Embedded Files
Page 23
disorientation, confusion, feeling drunk, feeling abnormal or having abnormal thoughts, feeling “too high”, feelings of unreality, feeling an extreme slowing of time • suspiciousness, nervousness, episodes of anxiety resembling a panic attack, paranoia (loss of contact with reality), hallucinations (seeing or hearing things that do not exist) • impairment of motor skills, and perception, altered bodily perceptions, loss of full control of bodily movements, falls • dry mouth, throat irritation, coughing • worsening of seizures • hypersensitivity (worsening of dermatitis or hives) 5 Canadian Centre for Occupational Health and Safety • higher or lower blood levels of certain medications • nausea, vomiting • fast heartbeat As Health Canada (2016a) states “Using cannabis or any cannabis product can impair your concentration, your ability to think and make decisions, and your reaction time and coordination. This can affect your motor skills, including your ability to drive. It can also increase anxiety and cause panic attacks, and in some cases cause paranoia and hallucinations.” These effects have been noted to last as long as 24 hours. The National Academies of Sciences, Engineering and Medicine (2017) report that there is moderate evidence of a statistical association between cannabis use and the impairment in the cognitive domains of learning, memory and attention (acute cannabis use). Effects of cannabis for an average user and average dose will vary. Health Canada (2016b) states: “Patients with no prior experience with cannabis and initiating such therapy for the first time are cautioned to begin at a very low dose (e.g. 1 mg THC) and to immediately stop therapy if unacceptable or undesirable side effects occur.” and “With inhalation (smoking, vaporizing), effects may be felt within a few minutes of dosing and will generally peak within 30 mins. Acute effects generally last between 2 and 4 hours but may be longer (e.g. 24 hours). With oral ingestion (e.g. oils, foods, capsules), acute effects may begin to be felt as quickly as 30 mins and as late as 3 or 4 hours after administration. This variability in timing depends on a number of factors (e.g. amount of food in stomach). It is prudent to wait a minimum of 2 hours between administration of single doses of oral products to avoid possible overdosing. Acute effects generally peak between 3 and 4 hours after dosing and can last up to 8 hours or longer (e.g. 12–24 hours). With topical application, it is not known how long it takes for potential therapeutic effects to appear, nor how long they last. There have been reports of hypersensitivity reactions (e.g. rashes, itching) when skin has come into contact with cannabis.” Similar impairment times are cited by a Joint Guidance Statement of the American Association of Occupational Health Nurses and the American College of Occupational and Environmental Medicine. (Phillips, 2015) The American College of Occupational and Environmental Medicine (ACOEM) also caution that there are few reliable studies, and many studies in the past were conducted when cannabis typically had lower THC concentrations. The American College of Occupational and Environmental Medicine states: “The majority of studies of impairment related to driving and cognition show return to a generally nonimpaired state within 3 to 6 hours after smoking cannabis among occasional recreational users.”, and “Impaired behavior from acute use differs between occasional users and long-term users. There is good evidence that chronic frequent cannabis users exhibit less impairment from acute THC than do occasional users, but the degree to which impairment is mitigated in safety-sensitive activities is unclear.” 6 Canadian Centre for Occupational Health and Safety Also noting that the length of time for impairment is unclear is Goldsmith, et al (2015), who state: “Although definitive conclusions about the acute and lingering effects of the drug have been elusive, there is now a large body of evidence to support the persistence of neurocognitive impairment lasting from hours to weeks.” and “The findings on transportation safety have been generalized through other lines of research. These include tests demonstrating that, at very
Report abuse