HESA Committee Report
If you have any questions or comments regarding the accessibility of this publication, please contact us at accessible@parl.gc.ca.
Mr. Ben Lobb Dear Mr. Lobb: I am pleased to respond on behalf of the Government of Canada to the Sixth Report of the Standing Committee on Health entitled Marijuana’s Health Risks and Harms, tabled in the House of Commons on October 21, 2014. On behalf of the Government of Canada, I wish to thank the Committee members for this valuable study. The Government supports the findings of this Report and welcomes the Committee’s recommendations. The Government appreciates the thoughtful insight from those who participated in the study, including medical professionals and scientific experts. The Committee’s study presents an informative analysis and highlights opportunities for the Government to continue to work toward reducing the health risks and harms associated with marijuana use. As noted in the Report, marijuana is the most commonly used illicit substance in Canada. According to Health Canada’s 2012 Canadian Alcohol and Drug Use Monitoring Survey (CADUMS), nearly 10 percent of Canadians aged 15 and older reported using marijuana in the past year. Meanwhile, 41.5 percent of Canadians have reported using marijuana at least once in their lifetime. Reassuringly, data from CADUMS also shows that rates of use are declining, particularly among youth (aged 15-24). In 2004 over 61 percent of youth had consumed cannabis in their lifetime. In 2012, that figure dropped to 34.8 percent, a reduction of 43 percent. Our Government’s anti-drug approach, led through the National Anti-Drug Strategy (NADS), is working to help prevent youth from smoking marijuana. While rates of marijuana use in Canada have been declining, they remain far too high, and it is clear that continued efforts are needed. Research shows that the rate of marijuana use among youth is particularly high – twice the rate of use among adults. In fact, when compared with other countries, Canada’s youth demonstrate high rates of marijuana use. There is also evidence that Canadians are not as well-informed about the risks of marijuana use as they are about other illicit drugs. Emerging evidence also suggests that marijuana is stronger today than it was in the past. As the scientific evidence continues to advance, there is an ongoing need to ensure that Canadians have the information they need to make informed choices about their health and prevent drug use. The Government is committed to raising awareness, supporting research, and working with key partners to address the health risks and harms associated with marijuana use, particularly among youth. While the Government has made much progress in recent years in working to reduce the harms and risks associated with illicit drug use through its NADS, the Committee’s Report has put forward some important recommendations that will help inform the Government’s future activities aimed at reducing the health risks and harms associated with marijuana use. To substantively address the issues raised by the Committee, the Government’s response addresses each of the recommendations individually. As Minister of Health, I am committed to ensuring that all Canadians lead healthy, productive lives. This means supporting our youth in making healthy choices from a young age, to prevent chronic disease and long term health issues. We know the consequences of smoking tobacco, which is the leading preventable cause of death in Canada. Tobacco uses costs Canada an estimated $17B annually – which far outweighs the amount of money the federal and provincial governments collect from taxes on cigarettes and other tobacco products. So, just as we continue our efforts to reduce tobacco use, we must also focus on drug prevention so that Canadians do not have to bear these unnecessary costs. Recommendation 1: The Government of Canada work with relevant stakeholders and experts to develop a campaign to raise public awareness and knowledge of the risks and harms associated with marijuana use. As highlighted in the Committee’s Report, research shows that Canadians are not well-informed about the health risks and harms of marijuana use. The Report highlighted the need for increased public awareness and knowledge of the risks and harms associated with marijuana use so that youth and their parents can make informed choices. The Government recognizes the importance of improving awareness and knowledge of the health risks and harms related to marijuana use, especially for youth. As such, the Government agrees that it is important to address the preconceived notion among Canadians and youth in particular that marijuana is a benign substance, and that there is a need to clarify the confusion about its health impacts. To this end, the Government launched its Preventing Drug Abuse campaign from October 20 to December 31, 2014, to raise public awareness of the risks and harms associated with marijuana use and prescription drug abuse. The campaign was part of NADS, which is the Government’s key initiative to prevent, treat and reduce illicit drug use in Canada. The campaign was designed to educate parents on how to talk with their teenage children about the dangers associated with marijuana use and prescription drug abuse. Key educational messages focused on the negative impacts of marijuana use on mental health and brain development. In order to target its audience most effectively, the campaign delivered its messages in several ways – by leveraging TV, web and social media channels. The campaign messages were developed from peer-reviewed scientific research and other sources of credible information. The Government worked with research experts throughout the development of the campaign to ensure that it was based on the most up to date peer-reviewed scientific evidence. Of note, on April 30, 2014, I hosted a roundtable of the healthcare community and research experts to discuss the scientific evidence of the risks related to marijuana use by youth as well as strategies for raising awareness of these risks. The Government also engaged Canadian parents and youth across the country while developing the campaign to ensure that it would meet their needs. Moreover, through funding under NADS, the Canadian Centre on Substance Abuse (CCSA) conducted a scan of public education initiatives focused on youth and marijuana to inform the development of similar initiatives in Canada, including the Preventing Drug Abuse campaign. The Government monitored the impact of the campaign and is evaluating the findings in order to inform future public awareness campaigns of a similar nature Recommendation 2: The Government of Canada work with health professional organizations to increase their awareness of the scientific evidence related to the health risks and harms of marijuana use and promote the development and dissemination of tools to support these organizations’ efforts to prevent, manage and treat drug abuse. The Committee’s Report recognized the key role that health professionals play in raising awareness of the health risks and harms associated with marijuana use. It also identified the need to increase awareness of the scientific evidence concerning these risks and harms. The Government shares this view and is committed to collaborating with and supporting key stakeholders, such as health professional organizations, in this regard. The Government continues to work with key stakeholders to deliver a number of projects that raise awareness and support health professionals in their efforts to prevent, manage and treat drug abuse. Through NADS, the government collaborates with provincial and territorial governments, non-governmental organizations and community stakeholders, including health professional organizations, to address the risks and harms related to illicit drug use. For example, since 2007, Health Canada’s Drug Strategy Community Initiatives Fund (DSCIF) under NADS made $9.6 million available per year in contribution funding to support national and regional health prevention and promotion projects to discourage illicit drug use, particularly among youth. A number of DSCIF projects have specifically targeted marijuana use. For example, the Council on Drug Abuse received close to $1.4 million over five years from 2010 to 2015 to implement a drug prevention program that provides youth with reliable information about the short- and long-term health consequences of marijuana use. The program is being implemented in 39 communities in Nunavut, Manitoba and Saskatchewan. In addition, the Schizophrenia Society of Canada received $842,000 from 2008 to 2013 to address the link between marijuana use and early psychosis through research, to increase youth awareness, and to develop tools to support youth who experienced psychosis. Through NADS, the Government is also funding the CCSA with $11.9 million over five years from 2013 to 2018 for activities aimed at reducing drug use among youth. To this end, the CCSA is currently undertaking a major review and synthesis of the research literature on the effects of marijuana use during adolescence. The objective of this work is to provide clarity around misperceptions about marijuana, and make sense of conflicting results about the effects of marijuana use, including impacts on brain development and behaviour. The report, expected to be released in spring 2015, is anticipated to be a resource for those who work with Canada’s youth, including health professionals. The report is also anticipated to inform marijuana-related policy and program development. In collaboration with the Ottawa Hospital Research Institute, the CCSA completed a systematic review on the effectiveness of brief interventions for reducing the non-medical use of psychoactive substances other than alcohol, including marijuana. While the review concluded that it was too early to accurately measure the effectiveness of brief interventions in reducing marijuana use, it identified key areas of consideration for future studies. If deemed effective, such interventions could be used as point of care tools to support health professionals in reducing recreational marijuana use. The CCSA has also developed the Clearing the Smoke on Cannabis Series, which objectively reviews how marijuana use affects human functioning and development, and discusses implications for policy and practice. Prepared by expert researchers in the field, this series of peer-reviewed reports explores the impact of: chronic marijuana use on cognitive functioning and mental health; maternal marijuana use during pregnancy; marijuana use and driving; respiratory functioning; and the medical use of marijuana and its components. Moving forward, the CCSA is updating the reports focusing on pregnancy and driving with new scientific evidence that has accumulated since their release in 2009. The updated reports are expected to be released in early 2015. The Government is confident that new funding through NADS will continue to support efforts aimed at raising awareness of the health risks and harms associated with marijuana use and support health professionals in their efforts to prevent, manage and treat drug abuse. Recommendation 3: The Government of Canada continue to support, in collaboration with the provinces and territories and key stakeholders, strategies for the prevention of drug-impaired driving through the RCMP Impaired Driving Strategy. The Committee’s Report identifies that marijuana consumption can lead to impaired driving, resulting in harmful consequences. Impaired driving devastates families and communities, resulting in high costs to victims, offenders, communities and governments. Drug impaired driving is a growing concern in Canada and around the world. The Government shares this concern and is committed to ongoing enforcement of impaired driving laws and working with provinces, territories and key stakeholders on strategies and initiatives to prevent drug impaired driving. The Tackling Violent Crime Act, 2008 amended the impaired driving provisions of the Criminal Code to improve the ability of officers to detect drug impairment by authorizing an officer to demand physical coordination tests and an evaluation conducted by an evaluating officer trained in drug recognition and evaluation, if necessary. This has had a positive impact: in 2008, there were 188 drug impaired driving charges and by 2012, this total had increased six-fold to 1,126. However, concerns remain relating to the detection of drug impaired driving and work continues to study how best to detect it. Notably, in 2013, the Commissioner of the RCMP requested the development of a national Impaired Driving Strategy with the aim of changing Canadians’ attitudes with respect to impaired driving. Over the course of this three-year Strategy, the Government is committed to reducing impaired driving through enforcement and public awareness activities. In this regard, the RCMP continues to build on the work already underway at the provincial and territorial levels and explore partnerships with the non-profit sector, the law enforcement community, and with other government organizations invested in road safety. Specifically, this work aims to encourage people to not drive while impaired; to report impaired drivers; and, to increase the likelihood that those who choose to drive while impaired will be apprehended before they cause harm in Canadian communities. Examples of public awareness activities have included the development of public education campaigns to discourage impaired driving in partnership with RCMP divisions, partner agencies, special interest groups and other government agencies; increasing the use of social media to target messaging to discourage impaired driving; and, engaging youth in discussions on impaired driving through videoconferencing in schools across the country. The RCMP is also undertaking a number of enforcement activities targeted at reducing impaired driving. Since the Impaired Driving Strategy was launched in Fall 2013, the RCMP has held five national enforcement days to raise public awareness and to coordinate the enforcement of provincial and federal impaired driving legislation. Over 300,000 vehicles have been screened through this initiative. In addition, the RCMP is reviewing and updating standards for front line officers to help advance the detection and identification of impaired drivers. Moreover, the RCMP and contract partners have identified and purchased new equipment to support impaired driving investigations. It is also worth noting that the Government is supporting a number of research initiatives to better combat drug impaired driving. For example, the RCMP is collaborating with the Canadian Society of Forensic Science - Drugs and Driving Committee and the Ontario Ministry of Transportation to determine if there are reliable roadside oral fluid testing devices that can be used in the Canadian policing environment to test for the most common drugs involved in impaired driving. Research has been underway since March 2014 and the results of this study are expected by Fall 2015. As well, through the DSCIF, the University of Victoria Centre for Addictions Research of British Columbia received $458,081 over three years from 2010 to 2013 to promote literacy about drug impaired driving and to engage young people in creating healthy communities. The CCSA is also undertaking a series of activities to reduce drug impaired driving with funding provided through the DSCIF. Of note, several literature reviews were completed in order to inform the development of messaging that targets novice drivers and that could be included in licensing and testing materials. The CCSA is also developing a series of fact sheets that summarize the current evidence on the effects of various drugs, including marijuana, on driving behaviour. These resources will highlight important implications for young drivers and will help inform the development of content and messaging for driver handbooks and materials used in driver education, training programs and testing processes. Such materials will promote awareness of the risks and harms associated with drug-impaired driving to novice drivers in Canada. It is also worth noting that the CCSA recently released policy briefs on Administrative Sanctions and Drug Per Se Laws (i.e. laws stipulating that it is an offence to operate a vehicle with a concentration of a drug [or alcohol] in the body in excess of a specified threshold value) outlining key considerations for actions aimed at reducing the magnitude of the drug-impaired driving problem in Canada. Recommendation 4: The Government of Canada continue to fund research aimed at improving the understanding of the short- and long-term harms related to marijuana use, and, in particular, its relationship to the development of addiction in vulnerable population groups, such as youth and individuals with mental illnesses. The Committee’s Report places an emphasis on the status of research related to the health risks and harms associated with marijuana use in a range of areas, including cognitive functioning and brain development; mental health and addiction; respiratory effects; cardiovascular disease; and motor vehicle accidents. The research highlighted in particular how youth are at risk for possible negative health effects. Research into further understanding the health effects of marijuana use remains a priority for the Government, as these efforts provide for a more robust picture of the associated health risks and harms. Through the Canadian Institutes of Health Research’s (CIHR) investigator-initiated funding scheme, the Government is supporting a variety of research projects on the effects of marijuana use. Projects funded by CIHR have focused on examining possible risk factors related to marijuana use; the relation between the use of marijuana and the development of mental health problems; prevention strategies and interventions to combat or address marijuana use and/or addiction; treatments for adverse effects of marijuana use among specific populations, including youth and adolescents; understanding the mechanisms of action of marijuana; the impacts of marijuana use on driving; and, providing evidence to inform policy development. For example, one CIHR-funded research project examined the effects of marijuana use on vehicle collisions to provide evidence to policy makers for improved road safety policies. Results of this project demonstrated an elevated risk of motor vehicle accident mortality when using marijuana, among both men and women. Another CIHR-funded research project provided concrete evidence of the long-lasting effects of prenatal exposure to marijuana on certain areas of the brain among youth and young adults. Results from this research suggested that brain functioning in young adulthood could be influenced by prenatal exposure to marijuana. CIHR is also supporting important research in the area of illicit substance use, including marijuana, through NADS. Since the inception of the program in 2007, CIHR has invested more than $4.2 million towards 28 projects aimed at researching treatment systems for illicit drug use, and overall treatment strategies for substance abuse and addiction. Through NADS and CIHR’s investigator-initiated funding scheme, the Government is committed to continuing to support research to improve the understanding of the short- and long-term effects of marijuana use. As such, the Government invites researchers and trainees interested in advancing knowledge in this important area to continue applying to relevant funding opportunities launched by CIHR. Conclusion The Government of Canada thanks the Committee for their important work in studying the health risks and harms related to marijuana use. The Government has made advances in working to reduce these risks and harms in recent years, and will continue to work to improve awareness and knowledge to enable Canadians to make informed choices about their health. I trust that this response demonstrates the Government’s commitment to support research and continue to work closely with key stakeholders and Canadians toward reducing the risks and harms associated with marijuana use. Sincerely,
|