Cannabis edibles present novel health risks

With the recent legalization of cannabis edibles in Canada, physicians and the public must be aware of the novel risks of cannabis edibles, argue authors in a commentary in CMAJ (Canadian Medical Association Journal).

"Although edibles are commonly viewed as a safer and more desirable alternative to smoked or vaped cannabis, physicians and the public should be aware of several risks related to the use of cannabis edibles," write Drs. Jasleen Grewal and Lawrence Loh from the University of Toronto, Toronto, Ontario.

Cannabis edibles take on average four hours longer to produce noticeable effects in comparison to inhaled cannabis, which can increase the risk of overconsumption. With effects lasting up to 8 hours, edibles can also lead to a longer period of impairment compared to inhaled cannabis. While federal regulations have standardized the presentation of dosing information, the authors warn that "individuals' responses to different products may vary and overdosing may still occur, with cannabis-naive individuals particularly at risk."

At particular risk are children and pets as many edibles look like candy and other appetizing food and drink. Other vulnerable groups include older people and youth; of note, a recent Canadian report found that youth believe cannabis edibles have positive effects on sleep, mood and anxiety, which actually runs counter to what is seen in evidence.

"Physicians should routinely question patients who ask about cannabis about their use or intended use of edible cannabis products so that they can counsel these patients regarding child safety, potential for accidental overconsumption and delayed effects, and potential for interactions with other substances such as alcohol, benzodiazepines, sleeping aids and opioids," caution the authors.

Population-level monitoring, and evaluation of the effects of legalized edibles will ensure that regulations are best able to protect children, youth, seniors and other age groups from health effects related to the consumption of cannabis edibles.

"Health considerations of the legalization of cannabis edibles" is published January 6, 2020.