Since we are probably all suffering from a bit of COVID-19 fatigue, I decided to write about something a little more calming and relaxing—cannabis. In the October 2018 issue, I authored an editorial on the legalization of cannabis in BC for residents aged 19 and older. Since almost 2 years has passed, I thought it was time to revisit this topic.
I suggested that cannabis might trend toward its big brother, alcohol, as a significant part of our social culture. In my circles, this really has not happened but, admittedly, I do not have much of a social life due to my unpleasant and increasingly grumpy demeanor. In addition, get-togethers have certainly been limited the last 6 months (due to the pandemic that should not be mentioned).
Regardless, cannabis use at functions appears to be pretty much as it was before. Individuals who liked to smoke are still using it. Cannabis certainly has not showed up on any restaurant or bar menus that I have seen. I guess we will have to continue to wait for the chef’s menu with cannabis pairings. Also, cannabis-infused alcoholic beverages are not flooding the drink market.
I was worried that cannabis use in public spaces would become a problem but, to be honest, other than perhaps getting more frequent wafts of cannabis smoke, this has not happened.
As for the issue of driving while under the influence of cannabis, I could not find any statistics that show offences have climbed since the legalization of cannabis. This does not mean individuals are not driving under the influence, just that they are not being caught or charged.
One change I have noticed is the increasing use of cannabis, particularly CBD (cannabidiol), products by the general population for health-related reasons. Some patients are rubbing CBD creams on every body part while others are using drops and edibles for every type of ailment. A few years ago, cannabis consumption in seniors was a rare event, but among my patients and according to Statistics Canada, medicinal use in this population is increasing rapidly.
Perhaps there is a benefit to using cannabis for certain medical conditions, but it is unlikely to be a panacea for all the diseases it is currently being promoted for. One problem is that a controlled double-blinded study is unlikely to ever be done, as who would fund it? Cannabis producers would not want a study to show a lack of benefits and drug companies have no interest in funding something they cannot patent.
The major driving force behind legalization was to remove the criminal element behind cannabinoid production. For this to occur, legal cannabis would have to be of good quality and the same price as the black-market product, which has not happened. My savvy patients relate that criminal cannabis is much cheaper and often of a superior quality. Therefore, significant money is still being made illegally without much in the way of prosecution as the opioid crisis is consuming most of the law enforcement resources.
I am relieved that legalization of cannabis does not appear to have negatively impacted the citizens of BC. Admittedly, it is still early in the process of legal cannabis production, but it seems that most of the concerns I expressed in my 2018 editorial have dissipated like a puff of acrid smoke.
—David R. Richardson, MD
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org