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Cannabis Update - Summer 2020
July 14, 2020
Brought to you by the Canadian Veterinary Medical Association (CVMA) and the Canadian Association of Veterinary Cannabinoid Medicine (CAVCM)
Cannabis and cannabis products remain regulated under the Cannabis Act of Canada, but changes in the past year include the ability to legally purchase cannabis edibles, concentrates, and topicals, which were not originally available when cannabis was legalized in October, 2018.
Legal pathways to purchase cannabis remain limited to the following:
- Medical Use - Directly through a federally licensed cannabis producer with medical authorization from an MD or NP (Note: veterinarians are not able to authorize medical cannabis under this existing pathway).
- Adult-Use (aka non-medical or recreational) - Directly through a provincially licensed cannabis retailer, either online or store-front.
Both of the above pathways now include a range of product formats including edibles, concentrates, and topicals; in addition to previously available dried flower, pre-rolled, oils, and capsules. All product formats can include high-THC, blended THC:CBD, and CBD-dominant products.
- Rx drugs - Health Canada approved pharmaceuticals containing cannabis, with a DIN (eg. Sativex)
Black-market products, intended for human consumption and/or pet consumption, are still widely available to consumers and remain poorly regulated. The greatest concern about the use of these products (aside from their legal status) is that multiple studies in both the US and Canada have consistently found that many of these products are mislabeled with regard to their cannabinoid profile and may contain pesticide, heavy metal, or microbial contaminants. When clients choose to initiate treatment with these products, it is important that veterinarians are able to counsel them on both the legal issues, and potential risks surrounding their use.
Veterinary Research Updates
The preceding months have seen a number of published studies on the medical applications of cannabis; not only in human medicine, but also in veterinary medicine. Further studies focused on multiple species including dogs, cats and horses, are currently underway. Many of these studies have examined both the safety and efficacy of cannabis products when used responsibly as part of a multi-modal treatment plan. The results, to date, have been very favorable and encourage ongoing studies to further evaluate the role that cannabis can play in the treatment of animals.
When we examine the studies using low-THC, CBD-dominant cannabis extracts for dogs, the most common side effects noted in these studies include diarrhea, sedation, and an increase in ALP (without changes in bile acids). This mimics the WHO report on cannabidiol (CBD) that found it well tolerated, but with the potential to act as a CYT P450 inhibitor of other drug metabolism. To date, veterinary studies have not identified any significant drug interactions in clinical use when combined with NSAIDs or during use of anticonvulsant medications. Studies are now underway with results being published in multiple species, including cats and horses.
The CVMA and CAVCM have advocated extensively on the issues surrounding cannabis in veterinary practice. With the introduction of cannabis edibles, which pose an increased risk due to increased palatability, and potentially toxic additives such as chocolate and xylitol, we worked tirelessly to ensure new Consumer Handouts included a warning to keep these products out of the reach of both children and pets. We will continue to work to have veterinarians included as health professionals able to authorize medical cannabis use, and both the CVMA and CAVCM have offered our input on Health Canada’s introduction of edibles, and their proposed new class of cannabis products, Cannabis Health Products for Animals.
Discussing Veterinary Cannabis Use With Clients
With a growing number of Canadians looking to cannabis to help address concerns with their pet’s health, it remains incumbent upon our profession to be educated on the topic in order to provide appropriate harm reduction education and guidance for client-initiated cannabis treatment. While specifics may vary between provincial regulators, the Canadian Council of Veterinary Regulators (CCVR) published information last summer to assist veterinarians who are advising on cannabis use. As with all discussions with clients, recording information on cannabis use (type/dose/etc.) and any advice provided is a vital part of maintaining complete medical records.
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