabis through
edibles or when mixed with other
drugs like alcohol, gabapentin,
morphine, codeine, antidepressants,
or anti-anxiety medications
like Valium.
Long-term heavy cannabis use
may worsen depression and anxiety
or result in an increasing tolerance
to the benefi cial eff ects of cannabis.
Larger doses may become necessary
to achieve the same therapeutic
eff ects and can have signifi cant
fi nancial costs. Heavy cannabis use
can cause nausea and vomiting,
called cannabinoid hyperemesis
syndrome, which is very diffi cult
to treat.
This usually occurs in individuals
who use cannabis long term, with
heavy use every day.
The potential health impacts
and risks associated with cannabis
use have not been exhaustively
researched. It is best to approach
your family physician with any
specifi c questions about your
personal use of cannabis for pain
management. In fact, if you and your
doctor believe this would be a good
option for you, your physician may
send you to a specialized cannabis
clinic with health care practitioners
that are trained to assess and treat
people with the proper strains
and dosing. It is also possible to
self refer for an evaluation. With a
prescription, you will have access
to licensed producers of medical
cannabis, which can be reviewed
at the Government of Canada site
for licensed cultivators, processors,
and sellers of cannabis under the
Cannabis Act (bit.ly/2Pi6Kuk).
More information can be found
at the links below. For more
information on medical conditions,
mental health, and wellness, see
HumanaCare’s “your eldercare
portal” at:
ec.myworklifeportal.com. ●
References
Canadian Nurses Association “Harm reduction for non-medical cannabis use” at bit.ly/2JjeR6d.
Aphria’s (commercial medical cannabis producer) “Cannabis Oil Guide for Health Professionals” at bit.ly/2PgZC1x.
National [U.S.] Council for Aging Care’s “The Complete Guide to Medical Marijuana for Seniors” at bit.ly/2pa8ICt.
Government of Alberta’s “Cannabis Legalization in Canada” webpage at bit.ly/2JjB97Q.
news&views WINTER 2019 | 25