Kevin Hamdullahpur, M.Sc., M.A.
In the last year, one in seven Canadians reports legally purchasing cannabis. While the majority of these individuals won’t experience problems from using cannabis, it’s estimated that 10% to 30% will. Sitting with these numbers, it’s important to highlight that shaming or stigmatizing individuals struggling with substance use disorders is not helpful. Decades of research tells us that rather than helping, stigma and shame often prevents those most in-need from reaching out and accessing help. Rather than leading with our judging gavels, adopting a curious attitude can help us better understand who is at risk of developing a cannabis use disorder (CUD), how we can notice warning signs, and what we can do about it.
What is a CUD?
A CUD is broadly defined as a pattern of use leading to negative impacts in important areas (e.g. school, work, relationships, health) or significant distress. CUD is a formal diagnosis and requires a licenced provider.
Who develops CUDs?
CUDs can occur in anyone, regardless of age, ethnicity, gender, or economic status. Risk factors supported by high quality research are broad. Among others, these include a family history of substance use disorders (e.g. genetics risk), personality characteristics like impulsivity, childhood and adult experiences of trauma, and difficulties with mental health. Research also tells us how often and why you use cannabis are more helpful questions that just asking if you use cannabis to identify at-risk individuals. For example, daily or near-daily cannabis is a strong predictor of developing a CUD and is more generally associated with depressed mood and heightened anxiety.
Motives for using cannabis are also a powerful indicator of problematic use. Recent evidence suggests using cannabis to reduce distressing, unwanted emotions (e.g. sadness, anxiety, anger) often signals more intense cannabis use and cannabis-related problems. This helps explain research evidence suggesting highly stigmatized groups are more likely to report using cannabis to regulate emotions and have a greater vulnerability to develop problems related to cannabis use.
Best Practices
The Canadian Research Initiative in Substance Misuse has released “Canada’s Lower-Risk Cannabis Use Guidelines” to help Canadians reduce health risks associated with cannabis use through science-based recommendations and are available here. Several guidelines are summarized below:
- Abstinence – Abstinence is the safest way to avoid cannabis-related harms, particularly for at-risk individuals
- When to use – Human brains continue to develop into the mid-’20s. Earlier use, particularly in adolescence, may negatively impact healthy development and increase risks of developing health, mental health, and social and educational difficulties. Cannabis use is also strongly discouraged when pregnant, breastfeeding, or operating heavy machinery.
- How to use – High THC concentration, consuming cannabis by smoking, and daily use are all associated with an increased likelihood of health problems. “Deep inhalation” is also discouraged as it can cause or contribute to breathing difficulties.