Health Committee on May 6th, 2014

[Dr. Kevin Sabet]

You're probably referring to the lung issues that I talk about.

What the American Lung Association and others have found is 50% to 70% more carcinogens than tobacco smoke. The link with lung cancer is mixed. Partially it's mixed because it's difficult to do the research when most of those heavy marijuana smokers who are being studied are also smoking tobacco cigarettes. Separating that is very difficult just in terms of the research.

We know that smoking anything is bad for you. Smoking lettuce is not good for you, let alone smoking a plant like cannabis. What I would say is that the cannabis grown in certain regions, especially in B.C. and in other places, is greatly genetically modified. This is stuff that is not the natural cannabis plant that would naturally occur. It is modified and bred selectively so that the THC, the levels of what gets you high, are artificially increased. That cannot be good for you to consume in your lungs.

[Terence Young, Conservative, Oakville, ON]

It contains an enzyme that converts hydrocarbons into a cancer-causing form. We know it took decades for scientists to finally agree that tobacco causes lung cancer because there is still no clinical evidence, but there are epidemiologic studies. It would take maybe decades more to prove conclusively that marijuana causes lung cancer.

[Dr. Kevin Sabet]

I certainly agree with you.

[Terence Young, Conservative, Oakville, ON]

Thank you.

Dr. Smith, what would be the best way to reduce the harms and risks of marijuana to Canada's youth?

[Dr. Andra Smith]

Educate them so they don't use it. Give them other ways of feeling that dopamine high that they're searching for.

[Terence Young, Conservative, Oakville, ON]

Thank you.

Dr. Sabet, what does that mean, a 0.01% risk of brain damage from marijuana? What does that mean in real numbers for the number of people who smoke marijuana? What is the real risk to the individual? What number of those who use it might develop permanent brain damage?

[Dr. Kevin Sabet]

We know that one in eleven adults who tried cannabis will become addicted if they try it later in life, and one in six kids, as I mentioned earlier.

I will say that the research showing one in six for the addiction rate was from the mid- to late-1990s when the cannabis was very different. I would actually argue that we need much more research now on the cannabis that is being consumed now, which oftentimes, in this butane hash oil extraction, is vaporized at high levels, or even has much higher THC in the smoked joint than it did in the 1990s. So, conservatively, it's one in six, but we need to do more research now. In terms of driving and that risk, it doubles your risk of a car crash. We know that from all the research kind of blended together. It obviously depends on the outcome you're looking at.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

Mr. Lamoureux, welcome. You have seven minutes, sir.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Thank you, Mr. Chair.

I'll start it off by looking at marijuana and the ingredients that can be found in it. Is it safe to say that across the country, depending on where it is you get your marijuana or cannabis from, it's really difficult to tell what the ingredients are?

Very quick comments.

[Michel Perron]

I think, if you're suggesting that there is a variety of strengths and contents to cannabis produced illegally, yes.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

There are different ingredients like the THC. I've heard of CBD. Are those addictive? Are there other ingredients that could be put into marijuana that some sellers are possibly selling to youth or adults?

[Michel Perron]

The cannabis itself obviously has a number of compounds, as has been alluded to earlier, THC being the psychoactive one. CBD is another compound found in cannabis that has a non-psychoactive effect. The question is, can people produce or sell cannabis with other adulterants in it? Yes, of course they can.

In terms of how the potency of THC is presented in any cannabis sample versus CBD ratios, that again is going across the board. As we've seen, there has been a general increase certainly in a lot of street cannabis towards a higher level of THC, which is the psychoactive element, which does then precipitate some of the greater risks and harms we've seen.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Regarding today's marijuana, is it safe to say we have no idea what is actually being purchased, that it's completely random?

[Michel Perron]

Again, I think if you were to do an examination of samples seized by police, that would probably be a better assessment as to what exactly is being presented across the country. Typically, for any person arrested with cannabis, it has to be determined that it is cannabis and that's the substance included.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Are there incidents you would be aware where cannabis could have been laced with something more damaging for a person's health and well-being?

[Michel Perron]

Certainly there has been anecdotal evidence of reports of that, yes.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Are there addictive ingredients that could be added that would cause people to want more cannabis?

[Michel Perron]

Again, this is rather speculative. In terms of what is hypothetical, of course you could add any substance you wish to any drug to make it more addictive or more psychoactive for the user.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Sabet, I'm wondering if you could provide a comment.

You mentioned that the United States seems to be moving on a path to legalization. That is somewhat what you indicated.

When you look at Colorado and Washington, do they regulate the content of the marijuana?

[Dr. Kevin Sabet]

Thank you for the question.

They try to regulate the content, but it hasn't gone too well. That's mainly because, first of all, you have commercial interests that want to make sure they can do whatever they want with cannabis. That's why you have all of these edibles. Even when regulated, 15% THC does not make it safer than 15% THC marijuana that is smoked from the street. It really doesn't. The issue is that is what is harmful.

With regard to the edibles, the cookies and candies, the committee should know that there have already been two deaths related to legal marijuana ingestion. That was basically cookies and brownies bought legally at a marijuana store. For one young man, and he had nothing else in his system, after consuming the cookie, he fell off a balcony and died. The second man, who killed his wife while she was on the 911 call, had just had a marijuana edible.

The issue with the edibles is that when you ingest that all at once, it's different from smoking it, where you are taking in the THC more intermittently. You ingest the THC all at once with these edibles, and that's been a really unfortunate side effect of the legalization.

I think the states are trying to “regulate” it. You must also remember that the black market in Colorado is alive and well. You can't sell it to young people, so the black market is making sure it is filling the gap for the young people, who are their biggest customers and cannot buy from the legal stores.

Certainly I don't think it's showing positive outcomes so far.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

As the governments in the United States have moved more toward legalization of marijuana, where they've been found lacking is in having strong regulation to ensure that the examples you have just given are prevented.

Is that a fair assessment?

[Dr. Kevin Sabet]

I'm not sure it is fair, sir. They would argue that their regulation is very strong. They would argue that they went through years...and made sure that what they did was as careful as it could be.

The problem is that when you increase access and availability, when you legalize something, that is sending a signal to young people that the harmfulness has been reduced. Both Canadian and American youth right now, in a legal or illegal context, from looking at celebrities and others who may use and publicly talk about their use, are getting the impression that this is something that is okay and is acceptable.

Let's be clear. Most people who use cannabis are not going to go on to a disorder. I should have said that in the beginning. Most people who use will stop after using it one to five times and will not become addicted. They won't crash their car, etc. The problem is the small proportion of overall users who consume most of the substance. That small proportion grows, I think, under a policy that has legalized and increased its acceptance through some kind of “regulation”.

Again, as Mr. Perron said, alcohol and tobacco are good examples. Whatever good intentions they've had with regulation in Colorado, which is the only place they've started, the results so far are not good.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Yes. Now they've also done work in that area in Washington. Are you familiar with that particular program?

[Dr. Kevin Sabet]

I'm very familiar with it. The State of Washington has not begun selling legally in stores. They're starting to license them now. They've taken longer to do so. It's a bit of a different set-up. We'll see how that works. We can also look at states that have not technically legalized to learn what regulation does. I would say look at California. Look at Colorado before Colorado legalized it. Remember, I said they had a regulated scheme for five years under the guise of medicine, but again, if you had a pulse and backache, you could get marijuana. It wasn't that you had to have cancer or something. Again, those results haven't been good. For Washington, it remains to be seen.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Let's go back to the idea of this small portion—