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Cannabis control needs new approach, public-health experts say

Even though it's a criminal offence to smoke marijuana – with a few medical exceptions – about 10 per cent of Canadian adults admit to having a toke on an occasional or regular basis.

A panel of medical experts say it's time to adopted a new approach to cannabis control, based on the principles of public health, including awareness and harm reduction. In the current issue of the Canadian Journal of Public Health, they have proposed a series of guidelines for minimizing the potential health risks associated with pot consumption.

"This is not about endorsing cannabis use," said the lead author of the guidelines, Benedikt Fischer, who holds research positions at both Simon Fraser University in Vancouver and the Centre for Addiction and Mental Health in Toronto.

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"This is about accepting the fact that millions of Canadians are actively using this substance," he said, stressing that "cannabis is not a benign drug."

The best available scientific evidence suggests using cannabis frequently, and starting the practice at a very young age, increases the chances of health problems, such as impaired memory, respiratory ailments as well as dependency.

Dr. Fischer would like to see education campaigns targeted at high-risk groups, especially teens and young adults. (In the 16-to-25 age group, one third used cannabis in past year). Some ads would also inform the general public about ways to reduce the potential risks if they choose to imbibe.

For instance, the guidelines, which have been endorsed by the Canadian Public Health Association, suggest:

* There is "no safe age" to begin using cannabis, but the later the better – allowing the brain ample time to develop fully.

* Don't drive a vehicle for three to four hours after smoking up.

* Pregnant women should abstain from pot to protect the developing fetus.

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* People with a history of mental disorders should also refrain as it may trigger psychotic episodes.

Dr. Fischer said this initiative is very similar to the introduction of guidelines for safer alcohol consumption about 15 years ago.

"It seems like a totally natural step to follow the same route with cannabis," he added.

However, acceptance of guidelines won't be easy, given the almost zero tolerance to cannabis use under federal criminal law. In an accompanying editorial in the journal, Patricia Erickson, a senior scientist at CAMH, writes the guidelines are "reasonable" but they stand little chance of being implemented.

Even so, Dr. Fischer remains optimistic because the federal government doesn't have "primary jurisdiction" over health matters or drug education. The guidelines could still succeed if they are embraced by provincial and local governments as well as public health bodies, he said.

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