Matheson Justin, Le Foll Bernard
Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Front Psychiatry. 2020 Sep 23;11:591979. doi: 10.3389/fpsyt.2020.591979. eCollection 2020.
Legalization and commercial sale of non-medical cannabis has led to increasing diversity and potency of cannabis products. Some of the American states that were the first to legalize have seen rises in acute harms associated with cannabis use, e.g. Colorado has seen increases in emergency department visits for cannabis-related acute psychological distress and severe vomiting (hyperemesis), as well as a number of high-profile deaths related to ingestion of high doses of cannabis edibles. Over-ingestion of cannabis is related to multiple factors, including the sale of cannabis products with high levels of THC and consumers' confusion regarding labelling of cannabis products, which disproportionately impact new or inexperienced users. Based on our review of the literature, we propose three approaches to minimizing acute harms: early restriction of cannabis edibles and high-potency products; clear and consistent labelling that communicates dose/serving size and health risks; and implementation of robust data collection frameworks to monitor harms, broken down by cannabis product type (e.g. dose, potency, route of administration) and consumer characteristics (e.g. age, sex, gender, ethnicity). Ongoing data collection and monitoring of harms in jurisdictions that have existing legal cannabis laws will be vital to understanding the impact of cannabis legalization and maximizing public health benefits.
非医用大麻的合法化及商业销售导致了大麻产品的种类日益多样、效力不断增强。一些率先将大麻合法化的美国州，与大麻使用相关的急性危害有所增加，例如科罗拉多州因大麻相关的急性心理困扰和严重呕吐（大麻中毒）前往急诊室就诊的人数有所上升，还有一些与摄入高剂量大麻食品相关的备受瞩目的死亡案例。大麻摄入过量与多种因素有关，包括销售四氢大麻酚含量高的大麻产品以及消费者对大麻产品标签的困惑，这些因素对新用户或无经验用户的影响尤为严重。基于我们对文献的综述，我们提出了三种将急性危害降至最低的方法：尽早限制大麻食品和高效力产品；提供清晰一致的标签，注明剂量/每份食用量及健康风险；实施强大的数据收集框架，按大麻产品类型（如剂量、效力、给药途径）和消费者特征（如年龄、性别、性取向、种族）对危害进行监测。在已有合法大麻法律的司法管辖区持续收集数据并监测危害，对于理解大麻合法化的影响以及最大化公共卫生效益至关重要。
