Researchers are asking the federal government to tighten restrictions on cannabis, after a new study found that cannabis-related hospitalizations have spiked, especially among children, in the years since recreational use of the substance was legalized in Canada.
But industry proponents are arguing the opposite. Cannabis producers, they say, will have trouble running viable businesses without a loosening of restrictions in the 2018 federal legislation that governs the weed business in Canada. Among other things, producers are asking for the ability to sell edible products that contain more than the current legal maximum of 10 milligrams of THC, cannabis’s active ingredient.
That legislation, known as the Cannabis Act, contains a provision that obliges Ottawa to examine legalization’s impact after three years. With that review now almost a year overdue, both sides are gearing up for a battle over how permissive Canada’s cannabis laws should be.
The new study, funded by the Canadian Centre on Substance Use and Addiction and published in the New England Journal of Medicine, was released this week. It found that the rate of hospitalizations for children under 10 with cannabis poisoning was more than 6 times higher by September 2021 than it was in October 2018, when legalization went into effect. Although the rate of hospitalizations for pediatric cannabis poisonings went up across the country, the surge was more than double in provinces that allow the sale of cannabis edibles, according to the study.
“It’s important to note that the provinces that permitted edibles still had strict rules, including plain and child-resistant packaging, a maximum of 10 milligrams of THC per package, and consumer education campaigns,” said Daniel Myran, a health services researcher at the University of Ottawa and lead author of the study.
“Our findings suggest that countries that allow the sale of legal edibles as part of their approach to legalization, regardless of other regulations, could encounter large increases in poisoning events, some severe, in young children,” he added.
A total of 581 children were hospitalized across the country for cannabis poisoning between January 2015 and September 2021, the study says. The vast majority of those incidents happened after legalization.
Cannabis poisoning means exposure to THC that leads to harmful effects. Those could include relatively mild ones, like severe impairment or loss of co-ordination, or more serious ones, like seizures or difficulty breathing.
In previous research, Dr. Myran studied the number of cannabis-related emergency room admissions in Ontario between the date of legalization and early 2020, when the provincial government removed a cap on the number of private cannabis stores allowed in the province and eliminated pre-qualification requirements for prospective cannabis retailers.
While Ontario’s strict retail controls were in place, the researchers found, admissions did not increase significantly, compared to pre-legalization levels. But the rates rose when the cap on the number of stores was lifted.
“When you create new products and allow lots of retail stores, a lot of promotion and industry expansion, you start running into these health impacts,” Dr. Myran said. “I think you see this similarly with other types of substances, like alcohol and tobacco. You run a serious risk when you allow the commercialization of these products.”
He cautioned that it is unclear whether the pandemic had an impact on the numbers in his studies.
Among the changes the cannabis industry is hoping the federal government will implement during the Cannabis Act review are reforms to the country’s severe restrictions on the way cannabis products can be advertised. The industry argues it needs more options to connect with its customers.
“Our ability to talk about our products is very limited. So it’s very difficult for the licence holders to create kind of a brand connection to the consumer,” said George Smitherman, president of the Cannabis Council of Canada, which represents Canada’s licensed producers and processors of cannabis.
Mr. Smitherman also criticized the “serious limitations in product formats,” especially the government’s requirement that each package of cannabis edibles contain no more than 10 milligrams of THC, which he called a very low dose for a regular consumer of those products.
“This is where we say to the government: We can’t offer the consumer the product that they are looking for, so they’re getting it from the illicit market,” he said.
Mr. Smitherman, who is a former Ontario health minister, said it is those illegal products that are responsible for the increase in emergency room visits.
Other industry demands include stronger action against the black market for cannabis. The Cannabis Council is also calling for tax cuts. The federal excise tax on cannabis has remained $1 per gram, even as retail cannabis prices have drastically dropped.
David Hammond, a professor at the School of Public Health Sciences at the University of Waterloo, who was not involved in the study, said the federal limits on potency and advertising are working in the interest of consumers.
“When you have a commercial industry, it’s in their interest to promote their products,” he said. “And we have a century of evidence from tobacco and alcohol that those industries promote their products. And promotion above all increases use among young people.”
The public needs better information about the health impacts of cannabis, so consumers can make the best choices for themselves, Prof. Hammond said.
“Most Canadian consumers are quite illiterate when it comes to things like THC.”
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