Hello and welcome. I'm Dr George Lundberg and this is At Large at Medscape.

You have to hand it to those folks north of the border. Canada is one helluva good country: intelligent, educated, scientific, compassionate, healthy, hard-working, blessed with common sense, and still having fun. On October 17, 2018, the Cannabis Act went into effect for the entire country, thereby legalizing cannabis for adults in Canada.

Some implementation variables have been enacted by province.[1] Here, paraphrased, are some particulars provided to the public for one province, Nova Scotia.

  • The Cannabis Act is designed to protect the health and safety of Canadians, to keep cannabis out of the hands of young people, and to keep profits out of the hands of criminals and organized crime. A person must be 19 years old or greater to buy, possess, or use cannabis. There are strict penalties for selling or giving cannabis to anyone under that legal age.

  • Legal (as opposed to black market) cannabis can be distinguished by a color-coded excise tax stamp. The use of cannabis carries risks, and the user is advised to learn how to use it responsibly.

  • Cannabis can cause impaired ability to drive an automobile or operate equipment, and there are serious criminal penalties for doing such while impaired. Cannabis should be stored securely away from children, teenagers, and pets.

  • It is illegal for cannabis to be transported across the national Canadian border, either inbound or outbound. Cannabis for medical purposes is still to be provided by authorized healthcare practitioners.

For more information, click to the Canadian government's website, Cannabis in Canada. Many details are freely provided.

Now, doesn't all of that make perfectly good sense? What is the fuss? And why are all those folks still sitting in American jails because of cannabis?

My writings about the science, toxicology, and clinical—as well as historical, social, and political—aspects of cannabis use date to the 1970s.[2,3,4] I do not use cannabis, so I do not write from personal experience. I do think a higher minimum age limit would be preferred; as with other psychoactive drugs, the younger the person is at the beginning of use, the greater likelihood of physical or mental harm.

A couple of points for cannabis users: Remember that, just as the dose of any psychoactive drug matters, so does the dosage form and the route of administration. The user can probably titrate the effect better by smoking cannabis than by other routes, as effects from smoking are very rapid. Oral consumption has a lag time to effects that may make titration difficult. One absolute: Do not use an injectable form of cannabis made by brewing the plant material and then shooting it intravenously. That makes for sudden, severe toxicity.

That's my opinion. I'm Dr George Lundberg and this is At Large at Medscape.

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