Harm Reduction and the Future Regulations on Additional Cannabis Products

Joao Velloso

28 mars 2019

Edibles, extracts and topicals were sorely missed when cannabis became legal last October 17. The Cannabis Act did not regulate edibles, extracts and topicals, despite the popularity of these edible cannabis products in other jurisdictions where cannabis is legal. In theory one could make these kinds of products with legal cannabis products and the home-made versions are permitted under the law. In fact, it is not difficult to find information on how to make these products. There is an increasing number of recipes online, including recipes for Instant Pots, Crock Pots, and other popular kitchen gadgets. But optimal results are not a guarantee. Indeed, there are risks with these do-it-yourself cannabis products. The concentrations of tetrahydrocannabinol (THC), tetrahydrocannabinolic acid (THCA), cannabidiol (CBD), and cannabidiolic acid (CBDA) may vary considerably because of the ingredients, the processing equipment, and the skills of the manufacturer. This blog considers how we can reduce harm arising from these products.

The Proposed Regulations for Edibles, Extracts and Topicals

An important step towards reducing harms is through government regulation. The Federal Government plans to allow for the commercial sale of cannabis edibles, extracts and topicals as early as next October 17 – on the first anniversary of the Cannabis Act. In preparation, Health Canada launched a public consultation on the regulation of additional cannabis products on December 20. Health Canada published draft regulations in the Canada Gazette and the Regulatory Impact Analysis Statement (RIAS), which describes the rationale and proposed regulatory framework for these additional products. Health Canada also released a reader-friendly one page Infographic with the Proposed Regulations for Edible Cannabis, Cannabis Extracts, and Cannabis Topicals, which summarizes the regulations.

The Federal Government proposes to strictly regulate six categories of products: (1) solid edibles; (2) beverages; (3) ingested extracts; (4) inhaled extracts; (5) concentrated THC products; and (6) topicals. The Proposed Regulations stipulate the following requirements: a) limits on THC (the general per unit/dose rationale is a maximum of 10mg of THC; extracts and topicals may contain up to 1000mg per package); b) product rules (e.g. limits to caffeine, sugars, etc.); c) packaging (e.g. requiring plain and child-resistant packaging); and d) detailed labelling requirements (including standardized cannabis symbol for products containing THC, health warnings, THC/CBD content, list of ingredients, allergens, a nutrition table, and directions for use in the case of extracts and topicals). Notably, the regulations require that these products must not appeal to kids, cannot make any health or dietary claims, and cannot be associated with alcoholic beverages or brands of alcohol.

Let’s be frank: cannabis users will continue to experiment and create additional cannabis products on their own. However, the Proposed Regulations are a significant improvement in terms of harm reduction when compared to the current do-it-yourself gray zone. First, consumers will be better informed on what they are consuming – whether it is what they are eating, drinking, ingesting, inhaling, or applying topically. Second, products will not be mixed with other legal drugs such as alcohol, caffeine, nicotine and, in the case of cannabis extracts, sugar. Third, rules packaging and labelling rules will help reduce misunderstanding and help differentiate cannabis products (edibles, extracts or topicals) from regular products without THC. Fourth, the regulations will seek to protect children since packages must be child-resistant and products should not be designed or packaged in a way that is appealing to them, although it remains to be seen how this will work. Finally, the regulations will require additional product testing – not only to regulate THC limits and concentration, but also regarding residues of pest control products, microbial and chemical contaminants, caffeine and other stuff that you may find in your friends’ muffin or “cannabutter”.

The upsides and downsides of edibles, extracts and topicals: reducing potential harms

Additional considerations arise over and above those addressed by the Proposed Regulations (packing, quality control, accessibility, etc.). These include the risks of harm that may arise from the consumption of cannabis edibles and extracts; the impact that the regulation of edibles and extracts will have on the regulation of smoking and vaping; and how the legalization and regulation of cannabis impacts traditional cannabis use.

First and foremost, there is still much to learn about how to safely consume edibles, extracts and topicals. Although the general per unit/dose rationale of the Proposed Regulations (max of 10mg of THC) is roughly equivalent to the amount of THC consumed when smoking a 0.25g joint, the absorption of THC is quite different. Smoking a 0.25g joint will “burn” most of the THC (17mg), putting around 10mg into your system (although other smoking methods such as using a vaporizer may be more THC efficient). In contrast, a much higher proportion of THC is absorbed from edibles. The kinetics of THC absorption also differs between the two modalities. THC reaches the bloodstream quite quickly after being absorbed by the lungs, producing certain effects that users learn to experience (I will return to this point below). By contrast, the liver metabolizes THC from edibles much more slowly, both delaying and prolonging its delivery to the bloodstream. As a result, users tend to experience stronger effects for a longer period than those who smoke cannabis.

Edibles, ingested extracts and some topicals (patches) are often considered to pose fewer health risks than smoked cannabis because of the harmful side effects of smoking. Yet there are important risks arising from the slower and longer metabolization of these products. For example, an inexperienced user who consumes a 10mg THC edible may be taken by surprise by the stronger and longer intoxicating effect. When we add parties, cars, and work places into the equation, the risks of unintended consequences can multiply.

How do we mitigate these risks? Public education is an important first step. For example, last year the Los Angeles Times published a helpful article, “A simple guide to pot, THC and how much is too much”, which includes a few comparison tables that readers can play around with to figure out how much THC various products may contain and their effect on different kinds of users. Educating users is not necessarily the focus of the Proposed Regulations, but I argue that federal, provincial and municipal governments must develop further policies towards educating the public about how to use these new products safely to reduce the potential harms associated with their use.

Second, how will these new regulations impact the existing regulatory frameworks for cannabis that emerged following the Cannabis Act? Legal cannabis opened a Pandora’s Box of regulations. Indeed, some have argued that the result is a micromanagement of cannabis users – every level of government and many organizations are regulating the consumption of legal cannabis. The result has been a patchwork of overlapping rules.

Take for example Ottawa’s two universities: uOttawa and Carleton University. Both are under the same federal, provincial and municipal jurisdictions. Yet Carleton prohibits cannabis use on campus, while uOttawa adheres to the provincial framework by allowing smoking and vaping wherever tobacco is allowed (at least for the moment.) At other universities, the regulatory frameworks are even more complex. For example, Université Laval’s policy mentions at least ten legal statutes and at least twelve from the university (and this does not include the collective agreements and other texts or contracts establishing working conditions at the university). In my view, the legalization of edibles, extracts and topicals has the potential to push back the micromanagement approach. On one hand, users who face limits on smoking cannabis, may simply switch to using these additional products. On the other hand, different levels of government may realize that the current (over)regulation of cannabis is not effective in a world of edibles, extracts and topicals. The arrival of these new products offers a tremendous opportunity to revise local policies and adjust harm reduction strategies.  

Finally, the legalization of cannabis edibles will have an important impact on cannabis use – cannabis use may shift from a collective experience to a more individualized one which may, in turn, increase the risk of harm. Here, Howard Becker’s seminal contribution, “Becoming a marijuana user” (1953), is illustrative. Becker suggests that people are able to use marijuana for pleasure only after a learning process that is essentially interactive with both the cannabis product and other users. The user must learn to smoke cannabis in a way that will produce effects: she must learn to recognize the effects and connect them with drug use, and she must learn to enjoy the sensations she perceives. According to Becker, this learning process is a collective one. Collective use may reduce the potential harms associated with cannabis use because cannabis users learn how to consume and to enjoy the THC effects in the presence of more experienced users. Legalized cannabis may disrupt Becker’s process as the multiple regulatory regimes seem to push towards individual consumption rather than collective consumption. In my view, the legalization of edibles, extracts and topics will also shift cannabis use towards a more and more individual cannabis experience. The unit/dose rationale of the Proposed Regulations suggests an individualization of consumption. It is my cookie, my inhaler, my pill with extracts. Users may consume in small groups, but the legal market seems to be designed for a more individual experience. With less consumption in collective contexts, we may ask how individuals will learn to safely use these new forms of cannabis. As discussed above, there are important concerns about THC absorption and metabolization. The effects of smoking are relatively fast compared to edibles. By contrast, the effects of edible and extracts appear hours later and as a result may be experienced individually as opposed to with others.

In my opinion, harm reduction has an important role to play in addressing these issues. We need to look at the experiences of other jurisdictions and even at different kinds of drugs and drug users. That said, in many respects Canada is at the forefront of these regulatory issues – we are one of the world’s labs on legalizing cannabis. As such, we also need to be ready to learn with users how to reduce harms, intended or not.

Joao Velloso is a Professor of Law at the University of Ottawa.