Thank you, Mr. Chair, for the opportunity to appear before the committee to discuss the health risks of marijuana use.
My name is Hilary Geller. I'm the assistant deputy minister of the healthy environments and consumer safety branch at Health Canada. My colleagues are responsible for various programming aspects that collectively support the government's ongoing efforts to protect Canadians from the health risks associated with illicit drug use.
Robert Ianiro is the director general of the controlled substances and tobacco directorate, and he can discuss questions regarding Health Canada's role in regulating controlled substances such as marijuana. Cindy Moriarty is the executive director of health programs and strategic initiatives, and she is involved in Canada's national anti-drug strategy programs.
In my remarks this morning, I will provide a brief overview of the principal drug control legislation in Canada, and following this, some surveillance data regarding the health impacts of marijuana use, including knowledge regarding public awareness of the associated risks of using marijuana.
I understand that you'll be having the opportunity to hear from research experts, as well as representatives from national and other health care organizations over the course of your study. I'd just like to say that at Health Canada we do not perform the kind of basic research that they do. However, we do rely very heavily on their work and the advice of their experts to help inform us when we make decisions around drug scheduling, youth outreach, and Canada's participation in various international drug policy fora.
As the committee begins to examine the harms associated with marijuana use, it may be helpful to have an overview of the legislative framework that governs controlled substances like marijuana. The Controlled Drugs and Substances Act, the CDSA, is Canada's federal drug control statute. It provides a legislative basis for the control of substances that can alter mental processes and that may cause harm to the health of an individual or to society when abused or diverted to the illicit market. Hundreds of substances are regulated under the CDSA. Those substances range from prescription opioids, like codeine and morphine, to street drugs, like crystal meth.
The CDSA fulfills Canada's international obligations under three United Nations drug conventions, all of which aim to ensure access to controlled substances and the chemicals that are used to make them for legitimate medical, industrial, or scientific purposes, while subjecting them to tight controls to reduce the opportunity for diversion from the legitimate supply chain. So the CDSA has a dual purpose: protecting public health and maintaining public safety.
The act also sets out the offences in the form of direct prohibitions on many activities involving controlled substances, such as production, possession, distribution, import, or export. In this regard, of course, legitimate activities are allowed, but they're only allowed when they're authorized through regulation or an exemption from the act. The act also sets out the penalties for offences.
As you may know, Canada is one of four countries that have some form of a medical marijuana regime. This regime exists under the new, as of last June, marijuana for medical purposes regulations. These regulations enable access to marijuana for medical purposes to individuals who have the support of a health care practitioner. However, dried marijuana is not an approved drug or medicine in Canada, and Health Canada does not endorse its use. Notwithstanding that the courts require Canada to provide reasonable access to a legal source of supply of marijuana for medical purposes, the recreational use of the drug remains illegal under the terms set out in schedule II of the CDSA.
Substances regulated under the CDSA are grouped into six schedules. In determining whether a substance should be added to one of the schedules to the act, and to which schedule, Health Canada considers six factors: international requirements and trends in control or scheduling; the chemical and pharmacological similarity to other substances that are already listed under the act; addiction liability and the potential for abuse of the drug; evidence of the extent of actual abuse in Canada and internationally; risk to personal and public health and safety; and legitimate use—therapeutic, scientific, industrial, or commercial.
The UN conventions, to which I just referred, form the basis of the global drug control regime as it exists today and the general prohibitions on activities involving marijuana. Canada is consistent with most other countries in having marijuana regulated as a controlled substance. In fact, marijuana has been regulated as a controlled drug in some form or other in Canada since 1923. Since 1996 it has been listed in schedule II of the CDSA, which includes the plant itself, its derivatives, preparations, and similar synthetic preparations.
Emerging information suggests that marijuana is stronger today than it was in the past. As a result, the potential for harm to physical and mental health may also be greater today. While the evidence detailing the increasing potency of marijuana is largely based on U.S. and European data, there are indications that the situation in Canada is similar.
Information obtained from Health Canada's drug analysis service provides some evidence that the levels of THC in marijuana steadily increased between 1988 and 2010. This evidence is consistent with data seen in other jurisdictions and suggests a significant increase in the THC levels in marijuana available today, in contrast to a few decades ago.
When considering the increased potency of marijuana, it is also worth noting the high rates of reported marijuana consumption among Canadians who seek to access drug treatment services. In the 2014 “National Treatment Indicators Report”, the Canadian Centre on Substance Abuse reports that cannabis is the second most commonly used illicit drug among individuals accessing publicly funded treatment services.
In addition to the impact on treatment services, hospital administrative data provides important information on the impact marijuana use is having on the health system. Data collected by the Canadian Institute for Health Information on marijuana-related hospitalizations show a steady year-over-year increase in the total number of cases where a diagnosis is related to marijuana. For example, in 2008-09, 11,800 admissions to hospitals across Canada were related to marijuana. The number nearly doubles when looking at the same data from 2012-13, when over 21,000 admissions were linked to marijuana use.
Knowing that marijuana is stronger today than it was in the past is important when you consider that marijuana is the most commonly used illegal drug in Canada. Data from Health Canada's 2012 Canadian alcohol and drug use monitoring survey shows that 10.2% of the general population reported using marijuana in the past year, and that men are nearly twice as likely to report using it as women.
Rates among youth are about two times higher compared with adults, with 20.3% reporting having used marijuana in the past year. Canadian youth are among the highest users of marijuana when compared to their peers in other developed countries. This is despite the fact that rates of use among youth in Canada have been declining over the past number of years.
It is clear that Canadians are using marijuana more than any other illicit drug. It is equally clear that Canadians, particularly young Canadians, are not aware of the health risks associated with marijuana use and that they view it as a relatively harmless substance.
For example, the 2009-10 health behaviour in school-aged children study, administered by the Public Health Agency of Canada, showed that among youth in grades 9 and 10, 25% reported using marijuana in the past 12 months; 10-12% reported using it three or more times in the past 30 days; and a substantial number of youth reported that they felt there were slight or no risks when they were asked about the potential health risks.
In addition, a public opinion survey conducted as a part of our national anti-drug strategy confirmed that while parents and youth are aware of the risks and harms associated with drugs like cocaine, crack, ecstasy, and crystal meth, very few identified marijuana as being harmful.
Notwithstanding the evidence that Canadians and youth in particular do not associate a high degree of risk with marijuana use, under the national anti-drug strategy the government has prior experience and success in educating youth and parents about the harms of illicit drug use.
In an evaluation of the national anti-drug strategy mass media campaign a couple of years ago on the harms of using hard street drugs, it was shown that there were positive results. For example, 25% of parents who saw the TV ads talked to their children about the harms of drugs. There was also an increase in the number of youth who said they understood, knew about the potential effects of illicit drug use on relationships with their family and their friends, and looked for further information. In addition, one in five kids who saw the ads took some action, most talking to or warning friends about the dangers of drugs.
The progress made under the national anti-drug strategy to inform youth and parents about the dangers of hard street drugs can inform new efforts to help Canadians understand the harms and risks associated with marijuana use, and to help clarify any confusion resulting from the public debates surrounding medical marijuana in Canada and legalization in the United States.
Health Canada's national anti-drug programs are already enabling stakeholders to better understand the effects of marijuana use, in particular on youth. For example, the Minister of Health recently announced funding of $11.5 million over five years to the Canadian Centre on Substance Abuse to reduce drug use among youth, including for research into the impact of marijuana on brain development and impaired driving.
In addition, in an effort to engage key stakeholders and experts in the field,Minister Ambrose met with leading researchers and health care professionals yesterday, on April 30, to discuss the scientific evidence on the health impacts of marijuana use by youth, as well as to identify strategies for raising the awareness of Canadians as to its risks.
In conclusion, while rates of marijuana use in Canada remain high, and there is evidence that Canadians are not as well-informed about the risks of marijuana use as they are about other illicit drugs, the national anti-drug strategy and its successes provide us with a strong foundation upon which to take action to address the harms associated with marijuana, particularly among youth, and more broadly to better inform Canadians and assist them in making healthy choices for themselves and their families.
Thank you.
