Pubdate: Thu, 12 Nov 2015
Source: Victoria Times-Colonist (CN BC)
Copyright: 2015 Times Colonist
Contact: http://www2.canada.com/victoriatimescolonist/letters.html
Website: http://www.timescolonist.com/
Details: http://www.mapinc.org/media/481
Authors: Richard Stanwick & Patricia Daly
Page: A11

PUBLIC HEALTH CONCERNS SHOULD GUIDE DRUG LAWS

More research is needed into the effects of e-cigarettes as well as
marijuana

Two drug-containing products of increasing public acceptance remain
illegal - but perhaps not for long. If and when these products are
legalized, proper policies and regulations should be implemented to
minimize harm and promote health.

The first is marijuana, a flashpoint in the recent federal election
and a source of the psycho-active drug THC. Currently, legal access is
only through Health Canada's highly controlled medical marijuana
program. Changes by the previous Conservative government also
disallowed new program participants from "growing their own."

This seemingly coincided with a national increase in non-sanctioned
storefront marijuana retailers, with some purveyors promoting
marijuana for "health indications" far beyond evidence indicating a
medical benefit.

Enforcement issues fall to policing agencies. However, faced with more
than 100 marijuana retailers, the City of Vancouver is attempting
control through comprehensive business licences. The requirements
focus exclusively on the businesses' operations and the character of
the operators, as this is all that is legally allowed. Regulation of
the actual product remains a federal responsibility.

A second currently illegal drug-containing product has garnered much
less attention - electronic cigarettes containing nicotine, the
primary psychoactive ingredient in tobacco. Health Canada does not
authorize the importation or sale of e-cigarettes containing nicotine,
as their safety, quality and efficacy remain unknown. As well, Health
Canada has not approved any e-cigarette-manufacturer's marketing of
their product using health claims such as being a smoking cessation
aid.

Despite this, e-cigarettes containing nicotine are readily available
in a wide range of venues. The number of Canadian purveyors of
e-cigarettes containing nicotine easily exceeds the number of
marijuana retailers. (A leading U.S. financial analyst predicts sales
of nicotine-containing e-cigarettes will surpass conventional
cigarette purchases within a decade.) Enforcement falls to a small
number of Health Canada inspectors whose availability is limited.

The Conservative government's investment in achieving compliance with
nicotine-containing ecigarettes and marijuana regulations was, at
best, uneven. A 2002 Canadian Senate report estimates that $200
million to $500 million was expended annually in administering
Canadian marijuana laws.

Enforcement efforts aside, purveyors of both products are growing
exponentially in economic clout and associated influence.

Currently, retail sales of these products are not subject to a "sin
tax" as levied on conventional cigarettes. Consequently, the future
tax-generation potential of these products also might serve as a
motivation for legalization. There could also be considerable savings
in curtailing current expenditures on policing and
prosecutions.

We recommend future policies be forged only after considering the
far-reaching impact of these drug-containing products on human health.
Neither nicotine nor marijuana should be used by pregnant women, as
their use could harm an unborn child's brain development.

The area of the brain controlling judgment and decision-making is not
fully developed until the mid-20s. The younger an adolescent begins
using nicotine or marijuana, the more likely it is that drug
dependence or addiction will develop in adulthood.

Both using e-cigarettes and smoking marijuana generate large amounts
of fine particles, causing potential breathing problems in users and
bystanders. Also, cancer-causing compounds have been found in the
smoke/vapour.

As a smoking-cessation aid and harm-reduction tool for current adult
smokers, e-cigarettes are unproven. Concerns about the uses of
marijuana have been raised within mainstream medicine. For both
products, there is a need for more research and medical education.

The enticingly flavoured liquid used in e-cigarettes and edible
marijuana baked products and candies are particularly attractive to
children and youth. Serious childhood nicotine poisonings from
e-liquids and discarded cartridges are increasing. Edible marijuana
product poisonings are up in American states that have legalized marijuana.

Neither e-liquids nor marijuana products are meeting Canadian
standards for production or labelling. Manufacturers are not routinely
documenting the widely varying concentrations of nicotine and THC.

If one or both products are made legal, we advocate for the early
application of a public health approach to policies and regulations,
based on minimizing harm and promoting health.

If those products are legalized, Ontario's Centre for Addiction and
Mental Health provides a blueprint for legislation that should result
in a net benefit to public health and safety while protecting those
who are most vulnerable to harms from drug-containing products.

Regardless of regulatory outcome, evidence-based public education is a
priority, especially for children and youth who are most susceptible
to the harms from these products. If informed adults choose to use
drug-containing products, risks might be reduced by delaying use until
early adulthood, avoiding daily or near-daily use, and using
less-potent products.

Dr. Richard Stanwick is the chief medical health officer for Island 
Health and the primary author of the Canadian Pediatric Society's 
statement on e-cigarettes. Dr. Patricia Daly is the chief medical health 
officer for Vancouver Coastal Health and the primary public health 
consultant on regulation of medical-marijuana retail outlets for the 
City of Vancouver.
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