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— a growing Cannabis concern and a vyorldw order ')éf;'.',_"*‘.l?_'\L5|, ‘Jr,’ K‘ ~\n ' . '( :s=»- » : Excellent health erywhere, every time. a?éd ‘ AA Page 6 of 90 islandhealth 7.1

Outline Use and misuse ~ —youth and ° general ' ,1 ° The good a ” - Medical reco nce cepta hiss“ ° School syse 3 -. . A‘; Page 7 of 90 Page 2 islandhealth 7.1

Ewe T?tso 5UE>STANcEs ?g‘) To my Bicnusa‘; was I-ZTIMES § 3: pm N51’ CUKIOUS. [)9 USINQ suesmuces?gvgu mom use Is M‘! A/‘ ms . vswq ?«<osLa~\s ‘FOK / é \" 1 UsESv%§TANcg k veg so 0FTEN'vJn’H' » Fg\eN9s,U5UALL1ArTEK ‘\ OK 0'4 WEEKENW SCHOOL use My Su6sTANCE Qmmq mwe r i U51; sussmucgg M or oomqma E lsN’1' QETHN 1N ujae .M~/ DAM. Us OF sa+°oL>W03‘) WA‘! Page 8 of 90 7.1

Past-Year Use in Canada Fln?othonbncoofodfaopuhdunmhlonuounungcoudatubyogocatoply 30 25 20 IYouth (15-24) 15 Ieeneral Population (15+) lN.1ults (25+) 10 2009 2010 2011 2012 2013 2015 Source:CADUMS 2008-2012. CTADS 2015 9%: Dueto methodologcaldi?etenoes betweenCADUMS and CTADS. oomparisonsofptevalenoe (2008-2012) and CTADS estimatesbetweenCADUMS datashouldbemadewithcaution. % Page 9 of 90 Page 4 islandhealth 7.1

Plevalenceof cannabis usein the past yearamong Canadians aged 15+.2011-2013. 2015 20 3 17.2 15 3 € 12.3 § I0 9 3 -§ 5 o. . . . 0 2011 20 12 2013 2015 Year —BC —Canada $”""""’“_,,. Souce: A00 MorItornoPro)ea. °"",__,,,""“°"‘ afbta '' "‘ Centre for Addebons Reseatch 008C % Page 10 of 90 Page 5 islandhealth 7.1

in the general Substance use population use in BC. age 15+ 2011-2013. 2015 Prevalence of past yearsubstanoe E s E *5 8' s .9 2 : O 0 ~ —e V 2011 2012 2013 2015 Y“, incur-cl jsmoking :othor -lick drugs -éuoohol —Cannab:s (acute harm) (drone harm) (canon!) (past your) (past year) so supovessed. Esuvnaesunwleforothchct dvuosun 2011 ‘ & 2013 a“""“""',,.,_._ scum: “"'._,,,:““"‘ MorItornqPro)ect. A00 cnrbcca .' an‘ Ceou'eforAddaaons Research ol9C Page 11 of 90 Page 5 islandhealth V! O :- VI N O - 7.1

The Bad The Good risk of psychosis, Increase - May have value in pain depression and anxiety, nausea, Breathing problems and management, ° respiratory conditions muscle relaxation in tremor Chronic illness concerns and spasticity, PTSD, increasing reduction, coordination Attention Adjunct to therapies for ° . reduced, memory deficits anxiety, insomnia affect children's Pregnancy —can functioning, behaviour, cognitive Possible adjunct to ° future substance use behaviour substance use disorders and mental health. ?more with research - ?more with research (6) C-iv) ‘P ‘ <3 f2. - CI) -am.-... Q Page 12 of 90 Page 7 islandhealth 7.1

Medical recommendations - BC College of Physicians and Surgeons recommendation- not for use under age 25 Canadian Pediatric Society ° No sales to youth — for purchase for <25 Limit THC concentration — Responsible sales: — Not near schools, no self service, strict labelling, warnings, ° strict limitations on marketing, no marketing to youth, restrict on-line purchasing Extend clean air bylaws to include cannabis — Public campaign on dangers of cannabis — AA Page 13 of 90 Page 3 islandhealth 7.1

Safer use guidelines http://www.camh.ca/en/research/news_reports_and_books/Dpcuments/LRCUG.KT.Professional.1 5June201 7.PDF — safest Abstain ° not earlier than mid—20s Age of initial use ° — — high CBD:THC ratio Choice ° synthetic cannabinoids Avoid current — Avoid smoking combusted materials ° Avoid ”deep” inhalation ° — one day a week, weekend only Frequency ° No driving for at least 6 hours ° Not to be used by certain groups (including during ° pregnancy, family risk for certain mental illnesses) Avoid combining risky behaviours ° AA Page 14 of 90 island health Page 9 7.1

Legalization and youth Purchase minimum age 19 2 new criminal offences: giving or selling cannabis to youth, and — using a youth to commit a cannabis-related offence — Provincially much not allow a minor to consume or posses Prohibit: products that are appealing to youth — packaging or labelling cannabis in a way that makes it appealing to — youth selling cannabis through self-service displays or vending machines — promoting cannabis, except in narrow circumstances where the — promotion could not be seen by a young person Federal possession by youth is restricted to 5 gm. Provincially S (73) minor must not possess, consume .... .. AA Page 15 of 90 island n.;nn 7.1

Student supports - iMinds Guidance and supports ° - and dialogue Conversation in the classroom and school How to augment — community? "w 7 Can we learn from past tobacco campaigns with — peer led activities? Encourage open discussion on all substances/drugs " .APS resources L Discovery or AA Page 16 of 90 islandhealth 7.1

Schoolpohcy Mirror alcohol policies ° No on site consumption — No intoxication — Is there a need to distinguish "medical use” ° from ”non—medica| use” Handling of distribution or unregulated sale ° on school grounds Employee policies on both medicinal and non- ° Page 17 of 90 Page 12 islandhealth 7.1

use Managing - easiest to control Smoking Edible cannabis is not currently legal to sell as food. Self prepared edibles are not illegal. Non-smoke product delivery JUULs, juice systems: Page 18 of 90 islandhealth 7.1

Excessive use Inexperienced users may overconsume ° — particularly associated with edibles. can result in reduced Excessive consumption — and may not be readily responsiveness distinguished from opioid or benzodiazepine overconsumption Serious overdoses are uncommon, requires time — to metabolize cannabinoids from system - Chronic use and dependency Child youth contact — substance programing (Discovery/ADAPS) AA Page 19 of 90 Page 14 islandhealth 7.1

Island Health current supports - Local network of youth substance use counselling and residential resources with minimal wait times for service treatment - is family centered program and strives to engage with Programming and caregivers in the treatment plan parents (leveraging the attachments the youth and striving to to support — maintain the integrity of the family unit over the long term) - Workshop available for school parents "The Drug Talk” and caregivers their youth around the which supports and guides parents on supporting issue. - Recently piloted a workshop for school support staff and teachers around how to address substance use issues in the school - Expect more as provincial supports roll out AA Page 20 of 90 Page 1 5 islandhealth 7.1

Discovery/ADAPS offer: - Education & Information Youth, Parent, & Family Counseling ° Outreach ° - Individualized Service Planning and Coordination Referral ° Community Collaboration ° AA Page 21 of 90 Page 15 islandhealth 7.1

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