NORMALIZING CONVERSATION, NOT CONSUMPTION › Student_Support › Safe_Caring › SACY_Subst… ·...
Transcript of NORMALIZING CONVERSATION, NOT CONSUMPTION › Student_Support › Safe_Caring › SACY_Subst… ·...
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
NORMALIZING CONVERSATION, NOT CONSUMPTION
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 2
WELCOME
WewouldliketobeginbyacknowledgingthatthelandonwhichwegatheristheuncededterritoryoftheCoastSalishpeoples,includingtheterritoriesofthexʷməθkwəy̓əm(Musqueam),Skwxwú7mesh(Squamish),Stó:lōandSəl Mí
lwətaʔ/Selilwitulh(Tsleil-Waututh)Nations
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 3
OPENING AND INTRODUCTIONS
A PUBLIC HEALTH APPROACH TO CANNABIS
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
A COMMUNITY RESPONSE TO CANNABIS
CLOSING AND NEXT STEPS
TODAY
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2
3
4
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION
PARTICIPANT ROUNDTABLECONSULTATION OBJECTIVES
CONSULTATION GROUND RULES
OPENING AND INTRODUCTIONS
1
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 5
OPENING AND INTRODUCTIONS
Whatisyournameandroleinyourorganization?
Whatconnectsyoutothetopicofcannabisuse?
PARTICIPANT ROUNDTABLE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 6
OPENING AND INTRODUCTIONS
Today’sconsultationisdesignedtomeetthefollowingobjectives:1) Reflectonpersonalthoughtsrelatedtocannabislegalizationand
cannabisuse2) Discusscurrentevidencebaserelatedtocannabisandadesired
publichealthapproach3) Discusscurrentanddesiredapproachtocannabismonitoring
andsurveillanceinthecommunity4) Considerhowhealthandsocialserviceproviderscanrespondto
cannabisusetodayandhowlegalizationmayimpacthowserviceproviderscanrespondtocannabisuseinthecommunityinthefuture
CONSULTATION OBJECTIVES
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 7
OPENING AND INTRODUCTIONS
Today’ssessionisdesignedtoenabledialoguebetweenhealthandsocialserviceproviderswithdiverseprofessionsandbackgrounds:1) Ifyouwouldfeelmorecomfortableatanothertable,
pleasefeelfreetorelocatewithdiscretion2) Ifthereisaconflictatthetablethatyouwouldlikehelp
resolving,orisaffectingyourabilitytoparticipatefully,pleasefeelfreetospeakprivatelywithanyoftheCPHAorconsultationteam
CONSULTATION GROUND RULES
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION
CPHA PROJECT CANNABIS PRIMER
CANNABIS USE DEMOGRAPHICSRESEARCH EVIDENCE
HEALTH PROMOTION & HARM REDUCTION
A PUBLIC HEALTH APPROACH TO CANNABIS
2
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 9
CPHA PROJECT
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TheVoiceofPublicHealth
10OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
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TheVoiceofPublicHealth
11OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
TheGovernmentofCanadahasannouncedthatitwillintroducelegislationtolegalizeandregulatecannabis
Thegrowingacceptance,accessibility,anduseofcannabisraiseimportantpublichealthconcerns
TheCanadianPublicHealthAssociationismobilizingapublichealthapproachtocannabislegalization
CPHA PROJECT
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12OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
ShouldtheproposedCannabisActactcomeintolawinJuly2018,eachprovinceandterritorywillbelefttomaketheirownchoicesonseveralkeyitems,forexample:Age: minimumageof18yrs (discretiontoincrease)
Personal cultivation: numberofpersonalplants(4)(furtherrestrictionscanbeapplied)
Consumption: whereandhowcannabismaybeconsumed(restrictionsandrequirementstobesetlocally)
CPHA PROJECT
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TheVoiceofPublicHealth
13OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
CurrentBills(FirstReadings,April13,2017):BILL C-45: AnActrespectingcannabisandtoamendtheControlledDrugsandSubstancesAct,theCriminalCodeandotherActs
BILL C-46 - Impaired driving as it relates to substances including cannabis: AnActtoamendtheCriminalCode(offencesrelatingtoconveyances)andtomakeconsequentialamendmentstootherActs
CPHA PROJECT
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 14
A PUBLIC HEALTH APPROACH TO CANNABIS
Thegoalforthisprojectistoimprovethecapacityofthehealthandsocialservicesectortorespondtocannabisuse(andothersubstances)incommunitiesacrossCanadausingapublichealthapproach
Theaimisto‘normalizeconversation,notconsumption’
CPHA PROJECT
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 15
A PUBLIC HEALTH APPROACH TO CANNABIS
Toassesstheneedsofhealthandsocialserviceprovidersandinformthedesignofcapacitybuildingresources,theprojectismobilizingthefollowing:1) Ongoingenvironmentalscanning2) Keyinformantinterviews3) Communityconsultations4) An‘ExpertReferenceGroup’
CPHA PROJECT
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 16
A PUBLIC HEALTH APPROACH TO CANNABIS
CPHA project team: keyinformantinterviewsandongoingenvironmentalscanningtoinformandcreatecapacitybuildingresourcesGestalt Collective (GC): contentcreation,design,facilitationandreportingforcommunityconsultationsandExpertReferenceGroupengagementsSocial Research and Demonstration Corporation (SRDC): projectevaluationthoughdatacollectionacrossallofthecommunitiesconsultedandtheExpertReferenceGroup
CPHA PROJECT
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TheVoiceofPublicHealth
17OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
This is a pivotal time in the world of cannabis policy and research. Shifting public sentiment, conflicting and impeded
scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the
use of cannabis or its derivatives.
NationalAcademiesofSciences,Engineering,andMedicine.2017.TheHealthEffectsofCannabisandCannabinoids:TheCurrentStateofEvidenceandRecommendationsforResearch.Washington,DC:TheNationalAcademiesPress.
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 18
A PUBLIC HEALTH APPROACH TO CANNABIS
Theprojectendeavourstomobilizethehealthandsocialserviceprovidercommunitytotakeapublichealthapproachtocannabis,that:• emphasizesevidence-informed,pragmaticinitiatives• takesintoconsiderationsocialjustice,equity,respectfor
humanrights,efficiency,andsustainability• recognizesthatproblematicsubstanceuseisoften
symptomaticofunderlyingpsychological,social,orhealthissuesandinequities
CPHA PROJECT
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 19
A PUBLIC HEALTH APPROACH TO CANNABIS
CPHA PROJECT
CANNABIS USE/ CONSUMPTION
AUTHORIZED FOR MEDICINAL
PURPOSESRETAIL
PERSONAL GROWINGILLEGAL
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 20
CANNABIS PRIMER
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21OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
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22OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
Cannabisisaplantthathasmanyderivativesincludingmarijuana,hash,hemp,andmanymore
Thetwomainactiveingredientsincannabisare:
• THC (delta-9 tetrahydro-cannabinol or d-9-TCH): thepartoftheplantthatgivesthe"high”
• CBD (cannabidiol): analgesic,anti-inflammatory,andanti-anxietypropertieswithoutthepsychoactiveeffects(the“high”)thatTHCprovides
Themostcommonformsofcannabisareconcentrates,ediblesandflower
CANNABIS PRIMER
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TheVoiceofPublicHealth
23OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
Flower:Onceafemalecannabisplanthasmatured,growerstrimtheflowerstoproducewhatarereferredtoasbudsThebudsarecoatedwithacrystal-likeresincalledtrichomes andarerichwithTHCandCBDTherearetwostrainsofflower– sativaandindica – andhybrids,whichareacombinationofthetwostrains
CANNABIS PRIMER
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24OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
Concentrates:Procuredduringanextractionprocesswherethecannabisplants’cannabinoidsandterpenesareseparatedfromtheplantmatterresultinginaconcentratethatispackedfullofcannabinoids(morepotentthanflower)Cannabisconcentratesarecategorizedaseithersolventornon-solventbased(referstotheextractionprocess)• Solvent concentrates areextracted(mostcommonly)usingbutane,CO2,alcoholorethanoltoproduceshatter,wax,hashoil,tincturesandmore
• Non-solvent concentrates areextractednaturallytoproduce(mostcommonly)icewater,hashandkief
CANNABIS PRIMER
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TheVoiceofPublicHealth
25OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
Edibles:
Anyfoodorbeveragethatcontainscannabis,whetherornotthecannabinoidsarebioavailable
Mostoften,ediblesareinfusedusingingredientshighinfatlikebutteroroliveoilthatenableextractionoftheplant’sproperties
CANNABIS PRIMER
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 26
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TheVoiceofPublicHealth
27OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
Therearethreebasiccannabisdeliverymethods,eachwithavarietyoftechniquesusingdifferentformsofcannabisandhardwareortoolstofacilitateconsumption:1) Inhalation2) OralorIngestion3) Topical
CANNABIS PRIMER
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28OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
WATER PIPE
HAND PIPE
HOOKAH
ROLLING PAPERS
VAPORIZER
G-PEN
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 29
A PUBLIC HEALTH APPROACH TO CANNABIS
InhalationDeliveryMethods• Mostcommonwaypeopleusecannabiswithmanystrains
andproductstochoosefrom(e.g.cannabisflowers,concentratesandoils)
• THCandothercannabiscompoundsareabsorbedintothesystemthroughinhalingvaporizedorcombustedcannabisintothelungs
• Onsetofeffectsisrapidwithmostpeoplefeeling“high”within5-10minutesofinhalation
• Straingeneticsandpersonalbodychemistrymakethisuniqueforeveryone
CANNABIS PRIMER
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TheVoiceofPublicHealth
30OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
CHOCOLATE
CANDIES
HARD CANDY
SODA
TINCTURE
OIL
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 31
A PUBLIC HEALTH APPROACH TO CANNABIS
Oral/IngestionDeliveryMethods• Ingestibleproductsincludecannabis-infusedediblesand
beverages• Duringconsumptionofcannabisproducts,cannabinoidsare
absorbedthroughthedigestivetractandmetabolizedbytheliver• Duetocannabinoidsandothercompoundsneedingtobebroken
downinthedigestivesystem,onsetofeffectscantakeupto2hours(muchlongerthaninhalation)
• Therearemanyfactorsthatcanaffecttheexperiencewithediblesincludingwhethersomeonehaseatenrecently,howmuch,comfortlevelwithcannabisandthepotencyoftheproductingested
CANNABIS PRIMER
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 32
A PUBLIC HEALTH APPROACH TO CANNABIS
OralDeliveryMethods• Thefastestandmosteffectivemethodofmedicatingis
oral-mucosal,administeredunderthetongueandintotheliningofthemouth
• Absorbedintothebodyversusswallowedanddigested• Cannabistincturesarethemostcommonproductstouse
oral-mucosaldelivery• Duetotherapidonsetofeffects,thisisthepreferred
deliverymethodformanyseriousmedicalconditionslikeepilepsyandnervoussystemdisorders
CANNABIS PRIMER
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 33
A PUBLIC HEALTH APPROACH TO CANNABIS
• Oral/IngestionDeliveryMethods• C-45doesnotallowforfood-basedordrink-basededibles
tobemarketedandsold• Tinctures(takenorallyorsublingually)willbeallowedand
arecurrentlybeingsold
CANNABIS PRIMER
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34OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
SALVE
BODY CREAM
HARD CANDY
BATH SOAK PLEASURE OIL
CREAM SHAMPOO
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 35
A PUBLIC HEALTH APPROACH TO CANNABIS
TopicalDeliveryMethods• Commontopicalproductsincludebalms,oils,rubs,salves
andcreams• Topicalcannabisproductsareappliedandabsorbed
throughtheskin• Theeffectsofthecannabinoidsandothercompoundsare
localizedandcannotenterthebloodstreamsothereisno“high”fromtheseproducts
• Topicalproductscanofferrelieffrompain,inflammationandskinconditionslikeeczema
CANNABIS PRIMER
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 36
CANNABIS USE DEMOGRAPHICS
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 37
A PUBLIC HEALTH APPROACH TO CANNABIS
CANNABIS USE DEMOGRAPHICS
43%PercentageofCanadians(15+)thatreportusingcannabisinlifetime
12.2%PercentageofCanadians(15+)thatreportusingcannabisinpastyear
1.8%PercentageofCanadians(15+)thatreportusingcannabisdaily
3.2%PercentageofCanadians(15+)thatreportusingcannabisatleastweekly
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 38
A PUBLIC HEALTH APPROACH TO CANNABIS
CANNABIS USE DEMOGRAPHICS
8.3%
16.1%PercentageofmaleCanadians(15+)thatreportusingcannabisinpastyear
PercentageoffemaleCanadians(15+)thatreportusingcannabisinpastyear
Inallagegroupsexcept15to17,malesweremorelikelythanfemalestoreportpast-yearuse.
2.4%PercentageofmaleCanadians(15+)thatreportusingcannabisdaily
1.2%PercentageoffemaleCanadians(15+)thatreportusingcannabisdaily
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 39
A PUBLIC HEALTH APPROACH TO CANNABIS
CANNABIS USE DEMOGRAPHICS
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 40
14.2%
A PUBLIC HEALTH APPROACH TO CANNABIS
CANNABIS USE DEMOGRAPHICS
PercentageofBCadults(15+)thatreportusingcannabisinlifetime
10.5%
18.0%
PercentageofBCadults(15+)thatreportusingcannabisinpastyear
PercentageofmaleBCadults(15+)thatreportusingcannabisinpastyear
PercentageoffemaleBCadults(15+)thatreportusingcannabisinpastyear
46.2%
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 41
A PUBLIC HEALTH APPROACH TO CANNABIS
• BCYouths(15– 24):• 28% of BC youths have used cannabis in the past year• 30.8% of males and 25% females used in the past year• 11% reported cannabis abuse or dependence at any
point in their lives
CANNABIS USE DEMOGRAPHICS
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 42
A PUBLIC HEALTH APPROACH TO CANNABIS
• VancouverYouths(Grades9-12,2013):• 17% of youth had tried cannabis (2013), down from 24%
in 2003• 49% were 15 or older the first time they used cannabis
(up from 34% in 2003)• 54% of those who had tried cannabis had used it in the
past month (2013)• 9% had driven after using cannabis
CANNABIS USE DEMOGRAPHICS
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 43
A PUBLIC HEALTH APPROACH TO CANNABIS
Cannabisdependenceischaracterizedbyarecurrentpatternofusewhereatleastthreeofthefollowingoccurina12monthperiod:
CANNABIS USE DEMOGRAPHICS
• Increasedtolerance• Withdrawal• Increasedconsumption• Unsuccessfulattemptstoquit• Alotoftimelostrecoveringor
using• Reducedactivities• Continuedusedespite
persistentphysicalorpsychologicalproblemscauseorintensifiedbycannabisuse
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 44
A PUBLIC HEALTH APPROACH TO CANNABIS
Cannabisabuse*ischaracterizedbyarecurrentpatternofusewhereatleastoneofthefollowingoccurs:
CANNABIS USE DEMOGRAPHICS
• Failuretofulfillmajorrolesatwork,school,orhome• Useinphysicallyhazardoussituations• Recurrentcannabisrelatedproblems,orcontinuedusedespite
socialorinterpersonalproblemscausedorintensifiedbycannabisuse
*Bydefinition,thosewhomeetthecriteriaforcannabisdependenceareexcludedfrommeetingthecriteriaforcannabisuse
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TheVoiceofPublicHealth
45OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION
A PUBLIC HEALTH APPROACH TO CANNABIS
• InCanada,relativetootherdevelopedcountries,thereisahigherproportionofcannabisusersamongyouthaged15-25
• Youthwhoconsumeonaregularandheavybasisbeforeage15areatagreaterriskofnegativephysicalandmentalhealthoutcomes
• Therisk(negativephysicalandmentalhealthoutcomes)remainselevateduntilbrainmaturationatage25
• Delayingtheonsetofcannabisusehasbeenshowntoreducetheriskoffuturesubstancedependenceandotherassociatedchallenges
CANNABIS USE DEMOGRAPHICS
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46OCTOBER 2017|APUBLICHEALTHAPPROACHTOCANNABIS:COMMUNITYCONSULTATION 46
RESEARCH EVIDENCE
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 47
A PUBLIC HEALTH APPROACH TO CANNABIS
• Whilethereissomeevidencefortheassociationbetweencannabisuseandhealthrisksorharms,theevidenceisnotconclusiveandrangesfrommoderatetosubstantial
• Wedonotknowtheamountofcannabisneededtocausethesehealthortherapeuticeffects• For example, is it only for daily/heavy users?• If you stop using, do health or therapeutic effects
disappear?
RESEARCH EVIDENCE
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 48
A PUBLIC HEALTH APPROACH TO CANNABIS
Someoftheareaswherewehavemoderateevidencetosupportanassociationbetweencannabisuseandhealthrisksandharms:• Impairmentinthecognitivedomainsoflearning,memory,
andattention(acutecannabisuse)
• Asmallincreasedriskforthedevelopmentofdepressivedisorders
• Increasedincidenceofsocialanxietydisorder(regularcannabisuse)
RESEARCH EVIDENCE
TheHealthEffectsofCannabisandCannabinoids:Committee’sConclusions.January,2017.TheNationalAcademiesofSciences,Engineering,Medicine.Washington,DC
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 49
A PUBLIC HEALTH APPROACH TO CANNABIS
Someoftheareaswherewehavemoderateevidencetosupportanassociationbetweencannabisuseandhealthrisksandharms:• Increasedincidenceofsuicidalideationandsuicide
attemptswithahigherincidenceamongheavierusers
• Worseningofnegativesymptomsofschizophrenia(e.g.bluntedaffect)amongindividualswithpsychosis
• Increasedsymptomsofmaniaforthosewithbipolardisorder
RESEARCH EVIDENCE
TheHealthEffectsofCannabisandCannabinoids:Committee’sConclusions.January,2017.TheNationalAcademiesofSciences,Engineering,Medicine.Washington,DC
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 50
A PUBLIC HEALTH APPROACH TO CANNABIS
Someoftheareaswherewehavemoderateevidencetosupportanassociationbetweencannabisuseandhealthrisksandharms:• Increasedriskofoverdoseinjuries,includingrespiratory
distress,amongpediatricpopulationsinU.S.stateswherecannabisislegal
• Bettercognitiveperformanceforpeoplewithpsychoticdisordersandhistoryofuse
RESEARCH EVIDENCE
TheHealthEffectsofCannabisandCannabinoids:Committee’sConclusions.January,2017.TheNationalAcademiesofSciences,Engineering,Medicine.Washington,DC
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 51
A PUBLIC HEALTH APPROACH TO CANNABIS
Someoftheareaswherewehavesubstantialevidencetosupportanassociationbetweencannabisuseandhealthrisksandharms:• Worserespiratorysymptomsandmorefrequentchronic
bronchitisepisodes(long-termcannabissmoking)• Thedevelopmentofschizophreniaorotherpsychoses,with
thehighestriskamongthemostfrequentusers• Increasedriskofmotorvehiclecrashes• Lowerbirthweightofoffspring*
RESEARCH EVIDENCE
TheHealthEffectsofCannabisandCannabinoids:Committee’sConclusions.January,2017.TheNationalAcademiesofSciences,Engineering,Medicine.Washington,DC
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 52
A PUBLIC HEALTH APPROACH TO CANNABIS
Someoftheareaswherewehavesubstantialevidencetosupportanassociationbetweencannabisuseandhealthrisksandharms:• Lowerbirthweightofoffspring*• Thisconclusionreliedonprimarystudiesandoneoftwo
systematicreviewspublishedin2016• Asecondsystematicreviewandmeta-analysisonthistopic
controlledfortobaccouseanddidnotfindastatisticallysignificanteffectofcannabisonbirthweight
RESEARCH EVIDENCE
ConnerSN,Bedell V,Lipsey K,Macones GA,CahillAG,Tuuli MG.Maternalmarijuanauseandadverseneonataloutcomes:asystematicreviewandmeta-analysis.Obstet Gynecol.2016;128(4):713-23.GunnJK,RosalesCB,CenterKE,NunezA,GibsonSJ,ChristC,etal.Prenatalexposuretocannabisandmaternalandchildhealthoutcomes:asystematicreviewandmeta-analysis.BMJOpen.2016;6(4):e00986.
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 53
A PUBLIC HEALTH APPROACH TO CANNABIS
Possibletherapeuticeffectsofcannabisusecurrentlybeingstudiedinclude:• Treatmentforchronicpain• Treatmentofnausea• Improvingshort-termoutcomesforthosewithsleep
disturbances• Treatmentofmultiplesclerosis-relatedsymptoms
RESEARCH EVIDENCE
TheHealthEffectsofCannabisandCannabinoids:Committee’sConclusions.January,2017.TheNationalAcademiesofSciences,Engineering,Medicine.Washington,DC
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 54
ACTIVITY 1: (10 MIN)REFLECTION ON CURRENT RESPONSE
TO CANNABIS
• Readthequestionsandcaptureyourthoughtsinthespaceprovided
• Bepreparedtosubmityournotestothefacilitators
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 55
BREAK
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 56
HEALTH PROMOTION AND HARM REDUCTION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 57
A PUBLIC HEALTH APPROACH TO CANNABIS
Expertsidentifytheneedforanapproachtocannabisrelatedhealthpromotionmessagingthat(CPHA,2017;Rottach etal.,2009):• Includesharms,butdoesnotexaggerateorfixateonthem• Focusesontheplaceofcannabisinaperson’slifeandtheir
goalswithuse
HEALTH PROMOTION & HARM REDUCTION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 58
A PUBLIC HEALTH APPROACH TO CANNABIS
• Harmreductionreferstothepoliciesandpracticesfocusedonreducingtheproblematiceffectsofalcoholandotherdruguse(Ericksonetal.,2002)
• Harmreductionistheonlyglobaldrugpolicyresponsethathasproventosavelivesandmoneyatthesametimeasincreasingqualityoflife(Stone&Sander,2016)
• Examplesoffamiliarharmreductioninterventions:seatbelts,airbags,helmets,SmartServe,needleexchangeprograms,smoke-freepublicspaces
HEALTH PROMOTION & HARM REDUCTION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 59
A PUBLIC HEALTH APPROACH TO CANNABIS
• Afocusontheharmsnotonthesubstance
• Acceptancethattherearebenefitsandconsequencesofsubstanceuse
• Afocusondecreasingmoreimmediateharmsversusstrivingforadrugfreesociety
• Theneedtogivepeoplechoiceandaccesstoabroadrangeofoptionsforsafetyandhealth
• Afocusonwhatthepersonseesastheirmostimmediate need
• Acceptancethatsmallgainsaddupovertime
• Recognitionthatpeopleknowwhatisbestforthem
• Recognitionthatpeoplearedoingthebesttheycan withwhattheyhave
HEALTH PROMOTION & HARM REDUCTION
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 60
A PUBLIC HEALTH APPROACH TO CANNABIS
Examplesofcannabisharmreductionstrategies(CentreforAddictionsResearchofBC,2012):• “Beforeyoustart beclearaboutwhyyouwanttouse;be
sureyoutrustyoursource;tryasmallamounttotestthestrength”
• “Whenusingcannabis bediscreet;avoidcannabissmokeifpossible;preventburnsonyourlipsorfingers;takeshallowpuffs,notdeepinhalations;leavetobaccooutofthemix”
• “Ifeatingordrinkingcannabis takeyourtime”• “Cannabisanddriving don’tmix,stayawayfromthe
steeringwheel”
HEALTH PROMOTION & HARM REDUCTION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 61
A PUBLIC HEALTH APPROACH TO CANNABIS
Canada’sLower-RiskCannabisUseGuidelines(LRCUG):• PublishedJune23rd 2017in
AmericanJournalofPublicHealth• Brochureforthepubliccurrently
availableonCentreforAddictionandMentalHealthwebsite
HEALTH PROMOTION & HARM REDUCTION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 62
A PUBLIC HEALTH APPROACH TO CANNABIS
RecommendationsfromCanada’sLowerRiskCannabisUseGuidelines(LRCUG):1. Cannabisusehashealthrisksbestavoidedbyabstaining2. Delaytakingupcannabisuseuntillaterinlife3. Identifyandchooselower-riskcannabisproducts4. Don’tusesyntheticcannabinoids5. Avoidsmokingburntcannabis—choosesaferwaysofusing
HEALTH PROMOTION & HARM REDUCTION
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A PUBLIC HEALTH APPROACH TO CANNABIS
RecommendationsfromCanada’sLowerRiskCannabisUseGuidelines(LRCUG):6. Ifyousmokecannabis,avoidharmfulsmokingpractices7. Limitandreducehowoftenyouusecannabis8. Don’tuseanddrive,oroperateothermachinery9. Avoidcannabisusealtogetherifyouareatriskformental
healthproblemsorarepregnant10. Avoidcombiningtherisksidentifiedabove
HEALTH PROMOTION & HARM REDUCTION
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A PUBLIC HEALTH APPROACH TO CANNABIS
Considerationsforapublichealthapproachtoregulation:• Production,distributionandconsumptionofcannabisare
interrelated• Regulation“shouldavoidtrivialization”andnotproduce
setbacksinotherareasofpublichealth(e.g.renormalizingsmoking)
• Goalsofcommercializationconflictwithgoalsofpublichealth(i.e.profitandmarketsharevs.harmreductionandusereduction)
HEALTH PROMOTION & HARM REDUCTION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 65
A PUBLIC HEALTH APPROACH TO CANNABIS
GoodToKnowColorado:MarijuanainColorado,ColoradoDepartmentofPublicHealthandEnvironment,UnitedStates• State-widepublicawarenesscampaigninformingresidents
andtouristsofColoradospecificcannabislaws,harmreductionandhealthpromotionmessages,healtheffectsandyouthprevention
• Incollaborationwith:• Localmediavendor• Focusgroupresearchwithtargetaudiences• Youthadvisorycommittee
HEALTH PROMOTION & HARM REDUCTION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 66
A PUBLIC HEALTH APPROACH TO CANNABIS
GoodToKnowColorado:MarijuanainColorado,ColoradoDepartmentofPublicHealthandEnvironment,UnitedStates• Aprospectivecohortstudyfoundaccurateknowledgeof
cannabislawsincreasedsignificantlyfollowingthiscampaign(Brooks-Russelletal.,2017)
• Contentofthemediacampaignwasmostsalientamongcannabisusers
HEALTH PROMOTION & HARM REDUCTION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 67
ACTIVITY 2: (25 MIN)DISCUSSION OF CANNABIS PROGRAMS
& SERVICES IN THE COMMUNITY
• Identifyarecorderandreporter• Discussthequestionsasagroup• Capturethekeypointsmadebythegroupontheworksheet
provided(recorder)• Bepreparedtosharewiththelargegroup(reporter)• Submitonecompletedsetofworksheetstothefacilitator
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 68
LUNCH
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION
CANNABIS USE MONITORING AND SURVEILLANCE
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 70
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
• Mostsurveysavailablecaptureprevalencedata(firstuse,pastyearuse,ever-use)
• Somesurveysexploreadditionalusedata(threemonthusepatterns,dailyuse)andmethodsofuse(ediblesandvaping)
• Somesurveysaskquestionsaroundattitudesandperceptionstowardscannabis
• Overallthesurveysarelimitedintheirabilitytocapturedatarelevantforlocalprogramusesorequirelocaladaptations
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 71
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
• CanadianCommunityHealthSurvey(CCHS)• COMPASS• CanadianTobaccoAlcoholandDrugsSurvey(CTADS)• CAMHMonitor• CanadianStudentTobaccoAlcoholandDrugsSurvey
(CSTADS)• OntarioStudentDrugUseandHealthSurvey(OSDUHS)• BCAdolescentHealthSurvey• HealthBehaviourforSchoolAgedChildren(HBSC)• NationalCollegeHealthAssessmentSurvey(post-secondary
institutions)
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 72
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
CanadianCommunityHealthSurvey(CCHS)• Beganin2000withitsmaingoalsbeingtheprovisionof
population-levelinformationonhealthdeterminants,healthstatusandhealthsystemutilization
• ThisseriesofsurveysisajointeffortofHealthCanada,thePublicHealthAgencyofCanada,StatisticsCanada,andtheCanadianInstituteforHealthInformation(CIHI)
• TheCCHScomprisestwotypesofsurveys:• An annual component on general health• A focused survey on specific health topics
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 73
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
COMPASS• Isanine-yearstudystartedin2012-13aboutyouthhealth
behavioursfundedbytheCanadianInstitutesforHealthResearch(CIHR)andHealthCanada
• StartedinOntariobuthasexpandedtoBC,Quebec,andtheterritoriescovers70schools
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 74
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
CanadianTobaccoAlcoholandDrugsSurvey(CTADS)• TheCanadianTobacco,AlcoholandDrugsSurvey(CTADS)is
abiennialgeneralpopulationsurveyoftobacco,alcoholanddruguseamongCanadiansaged15yearsandolder
• TheCTADSisconductedbyStatisticsCanadaonbehalfofHealthCanada
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 75
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
CAMHMonitor• TheCAMHMonitor,firstconductedin1977,isthelongest
ongoingaddictionandmentalhealthsurveyofadultsinCanada
• ThesurveyisdesignedtoserveastheprimaryvehicleformonitoringsubstanceuseandmentalhealthproblemsamongOntarioadults
• TheCAMHMonitorprovidesepidemiologicaltrendsinalcohol,tobacco,andotherdruguse,problemuse,publicopinionregardingdrugissuesandpolicies,andmentalhealthamongOntarians
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 76
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
CanadianStudentTobaccoAlcoholandDrugsSurvey(CSTADS)• FormerlytheYouthSmokingSurvey(YSS),isabiennial
surveyadministeredtostudentsingrades7-12acrossCanada
• CSTADSisimplementedwiththecooperation,supportandfundingofHealthCanada.CSTADScollectsdataontopicssuchas:
• Tobacco use• Alcohol use• Drug use• Bullying• School connectedness• Mental health
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 77
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
OntarioStudentDrugUseandHealthSurvey(OSDUHS)• TheOntarioStudentDrugUseandHealthSurvey(OSDUHS)isa
populationsurveyofOntariostudentsingrades7through12• TheOSDUHSbeganin1977andisthelongestongoingschool
surveyinCanada,andoneofthelongestintheworld• Thisself-administered,anonymoussurveyisconductedacrossthe
provinceeverytwoyearswiththepurposeofidentifyingepidemiologicaltrendsinstudentdruguse,mentalhealth,physicalhealth,gambling,bullying,andotherriskbehaviours,aswellasidentifyingriskandprotectivefactors
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 78
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
BCAdolescentHealthSurvey• TheBCAdolescentHealthSurvey(BCAHS)isa
questionnaireusedtogatherinformationaboutyoungpeople’sphysicalandemotionalhealth,andaboutfactorsthatcaninfluencehealthduringadolescenceorinlaterlife
• TheBCAHSisconductedbytheMcCrearyCentreSocietyincollaborationwiththeprovincialgovernmentandpublichealthsystem,andwiththecooperationofBC’sschooldistricts
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 79
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
HealthBehaviourforSchoolAgedChildren(HBSC)• TheHSBCresearchnetworkisaninternationalallianceof
researchersthatcollaborateonthecross-nationalsurveyofschoolstudents
• TheHSBCcollectsdataeveryfouryearson11-,13- and15-yearoldyouthshealthandwell-being,socialenvironments,andhealthbehaviours
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 80
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
NationalCollegeHealthAssessmentSurvey(post-secondaryinstitutions)• TheACHA-NationalCollegeHealthAssessment(NCHA)isa
researchsurveyavailableforpurchasethatcancollectdataaboutstudents’healthhabits,behaviors,andperceptionsonawiderangeofhealthissuesincludingbutnotlimitedto:
• Alcohol, tobacco, and other drug use• Sexual health• Weight, nutrition, and exercise• Mental health• Personal safety and violence
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 81
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
Screeningtoolsthatmeasuremisusepatterns:• CannabisUseDisorderIdentificationTest- Revised(CUDIT-R):
abriefscreening/assessmenttoolthatcanbeusedwithadolescentandadultclientsinyourpractice
• Alcohol,SmokingandSubstanceInvolvementScreeningTest(ASSIST):ascreening/assessmenttoolforallsubstancesthatcanbeusedinprimaryandgeneralmedicalcaresettings
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 82
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
Thereisaneedforlocaldatatobecapturedatanearlystageondifferentpopulations(regions,socio-economicstatus,cultures,agegroups),socialcontextforuse(peers),personalcontextforuse,emergingmethodsofuse)
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 83
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
Ideally,whatwouldyouliketoknowaboutcannabisuseinyourcommunity?
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 84
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
CannabisRegulatoryApproaches.CanadianCentreonSubstanceAbuse,2015
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 85
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
Thefollowingplaceshavelegalizedcannabis:• Colorado• WashingtonState• Oregon• Alaska• Washington,DC• Uruguay
CANNABIS USE MONITORING AND SURVEILLANCE
CannabisRegulatoryApproaches.CanadianCentreonSubstanceAbuse,2015
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 86
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
• Regulationscontinuetoevolve• Thereportsuggestsforpeopletoconsultwiththe
respectivejurisdictionalregulatoryauthoritiesforadditionaldetailsandtoensurecurrencyofinformation
CANNABIS USE MONITORING AND SURVEILLANCE
CannabisRegulatoryApproaches.CanadianCentreonSubstanceAbuse,2015
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 87
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
PreliminaryevidencefromColorado hasdemonstratedthatlegalizationhashadmixedimpactsforpublichealth,forexample:• Aslightdecreaseinuseamongyouth• Higherratesofpoison-controlcallsandERvisitsfromoutof
statevisitors
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 88
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
TworecentreportshavebeenpublishedinWashingtonState• WashingtonStateMarijuanaImpactReport(Aug2017):
Theaimistodepictwherethestatestandsaftertwoyearsofcommercialization(2014– 2016)
• WashingtonStateInstituteforPublicPolicy(Sept2017):ReportfocusesoninitialresultsofoutcomeanalysesexaminingtheeffectsofInitiative-502implementation
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 89
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
WashingtonStateInstituteforPublicPolicy(WSIPP)(Sept2017,secondrequiredreport):• FollowingthepassingofInitiative502(I-502)legalizing
limitedpossessionandprivateuseofmarijuanabyadultsinNov.2012,WSIPPwasdirectedtoconductbenefit-costevaluationsoftheimplementationofI-502byexaminingoutcomesrelatedto:• Public health, public safety, substance use, the criminal
justice system, economic impacts, and administrative costs and revenues
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 90
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
WashingtonStateInstituteforPublicPolicy(WSIPP)(Sept2017,secondrequiredreport):• Reportresultsfocusesoninitialresultsof
outcomeanalysesexaminingtheeffectsofI-502implementationon:• Youth and adult substance use• Treatment admissions for cannabis abuse• Drug-related criminal convictions
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 91
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
WashingtonStateInstituteforPublicPolicy(WSIPP)(Sept2017,secondrequiredreport):• Theamountoflegalcannabissalesistheprimary
predictorexaminedintheoutcomeanalysesofthisreport
• Findingsreportedrepresentanintermediatesteptowardsthebroader,morecomprehensivebenefit-costanalysis
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 92
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
WashingtonStateInstituteforPublicPolicy(WSIPP)(Sept2017,secondrequiredreport):• Twomainanalysisstrategies:
• BetweenState:examinedtheeffectofI-502oncannabisabusetreatmentadmissions,comparingWashingtonStatetosimilarnon-legalizingstatesbeforeandafterI-502enactment
• WithinState:examinedhowlocaldifferencesintheamountoflegalcannabissalesaffectedcannabisabusetreatmentadmissions,youthandadultsubstanceuse,anddrug-relatedcriminalconvictions
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 93
AN INFORMED APPROACH TO CANNABIS PROGRAMS & SERVICES
Primaryfindings:• Itwasfoundthatcannabisabusetreatment
admissionswerenotaffectedbyI-502enactment• Theamountoflegalcannabissalesgenerallyhad
noeffectonoutcomes• Oneexceptionwasthatadults21andolderin
countieswithmoreretailcannabissalesweremorelikelytoreportusingcannabisinthepast30daysandtoreportusingitheavily
CANNABIS USE MONITORING AND SURVEILLANCE
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 94
ACTIVITY 3: (20 MIN)DISCUSSION OF CANNABIS
MONITORING AND SURVEILLANCE IN THE COMMUNITY
• Identifyarecorderandreporter• Discussthequestionsasagroup• Capturethekeypointsmadebythegroupontheworksheet
provided(recorder)• Bepreparedtosharewiththelargegroup(reporter)• Submitonecompletedsetofworksheetstothefacilitator
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 95
BREAK
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION
DISCUSSION
A COMMUNITY RESPONSE TO CANNABIS
4
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 97
A COMMUNITY RESPONSE TO CANNABIS
Whatwouldyouneedtosupportyourworkinthecontextoflegalcannabis?
DISCUSSION
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 98
A COMMUNITY RESPONSE TO CANNABIS
Howmightyoucontinuethisconversationtogether?
DISCUSSION
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION
CPHA PROJECTCONSULTATION EVALUATION
NEXT STEPS AND CLOSING
5
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 100
NEXT STEPS AND CLOSING
• Reportswillbeproducedfollowingeachcommunityconsultation
• Datafromcommunityconsultationswillinformresourcedevelopment
CPHA PROJECT
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 101
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TheVoiceofPublicHealth
OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 102
Public, provincial consultations in BC are underway and will go until November 1:• http://engage.gov.bc.ca/BCcannabisregul
ation
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 103
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EVALUATION
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OCTOBER 2017 | A PUBLIC HEALTH APPROACH TO CANNABIS: COMMUNITY CONSULTATION 104
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EVALUATION
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