CMAJ
May 29, 2017
vol. 189
no. 21
doi:
10.1503/cmaj.170555
- Editorial
Cannabis legislation fails to protect Canada’s youth
With tabling of Bill C-45, the federal
government has moved one step closer to fulfilling its election promise
to legalize
the use of cannabis in Canada, despite concerns over
the many health risks associated with its use. The purported purpose
of the act is to protect public health and safety,1 yet some of the act’s provisions appear starkly at odds with this objective, particularly for Canada’s youth.
Simply put, cannabis should not be used by young people. It is toxic to their cortical neuronal networks, with both functional
and structural changes seen in the brains of youth who use cannabis regularly.2 The Centre for Addiction and Mental Health has stated unequivocally that “cannabis is not a benign substance and its health
harms increase with intensity of use.”3
Although adults are also susceptible to the harmful effects of
cannabis, the developing brain is especially sensitive. The
Canadian Paediatric Society cautions that marijuana
use in youth is strongly linked to “cannabis dependence and other
substance
use disorders; the initiation and maintenance of
tobacco smoking; an increased presence of mental illness, including
depression,
anxiety and psychosis; impaired neurological
development and cognitive decline; and diminished school performance and
lifetime
achievement.”2 The lifetime risk of dependence on marijuana is about 9%; however, this increases to almost 17% in those who start using
as teenagers.4
Bill C-45 draws on the work of the federal Task Force on Cannabis Legalization and Regulation that recommended taking a public
health approach to the regulation of cannabis to minimize associated harms.5 Yet, in the bill, the federal government has set the national minimum age for purchase of marijuana at 18 years with no limits
on potency and allows for personal cultivation of cannabis for nonmedical purposes.1 Failure to set national standards for distribution also opens the door to substantial variation in ease of access.
Drawing on current evidence that suggests
that the human brain appears to mature until about age 25 years, the
Canadian Medical
Association (CMA), in its response to the federal task
force report, recommended that the minimum age of purchase and
consumption
be set at 21 years.4 Along with others, the CMA also called for restricting cannabis quantities and potency for those under the age of 25 years,
because higher potency increases the risk of adverse effects.2–4 These pragmatic recommendations balance protection of the developing brain with the hope of reducing use of illicit cannabis
among youth.
The federal government has stepped back from setting national standards for retail distribution systems.1
Because provinces and territories are mandated to set their own
regulations, ease of access to cannabis will likely differ
across the country and include various combinations of
mail order, online sales, storefront shops, liquor stores and other
modes of access. These differences will complicate
enforcement, particularly at jurisdictional borders, and may contribute
to diversion. And it is naive to think that organized
crime will not be involved in the legal production and distribution
of cannabis with the passing of Bill C-45, because it
is already implicated in the medical marijuana industry.6
Bill C-45 allows for personal cultivation of up to four marijuana plants, each no more than 1 m in height.1
Because marijuana plants can grow to a height of 6 m, the height
restriction will substantially reduce each plant’s yield
(although shorter cultivars are sure to be in the
offing). However, allowing personal cultivation will increase the risk
of
diversion and access to cannabis that is not subject
to any quality or potency controls.6 This is not consistent with the act’s goals of establishing strict safety and quality requirements for cannabis and restricting
its access to youth.1 In addition, allowing personal cultivation places pressure on law enforcement officials in interpreting and enforcing these
regulations.6
Most of us know a young person whose life was
derailed because of marijuana use. Bill C-45 is unlikely to prevent
such tragedies
from occurring — and, conversely, may make them more
frequent. Although an accompanying bill lays out stronger penalties for
impaired driving and proposed limits for blood levels
of tetrahydrocannabinol in drivers, there is grave concern that
legalization
of marijuana will result in a substantial increase in
impaired driving, particularly among young people and in conjunction
with alcohol use.6
The government appears to be hastening to
deliver on a campaign promise without being careful enough about the
health impacts
of policy. It’s not good enough to say that provinces
and territories can set more stringent rules if they wish. If Parliament
truly cares about the public health and safety of
Canadians, especially our youth, this bill will not pass.
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