1. About Cannabis

Cannabis is a plant that is formally called cannabis sativa. This guide uses the scientific term cannabis, which refers to all products obtained from the plant (including the flowers, leaves, stem, stalks, and resin). It is given different names (such as weed, pot, and marijuana) depending on the context. Different groups in different settings are likely to use other names.

The cannabis plant contains chemical compounds called cannabinoids, which act on receptors in the brain and have psychoactive or mind-altering effects.^[1]Canadian Centre on Substance Use and Addiction (2017). Canadian drug summary: cannabis. Retrieved from: http://www.ccdus.ca/Resource%20Library/CCSA-Canadian-Drug-Summary-Cannabis-2017-en.pdf The main chemical compound is delta-9 tetrahydrocannabinol, or THC.^[2]World Health Organization. (2018). Management of substance abuse: cannabis. Retrieved from: http://www.who.int/substance_abuse/facts/cannabis/en/ It is responsible for the high that follows cannabis use.^[3]Centre for Addiction and Mental Health. (2012). Health information A- Z: cannabis. Retrieved from: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/cannabis/Pages/default.aspx

Current methods used to grow cannabis have led to higher concentrations of THC.^[4]The Task Force on Cannabis Legalization and Regulation. (2016). A Framework for the legalization and regulation of cannabis in Canada. The final report of the task force on cannabis legalization and regulation. Retrieved from: https://www.canada.ca/en/services/health/marijuana-cannabis/task-force-marijuana-legalization-regulation/framework-legalization-regulation-cannabis-in-canada.html The average concentration of THC has gone from 3% in the 1980s to about 15% today, and some products, such as resins extracted from the cannabis flower, have levels as high as 80%.^[5]Ibid There is variation in THC levels in cannabis edibles and other products which results in different effects and intensities for people who use cannabis.^[6]Ibid The stronger the concentration of THC, the lower the dose needed to reach the desired effect.^[7]Ibid Higher potency may also result in greater harms to the person using it.^[8]Ibid

Another chemical compound is cannabidiol, or CBD. CBD does not produce psychoactive effects but may moderate the effects of THC.^[9]Health Canada. (2018). Drugs and medication: cannabis. Retrieved from: https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/about.html Cannabis can be used in various ways, such as:

• Inhalation – This can be done in a variety of ways:
  • Smoking it rolled in paper (also called a “joint,” “blunt,” or “spliff”).
  • Combined with tobacco and smoked as a cigarette.
  • Inhaled through a vaporizer (also known as “vaping”), such as with an e-cigarette, water pipe (bong), and hookah, where the cannabis is heated below burning point and the vapors are inhaled.
  • Heating cannabis concentrates (a process called “dabbing”).
• Ingestion – Cannabis is added to food and drink, such as candies, baked goods, juices, teas, tinctures, and ingestible oils.
• Applied to the skin – Cannabis is rubbed onto the skin through a lotion, cream, or oil.

Smoking is the most commonly reported way to use cannabis in Canada. The Canadian Cannabis Survey found that 93% of respondents said they smoke cannabis and 33% said they consume it in food.^[10]Health Canada (2017). Canadian cannabis survey. Retrieved from: https://www.canada.ca/en/health-canada/services/publications/drugs-health-products/canadian-cannabis-survey-2017-summary.html

Synthetic cannabinoids, known as “Spice” or “K2”, are substances that are developed in a laboratory and copy the effects of THC.^[11]The Task Force on Cannabis Legalization and Regulation. (2016). A framework for the legalization and regulation of cannabis in Canada. The final report of the task force on cannabis legalization and regulation. Retrieved from: https://www.canada.ca/en/services/health/marijuana-cannabis/task-force-marijuana-legalization-regulation/framework-legalization-regulation-cannabis-in-canada.html Synthetic cannabinoids are often presented as a legal substitute to cannabis and referred to as “legal highs” or “herbal incense.”^[12]Ibid Synthetic cannabinoids have been associated with panic attacks, hallucinations, seizures, and other health issues, and there is limited research to determine their immediate and long-term, health-related harms.^[13]Canadian Centre on Substance Use and Addiction. (2014). CCENDU Bulletin. Synthetic cannabinoids in Canada. Retrieved from: http://www.ccsa.ca/Resource%20Library/CCSA-CCENDU-Synthetic-Cannabis-Bulletin-2014-en.pdf