News

Mental Health and Legal Cannabis in Canada

October 17, 2018

As of today, the recreational use of cannabis is now legal in Canada. Canada joins Uruguay, the first country to have legalized cannabis, and several U.S. states in taking a public health approach to managing cannabis production and use. In legalizing cannabis, the Government of Canada is taking a bold step in ending the criminalization of people who use cannabis, in addition to lessening the burden on the courts, blunting the impact of organized crime, and improving the health of Canadians by regulating and enhancing the quality and safety of the cannabis products they are consuming.

After alcohol, cannabis is the most widely used psychoactive substance in Canada.[1] It is consumed by Canadians for a variety reasons: medical purposes, pleasure, relaxation, experimentation, and stress management. Under the new Cannabis Act, adults 18 and older (or 19 in most provinces and territories) are permitted to possess up to 30 grams of legal cannabis bought from a provincially-licensed retailer, grow up to four cannabis plants for personal use, and make cannabis products at home.[2] In addition to these federal regulations, individual provinces and territories have set further regulations regarding its purchase and consumption that are specific to each jurisdiction.

Although cannabis is now a legally regulated substance, its use still comes with risks. Like alcohol or tobacco, the use of cannabis engenders potential short and long-term health consequences. Cannabis use may cause acute psychotic symptoms and cognitive impairment similar to schizophrenia;[3] it can increase the risk of accidents and injuries and is thought to be linked to reproductive and respiratory problems.[4] For youth in particular, the risks for negative health consequences may be higher due to the potential for harm that cannabis use can have on the developing brain.[5] Furthermore, people who become heavy cannabis consumers may develop substance dependence, mental health problems, and/or a cannabis use disorder (CUD).[6]

It is important to note that the legalization of recreational cannabis has not changed the current regime for medical cannabis access. In Canada, cannabis has been approved for medical use since 2001, which means that physicians can prescribe medical cannabis for any condition they believe it will aid.[7] Some patients with chronic illnesses such as epilepsy, cancer, and chronic pain have found cannabis to be a beneficial medication for treating their symptoms.[8] However, the stigma associated with cannabis use and concerns surrounding its safety and efficacy continue to prevent many physicians from prescribing cannabis to patients who may potentially benefit from its use.[9]

At this time, there is not enough conclusive research on the harms and possible benefits of cannabis for both physical and mental health.[10] Given the uncertainties of cannabis use on health, CMHA hopes to see greater investments in research to establish more conclusive evidence on the harms and benefits of cannabis consumption over the life course and its impact on mental health for Canadians.

As recommended by Health Canada, Canadians should speak with a medical or public health professional if they are interested in more information on cannabis use and how it can affect their health.[11] For those who choose to use cannabis recreationally, we recommend consulting Canada’s Lower-risk Cannabis Use Guidelines (LRCUG), which offer recommendations for reducing the harms associated with the consumption of cannabis.[12]

CMHA commends the Government of Canada for being a leader on the international stage by taking a public health approach to manage cannabis use. The Government announced last year that it would invest $46 million in cannabis public education and awareness activities for Canadians, with targeted prevention efforts for youth. As there is a possibility that legalization may lead to a higher number of Canadians experiencing problematic cannabis use, we strongly recommend that the government also invest in treatment. Investments in treatment can be supported by an intelligently designed revenue plan that dedicates a significant percentage of revenue from cannabis or cannabis-related sales to public awareness campaigns, community resources, and research that support cannabis consumers experiencing mental health or substance use problems. With legalization, safeguarding the health and well-being of Canadians is paramount.

 

[1] “Canadian Alcohol and Drug Use Monitoring Survey: Summary Results for 2012,” Government of Canada, April 8, 2014, https://www.canada.ca/en/health-canada/services/health-concerns/drug-prevention-treatment/drug-alcohol-use-statistics/canadian-alcohol-drug-use-monitoring-survey-summary-results-2012.html.

[2] “Cannabis Legalization and Regulation,” Government of Canada, October 11, 2018, http://www.justice.gc.ca/eng/cj-jp/cannabis/.

[3] Hall, Wayne, “What has research over the past two decades revealed about the adverse health effects of recreational cannabis use?” Addiction 110 (2015): 30.

[4] Fischer, Benedikt, Cayley Russell., Pamela Sabioni, Wim van den Brink, Bernard Le Foll, Wayne Hall., Jürgen Rehm and Robin Room, 10 Ways to Reduce Risks to Your Health When Using Cannabis: Canada’s Lower-Risk Cannabis Use Guidelines (LRCUG), 2018, https://www.camh.ca/-/media/files/pdfs—reports-and-books—research/canadas-lower-risk-guidelines-cannabis-pdf.pdf.

[5] Crépault, Jean‐François, Cannabis Policy Framework (Toronto, ON: Centre for Addiction and Mental Health, 2014), 5.

[6] Le Foll, Bernard. “Is Cannabis Addictive?” In The Effects of Cannabis Use During Adolescence, edited by Tony George and Franco Vaccaroni, 48-61, Ottawa, ON: Canadian Centre on Substance Abuse, 2015.

[7] Samoilov, Lucy and Claire P. Browne, “The Role of Medical Cannabis in the Opioid Crisis,” University of Western Ontario Medical Journal 87.1 (2018): 38.

[8] Kalant, Harold and Amy J. Porath-Waller, Clearing the Smoke on Cannabis: Medical Use of Cannabis and Cannabinoids—An Update (Ottawa, ON: Canadian Centre on Substance Abuse, 2016), 1-20.

[9] Juurlink, David N., “Medicinal Cannabis: Time to Lighten Up?” CMAJ 186.12 (2014): 897.

[10] Beirness, Douglas J., Harold Kalant, Opal A. McInnis, Darryl Plecas, and Amy J. Porath-Waller, Clearing the Smoke on Cannabis: Highlights – An Update (Ottawa, ON: Canadian Centre on Substance Abuse, 2016), 5; Couskin, Janna, Adrián E. Núñez, and Francesca M. Filbey, “Time to Acknowledge the Mixed Effects of Cannabis on Health: A Summary and Critical Review of the NASEM 2017 Report on the Health Effects of Cannabis and Cannabinoids,” Addiction 113.5 (2018).

[11] Government of Canada, Does Cannabis Use Increase the Risk of Developing Psychosis or Schizophrenia? Cannabis Resource Series (Ottawa, On: Minister of Health, 2018).

[12] Fischer, Benedikt, Cayley Russell., Pamela Sabioni, Wim van den Brink, Bernard Le Foll, Wayne Hall., Jürgen Rehm and Robin Room, “Lower-Risk Cannabis Use Guidelines (LRCUG): An evidence-based update,” American Journal of Public Health 107.8 (2017).

Canadian Mental Health Association calls for new legislation to bring mental health into balance with physical health.

EDMONTON (ALBERTA) September 17, 2018 – Over half of Canadians (53%) consider anxiety and depression to be ‘epidemic’ in Canada, with that perception spiking amongst younger people, according to a new survey commissioned by the Canadian Mental Health Association (CMHA).

Fifty-nine per cent of 18 to 34-year-olds consider anxiety and depression to be ‘epidemic’ in Canada, followed closely by addiction (56%) and ahead of physical illnesses such as cancer (50%), heart disease and stroke (34%), diabetes (31%) and HIV/AIDS (13%). The survey accompanies a national CMHA policy paper, Mental Health in the Balance: Ending the Health Care Disparity in Canada, released today, which calls for new legislation to address unmet mental health needs and bring mental health care into balance with physical health care.

“Our universal health-care system is a point of pride for Canadians,” says Dr. Patrick Smith, national CEO, CMHA. “But the reality is, we don’t have a universal health-care system, but a universal medical system that doesn’t guarantee access to some of the most basic mental health services and supports.”

Eighty-five per cent of Canadians say mental health services are among the most underfunded services in our health-care system — and the majority (86%) agree that the Government of Canada should fund mental health at the same level as physical health.

Despite recent unprecedented mental health funding commitments made by the federal government, over 1.6 million Canadians report unmet mental health care needs each year. Worldwide, mental illness accounts for about 23 per cent of the total disease burden, yet Canada dedicates only 7.2 per cent of its health-care budget to mental health. And, the need for mental health services and supports is growing. By 2020, depression will be the leading cause of disease in Canada.

“The Mental Health Parity Act we are advocating for is not just about increasing funding for mental health services, but also improving coordination, treatment, research and access and making better choices about how best to spend health-care dollars effectively,” says Dr. Smith.

Lengthy wait times are a problem, in part, because there has been a chronic underfunding of community-based mental health services and a reliance on intensive, high-cost services like psychiatrists and hospitals.

Up to 80 per cent of Canadians rely on their family physicians to meet their mental health care needs, but those services are limited. Evidence-based health care provided by addiction counselors, psychologists, social workers and specialized peer support workers is the foundation of the mental health response in other G7 countries, but these services are not guaranteed through our public system. Consequently, Canadians spend almost a billion dollars ($950 million) on counselling services each year—30 per cent of it out of pocket.

A more integrated continuum of care provided through community mental health services can meet the needs of as many people with mental health problems as possible by including early intervention and prevention, enhanced treatment for those who need it, and longer-term follow-up and supervision for those with severe and persistent illness.

In addition to improving quality of life and health outcomes, mental health promotion, mental illness prevention and early intervention can reduce the burden on our health-care system. A recent study on the treatment of depression estimated that every dollar spent on publicly funded psychological services would save two dollars for the health system.

To make sure that those who need services and supports get them, new legislation must also address stigma and discrimination—in the health-care system, amongst practitioners and at the individual level—and improve access for those who are marginalized. Investments in social spending would address the root causes of mental illness: poverty, trauma and marginalization. In return, we boost our most vulnerable citizens’ ability to contribute to their communities and lessen the burden of illness nationally.

The imbalance in research funding of mental health vis-à-vis physical health, should also be addressed. The Canadian Institutes of Health Research (CIHR), for instance, spends only 4.3 per cent of its annual research budget on mental health. Canada needs sustained research investment in mental health to spur innovation, better translate scientific knowledge into practice and develop therapies that are appropriate, effective and that promote treatment acceptance for people with mental illnesses.

“The system is ailing, but we have a treatment plan to nurture it back to health,” says Dr. Smith. “When we improve service and supports for the one in five Canadians who will experience mental illness in any given year, we will see benefits in health outcomes, quality of life and wellbeing for all Canadians—the five in five—who have mental health.”

Mental Health in the Balance — Ending the Healthcare Disparity in Canada FULL REPORT 

Mental Health in the Balance — Ending the Healthcare Disparity in Canada SUMMARY REPORT

About the survey

CMHA partnered with Maru/Matchbox to conduct an online survey from September 5-6, 2018 among a total of 1,510 randomly-selected Canadian adults aged 18+ who are members of Maru Voice Canada (formerly known as the Angus Reid Forum)—the premier Canadian online panel with many features that differentiate it from traditional online access panels. The margin of error, which measures sampling variability, is +/- 2.5%, 19 times out of 20. The results have been statistically weighted according to education, age, gender and region (and in Quebec, language) Census data to ensure a sample representative of the entire adult population of Canada. Discrepancies in or between totals are due to rounding.

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About the Canadian Mental Health Association

Founded in 1918, the Canadian Mental Health Association (CMHA) is the most established, most extensive community mental health organization in Canada. Through a presence in more than 330 communities across every province, CMHA provides advocacy, programs and resources that help to prevent mental health problems and illnesses, support recovery and resilience, and enable all Canadians to flourish and thrive. For more information, visit www.cmha.ca

The Canadian Mental Health Association, Alberta is made up of eight Regions, the Centre for Suicide Prevention (located in Calgary), and the Division (Provincial) office (located in Edmonton). CMHA Regional offices focus on the delivery of mental health recovery services, housing, advocacy and mental health promotion. CMHA’s Divisional office supports and promotes the work of CMHA across the province of Alberta for collective impact. The Division and Regions work cooperatively to advance the vision of mentally healthy people in a healthy society.

 For more information, or to arrange an interview with a regional/local spokesperson, please contact:

 

Primary Contact

David Grauwiler

Executive Director

Canadian Mental Health Association, Alberta Division

780.399.5228

executivedirector@cmha.ab.ca

 

Secondary Contact 

Jocelyn Wady

Communications Specialist

Canadian Mental Health Association, Alberta Division

780.975.1767

 

By the Canadian Mental Health Association’s Centre for Suicide Prevention

Today is September 10, World Suicide Prevention Day. This is the one day a year focused solely on awareness around the issue of suicide and its prevention. This year, we’re spreading the message that suicide can affect anyone, and anyone can prevent suicide; this year’s theme, as determined by the International Association for Suicide Prevention, is “Working together to prevent suicide” — suicide prevention is everyone’s business.

Understanding suicidal crisis

People who think about and attempt suicide don’t want to die: they want a way out of their deep, psychological pain. They often describe feelings of being overwhelmed, stuck, and unable to see a way out. We work to prevent suicide because it can be prevented: we can shine the light in a person’s life to help them see that there is hope in living, that help is available and that they’re not alone.

To better understand the excruciating psychological pain a person in suicidal crisis may be experiencing, here are some first-hand accounts:

 “I didn’t want to be here anymore, I thought it would be better somewhere else. Unless you’ve been in the moment where you can feel that absolute darkness, hopelessness, pain… it has nothing to do with anyone else, it’s just wanting to like remove myself from a situation and stop that pain.”

“I was stuck. Yeah, that overwhelming feeling was just, I hate it, I hated my life, I hated everything about it and I wanted to go die and I wanted to get rid of it… I just wanted to take it out on someone but the only person I was okay taking that out on was me.”

“I felt completely different and disconnected. And I know what it felt like because I knew what it was like to be emotionally and spiritually connected before, so the contrast was so painful. It felt like a broken leg, but it didn’t stop after an hour it kept going and going.”

Stigma remains the greatest barrier

Before you can reach out, you have to examine your own attitude toward suicide. Stigma remains the greatest barrier to suicide prevention, and if you believe that suicide can’t be prevented, then you won’t be able to help someone at risk. Ask yourself:

• Do you believe suicide can be prevented?
• Do you think that, with adequate knowledge and active listening skills, you could help someone at risk?
• Do you think that anyone could theoretically get to the point of considering suicide or do you think that only people with certain characteristics and traits would consider suicide?

If you answered “no” to any of the above questions, you may want to learn more about suicide and suicide prevention.

Learn the warning signs

We all can learn the warning signs of suicide. Any significant change in behaviour is a warning sign for suicide, and this includes things like:

• Change in mood, from happy to sad or even from sad to happy, and anything in-between
• Increase in drinking alcohol or taking drugs
• Change in outlook on life, for example, if someone talks about feeling hopeless and being a burden
• Talk about suicide and having a plan of action is a major warning sign – contact 9-1-1 if you’re seeing these signs

If you see that someone in your life is exhibiting these warning signs, reach out and talk to them. You can start the conversation that could save their life.

Suicide can be prevented

A person who is at the point of suicidal crisis has typically lost all hope and sees no other alternative to their deep, psychological pain than to end their life. When someone reaches out to a person thinking about suicide, the person sees that people do care about them, and that their life does matter.

Studies have found that 90% of people who were in the process of acting on their plan to die by suicide but were stopped before attempting – either by a passerby, security staff, or police – did not go on to attempt suicide again (Seiden, 1978).

People who think about suicide are desperate for human connection. One man who died by suicide on the Golden Gate Bridge in San Francisco wrote in his suicide note: “If one person smiles at me, I will not jump” (Friend, 2003, p.6).

Ask and listen

With this in mind, your role is to help the person at risk gain back the perspective that they’ve lost, by helping them identify what they have to live for. While this may seem simplistic, its effects are powerful.

Asking someone about suicide, listening to their response, and helping them see the hope in their lives is an extremely effective form of suicide prevention.

 

If you are in crisis, call 1-833-456-4566 or visit crisisservicescanada.ca. First Nations people and Inuit can also call 1-855-242-3310 or chat at hopeforwellness.ca.

To learn more about suicide prevention, visit Centre for Suicide Prevention at www.suicideinfo.ca.

 

References

Brown, S. & Stanley, B. (2012). Safety Planning Intervention: A brief intervention to mitigate suicide risk. Cognitive and Behavioral Practice, 19(2), 256-264.

Friend, T. (2003). Jumpers: The fatal grandeur of the Golden Gate Bridge. New Yorker. Retrieved from https://www.newyorker.com/magazine/2003/10/13/jumpers

Seiden, R. (1978). Where are they now? A follow-up study of suicide attempters from the Golden Gate Bridge. Suicide and Life-Threatening Behavior, 8(4), 203-216.

Xie, H. (2013). Strengths-based approach for mental health recovery. Iranian Journal of Psychiatry and Behavioral Science, 7(2), 5-

The tragedy of overdose is preventable

The Canadian Mental Health Association joins people and organizations around the world to mark International Overdose Awareness Day, a global event held each year on August 31^st.

The purpose of the day is to raise awareness of overdose and reduce the stigma of a drug-related death. It also acknowledges the grief felt by families and friends remembering those who have died or been harmed due to drug overdose.

Overdose happens when a person takes one or more drugs in a quantity or combination that exceeds what their body can handle. The word “overdose” usually brings to mind typical street drugs, but it can happen with many different types of drugs, from alcohol to opioids. And nobody is immune: overdose occurs in all segments of the Canadian population, including those who take prescription drugs and those who use drugs recreationally.

While Canada is, unfortunately, facing a range of issues related to drug-related poisoning, we are grappling with a steep increase in the number of opioid-related deaths among certain populations, including those who use drugs alone, men, youth, seniors, First Nations and people in correctional facilities. Last year, Canada lost almost 4,000 people to opioid overdoses—many linked to toxic drug supplies, fentanyl and other synthetic opioids. Worldwide, almost 200,000 people die prematurely because of drugs every year—the majority due to opioids.

In most cases, such deaths are avoidable.

 Recognizing warning signs

Recognizing the signs and symptoms of overdose can help prevent death and injury.

For opioids and depressants, some warning signs include:

–          Unresponsiveness or unconsciousness

–          Passing out or a “slumped over” posture

–          Shallow or irregular breathing, or no breathing at all

–          Slowed heart-rate or absence of a pulse

–          Choking or gurgling sounds

–          Purple lips and fingernails

–          Clammy skin

–          Low body temperature

–          Vomiting

–          Seizures

–          Loss of coordination

For amphetamines or stimulants, some warning signs include:

–          Tremors and muscle twitches

–          Hot, flushed, or sweaty skin

–          Headaches

–          Chest pain

–          Difficulty breathing

–          Hostile or violent disposition

–          Uncontrolled movements or seizures

–          Panic, paranoia, or symptoms of psychosis

–          Confusion or disorientation

An overdose is a medical emergency that requires immediate medical attention. Always call an ambulance or 9-1-1 if you suspect someone has overdosed.

 Preventing overdose

While it can be scary or upsetting to think about overdose, the good news is that education and preparation can help prevent it from happening.

If you use drugs, whether prescribed or not, or know someone else who uses drugs, carry a naloxone kit with you to reverse the effect of an opioid poisoning. In Canada, kits are available through community pharmacies, health-care workers and community-based organizations, often at no cost.

Consuming drugs at overdose prevention sites and supervised consumption sites can also reduce the risk of overdose.

We also recommend not using drugs alone. The risk of fatal poisoning is higher for people who consume illegal substances alone at home, given that they lack a peer or support network to intervene with naloxone and call 9-1-1.

 Helping a loved one

Although people use drugs for many different reasons, substance use can be a sign of underlying mental health problems and addiction. Some people use drugs to cope with untreated mental illness, childhood trauma, family difficulties, pain and other stressors.

If you suspect someone close to you might have a substance use problem or may be at risk of an overdose, talk to them. Listen with openness and without judgement. It can be difficult to watch a loved one experience substance use problems, and it is frightening to consider the possibility of overdose; you may have fears about your loved one’s safety, or maybe even your own.

If your loved one is actively using drugs or is at risk of an overdose, encourage them to follow harm reduction practices and use harm reduction services.

If using prescribed medications to manage pain, encourage your loved one to talk to their doctor or health-care professional about alternative therapies.

If your loved one is open to seeking treatment, talk to them or encourage them to speak to their physician or another health-care professional about their treatment options.

Many people are better able to recover when they have the support and encouragement of friends, family and peers. Listening, encouraging good communication and healthy habits, being patient, and helping to instill a sense of hope for recovery can help support a loved one.

 Learn more

To learn more about the opioid crisis in Canada and how to prevent overdose, please:

–          Contact your local CMHA to find support and resources in your area.

–          Read the recent CMHA policy paper, Care not Corrections: Relieving the Opioid Crisis in Canada.

–          Download the CMHA Ontario opioid overdose toolkit, Reducing Harm: Recognizing and Responding to Opioid Overdoses in Your  Organization.

Show your support

Join the 86 CMHA branches, regions and divisions across Canada on social media today to support those undergoing the grief of overdose and its effects. Send a message that every person’s life is valuable and that stigmatizing those who use drugs needs to stop.

#EndOverdose #CareNotCorrections #CMHA100

Registration is now LIVE for the 2018 workplace mental health conference

On September 17-18, the Canadian Mental Health Association, Alberta Division is hosting a workplace conference designed to improve mental health outcomes in Alberta workplaces. The conference is two days of networking, information exchange and dialogue that will advance efforts to support healthier workplaces across the province.

WORKING STRONGER brings together creative and inspiring mental health thinkers and leaders to share collective wisdom through keynote speakers, workshops, panels, presentations, training opportunities, and exhibits.

If you want to become a champion for workplace mental health in Alberta, this conference is for YOU! Find full conference details HERE.

Register before July 31 — $500
Register after July 31 — $600

 

If you have any questions, please contact Sherry Sim / sherry@innovative4you.com