Vast differences between smoked cannabis and newly legal products
Think the conversations around cannabis and workplace safety are subsiding? Think again.
On Oct. 17 of this year, cannabis edibles, extracts and topicals became legal in Canada.
However, due to the requirement of licenced producers to provide a 60-day notice to Health Canada, Canadians will not see these products available for sale until mid-December at the earliest.
The final regulations have some limitations that are aimed at reducing the attractiveness of these products to children and teenagers. By December, Canada should have a better idea of the type of products that will be allowed for sale, but it is expected that we will see baked products, snack food, drinks and creams on store shelves. The market is expected to be large.
Ingested cannabis is broken down by our body differently in comparison to smoked or vaporized cannabis, and the experience is also very different. Edible cannabis users wait longer to feel the effects, which may result in a different type of euphoria or “high.”
After ingestion of cannabis edibles, the active component of cannabis — delta-9-tetrahydrocannabinol (THC) — may take between 30 minutes and two hours before reaching the bloodstream and brain, which means that the individual may not feel any effect for one to two hours.
Effects and impairment lasts significantly longer than smoked or vaporized cannabis. The initial euphoria may last for 12 to 24 hours or more.
The prolonged time between ingestion and effect — compared to effects of smoking or vaporization which can be felt within seconds to minutes — is due to the slow and unpredictable absorption when ingested.
This is due to a number of factors that include:
• amount of food present in the stomach and gastrointestinal system (GI system)
• type of food (fatty versus low-fat)
• how quickly the body moves stomach contents through the GI system
• individual liver differences (where the substances are broken down).
With ingested cannabis, there is a slower rise of THC, as well as a larger quantity of an active breakdown metabolite called 11-hydroxy-delta-9-tetracannabinol, which is very potent and can result in a more profound psychoactive and euphoric effect.
Additionally, it is much more common for users to overconsume edibles. Because the effects of the ingested cannabis take so long to feel, many inexperienced individuals do not wait for the full effects and indulge in more edibles, thinking that what they had was not strong enough.
It is not uncommon for individuals who use cannabis with high THC levels to experience temporary psychotic symptoms such as hallucinations, delusions and severe anxiety.
Cannabis extracts include concentrates — or very high potency THC. Some contain up to 95 per cent THC, producing significantly greater intoxication and prolonged effects. In contrast, cannabis used recreationally in the 1960s and ’70s often contained levels of around three per cent.
With these new products, employees who work in safety-sensitive workplaces should recognize that what they do on their own time may indeed affect safety in their workplace. Prolonged impairment of edibles means usage on their own time can most certainly spill over to the workday.
Many workplaces do not feel that the new products will impact them any differently than legalized recreational cannabis did.
However, the first quarter of 2019 saw an increase in use of cannabis in Canada with 646,000 Canadians trying cannabis for the first time, according to Statistics Canada.
The National Cannabis Survey 2019 found that 13 per cent of cannabis users disclosed using cannabis before or at work, with the number jumping to 27 per cent when the same question was asked of daily or near-daily users of cannabis.
With edibles now on the scene, there may be greater interest and therefore an increase in use of these products by both experienced and inexperienced cannabis users.
It is important for employers to understand the differences between smoked or vaporized cannabis and the newly legal products so that they can ensure policies are up to date and employees are educated regarding expectations in the workplace. If alcohol and drug testing are part of the policy, it is important to ensure that the appropriate tests are being conducted.
Workplaces can begin by educating their employees about the differences the new legal cannabis products present and their impact in the workplace, especially in safety-sensitive situations. Policies should be reviewed and updated to reflect expectations regarding the newly legal products and substance use in the workplace in general.
If testing is part of the policy, ensuring that the tests conducted answer specific questions is of upmost importance. If an employer’s expectation is that staff avoid using cannabis for at least 24 hours before work, a drug test should be able to answer the question as to whether or not the employee used cannabis hours prior to the test.
DriverCheck has seen a substantial increase in the number of companies adding in, or changing to, laboratory-based oral-fluid drug testing. While this methodology is not new, there has been a renewed interest since the legalization of recreational cannabis in 2018.
Oral-fluid testing detects the remnants of THC left in the oral cavity after cannabis is consumed orally, smoked or vaporized. These remnants only remain in the oral cavity for hours before they are absorbed. This allows for a shorter detection window whereby a positive test indicates very recent use of cannabis.
In contrast to this, urine testing detects the metabolite of THC, which can stay positive for days to weeks after use. It is difficult to narrow the time frame of detection with urine testing to confirm when the use of cannabis took place, however.
Oral-fluid testing is also an observed test, which decreases the risk of substitution or adulteration of the specimen — a more common occurance in urine testing.
It is important for employers and employees to appreciate the differences between the various types of cannabis and their specific impacts.
Employee education is of the upmost importance. With these products expected to be legally available by year’s end, now is the time to ensure everything is in place in terms of workplace policy.
Just because cannabis is legal, does not mean that it is without potential risk in the workplace.
Dr. Melissa Snider-Adler is the chief medical review officer for DriverCheck, a third-party workplace medical testing and assessment company in Ayr, Ont.