Keep Calm & Legalize On (Dr. Saah Interview) + Cannabis & Indigenous Women’s Health

 Women Warriors Yellowknifer News Column. Printed May 16th, 2018

Dr. Rebecca Saah is an assistant professor in the Department of Community Health at the University of Calgary. She will be in Yellowknife on June 11th to present to high schools, health professionals, and recreation leaders on cannabis legalization and youth.

 

As cannabis legalization looms the questions surrounding safe usage, distribution and the stigma of drug usage is a swirling debate of misinformation and fear. As a leader of a health promotions program, I wanted concrete information and guidelines to share with my Women Warrior participants.

I used my connections through Women Warriors to the University of Calgary and interviewed Dr. Rebecca Saah, assistant professor in the Department of Community Health. Her research is focused on youth cannabis use and the public health policy implications of cannabis legalization in Canada.

Substance Use & Criminalization

Dr. Saah said all demographics of Canadians smoke pot and an important reason for legalizing cannabis is, “the harms of criminalizing the drug have outweighed the benefit. It is an ineffective use of law enforcement and the courts, and the fact is this stigma is not benign.” She’s referring to the fact that being charged with the possession of marijuana carries the same or similar consequences as more problematic substances such as meth, cocaine, heroin, and fentanyl. “The harms to people from cannabis use are considerably lesser than substances such as cocaine or tobacco. All drugs should not be treated the same.”

Dr. Saah discussed how having a criminal record carries life-long consequences including the inability to cross the border to the US or not being able to work with children or vulnerable populations. For example, not being able to coach your child’s sports team.

In addition, People of Colour and Indigenous peoples have been over policed and stigmatized regarding pot use and/or possession by law enforcement and the courts. The Vice.com article, “Black and Indigenous people are overrepresented in Canada’s weed arrests” states, “Indigenous people in Regina were nearly nine times more likely to get arrested for cannabis possession than white people during that time period. Meanwhile, black people in Halifax were more than five times more likely to get arrested for possessing weed than white people.”

While Ottawa debates granting amnesty for past convictions, the damage of a criminal record and the social stigma of being a convicted drug user or dealer has disproportionately affected minority groups. The incoming cannabis legalization means an important discussion on how to change the dialogue surrounding the stigma of substance abuse and why the war on drugs has been racialized.

Dr. Saah directed me to an expert in the field of race, crime and criminal justice, Dr. Owusu-Bempah, assistant professor at the U of T. In a recent article authored by him, Cannabis Legalization and Equity in Canada, he states, “minor cannabis offences can also serve as a “gateway” into the criminal justice system for people who become “known to police,” which increases their chances of further criminalization and social marginalization.”

Education: Harm Reduction 

Saah’s main goal during this time of cannabis legalization is harm reduction meaning learning about cannabis and its effects, safer ways of using it, and educating people on what is permitted and not permitted in the legal framework. People using cannabis now and buying it from an illicit source, get little to no information about what they are consuming. This is of particular concern in regards to the THC content of cannabis (the psychoactive ingredient that produces the ‘high’).

In terms of retail outlets, specifically that sell alcohol and cannabis at the same location – which will be the case in Yellowknife – Saah said it’s a controversial issue in public health.

“People think separate is better but we don’t have a lot of good research on the effects when alcohol and cannabis are sold together. It is assumed that it will encourage co-use of the substance, and in Ontario, they have gone for separate state outlets. There are dissenting opinions in the public health research community – some people don’t think it’s a problem, but some do.”

Consumption methods of cannabis include smoking, vaporizing, infused edibles and sublingual products, which is the application of the product under your tongue. The Canadian Cannabis survey, released December 2017 states, “smoking cannabis was the most common method of consumption with 94% reporting this form of use, another 34% using edibles, 20% vaporizing using a vape pen, and 14% vaporizing using a vaporizer.” From a harm reduction perspective, vaporizing is a safer mode of use than smoking because there is less risk of lung irritation and respiratory problems.

“Edibles can’t be bought from a store. The federal government has been cautious about not including them in the current framework because initially when legalization rolled out in Colorado this created problems for with inexperienced users and accidental pediatric ingestions because they allowed for candy. We will probably never allow for candy. We’re going to start without edibles and see how it goes. The Federal legislation leaves this open so they can grandfather it in later without passing a new bill,” she said.

As far as trends in consumption, “We are moving from smoking to vaping, and other ways of consuming like sublingual oils that people use medically because many people don’t like the smell and want to use discreetly. What we found in Colorado is that edibles take over 50% of the market share and I think especially with older people that are interested in using for chronic conditions like pain and insomnia, they will not be smoking in their homes. Consumers will be looking for an oil or a capsule they can consume.”

Public health concerns center on the accidental ingestion of cannabis products by pets or kids. “It’s a place of education, and it’s the same practice we use for alcohol.  We keep it out of the hands of children, and take precautions in the household.”

Youth & Cannabis

The Canadian Cannabis survey states that young people are the predominant users of cannabis. The reported usage over the past twelve months for respondents “aged 16-19 years and aged 20-24 was 41% and 45% respectively” and “the average age of initiating cannabis use was 18.7 years.”

“I wish we were as concerned about the impact of poverty, violence and early childhood trauma on the teenage brain as we are about cannabis and youth usage,” said Saah. There is a need for public education surrounding the implications of cannabis use by young adults.

“The research is there – while there are some real risks, we can’t say they are causal, and we can’t attribute all of the harms to cannabis alone. We know there is a relationship between heavy and early use of cannabis in bringing on schizophrenia in people that are vulnerable, but we can’t say it’s only cannabis. The safest thing to say is that early-onset use and frequent use are risks for brain and mental health and for longer-term problematic use of substances. It’s the same for alcohol and tobacco – if you’re starting using these things in early adolescents like 13 or 14 years old, it’s a risk for development.”

Saah said a better question to ask surrounding early youth usage is, “what’s going on in these kids’ context that they’re starting these substances at 13. There are probably other risk factors that are wrapping around them. I would like to see more ways to strengthen teen resiliency in family and community rather than a focus on cannabis per se. I think making cannabis legal will open up the conversation for youth, not overnight but over time and erode the traction that the illicit market has.”

Saah said the best way to educate youth on cannabis legalization and health implications is, “face-to-face interaction and open discussion. I think it’s not so much about getting the health facts accurate as it is about having an open mind and talking to young people about what they see as the benefits and risks. This is what we do with sexual education and to protect against unwanted pregnancy or talking about consent. Think about our model for sexual education and could we do the same thing around cannabis?”


May 17, 2018. The government of Canada signs Health MOU with Onion Lake Cree Nation. Left, Minister of Indigenous Services, Jane Philpott & Council member, Dolores Pahtayken at the signing.

 

I am currently working on a tobacco and cannabis survey for participants of Women Warriors as my research project this semester. I will analyze my findings over the summer and work in collaboration with the Onion Lake Health Centre to create an appendix for the Women Warriors manual and help with community education. The Women Warriors program is scheduled to start mid-September on Onion Lake Cree Nation, our first on-reserve program.

 

GRIP (Group for Research with Indigenous Peoples) Forum, University of Calgary, May 15, 2018. Women Warriors grad student, Megan Sampson was invited to present a poster on her research findings.

Cannabis & Indigenous Women’s Health

An important part of cannabis legalization is consultation with Indigenous communities about potential business opportunities as growers and distributors of cannabis. Eagle Feather News reported that “The Saskatchewan government announced in early January that 60 Saskatchewan communities will be issued permits to sell cannabis after it becomes federally legalized in July 2018. Three of those 60 communities are Onion Lake Cree Nation, Lac La Ronge Indian Band, and Peter Ballantyne Cree Nation – the only three First Nation communities chosen by the province.”

There are many benefits for First Nations interested in joining the cannabis marketplace. As Chief Pasap states in this article, Cannabis is coming and some Indigenous communities want in, “The economic development side [will] create jobs. There are profits that could go to addiction awareness, sports programs, financing other businesses, and poverty reduction,” he said. “The benefits of cannabis are becoming a local distributor for medical users, getting rid of drug dealers and dealing with cannabis that is laced with other drugs and quality control.”

On March 19th and 20th, Cheryl Maurice, CEO of Digital Buffalo held a conference about Indigenous inclusion in the hemp and cannabis industries. She said it was well attended by First Nations leaders looking to partner with business leaders in the cannabis industry. Cheryl said, “our mandate is to partner with local First Nations and promote entrepreneurship.” If you are interested in learning more about cannabis business opportunities please contact Cheryl at the email above.

My experience as the facilitator of an Indigenous women’s health promotions program is that cannabis will be an important tool for improving Indigenous women’s health outcomes. One of the most requested resources in the program was mental health support. Now that the threat of incarceration has been removed, I posit that Indigenous women will be more open to accessing marijuana for their health needs including anxiety, PTSD, depression, and chronic pain/illness.

In addition, the revenue from cannabis sales on-reserve could improve Indigenous women’s social determinates of health such as high levels of unemployment and poor housing making it difficult for Indigenous peoples to stay in their home communities. In order to improve their life situation, they are forced from their reserves to an urban setting, cast away from their social safety net. This dislocation interrupts their sense of identity and feelings of belonging to a community and causes an increase in social anxiety.

The aspect of legalization I’m concerned with is educating participants on the legal framework to keep them safe from incareration and criminal charges. This Regina Leader-Post article has some informative do’s and don’ts of legal cannabis. Also, many of our participants have asked about youth usage and long-term effects of cannabis. These questions are guiding me as I create my tobacco/cannabis survey and decide what to put in the appendix.

Check out this Government of the Northwest Territories resource page for cannabis that features audio about the health effect of cannabis in the following Indigenous languages: Chipewyan, Gwich’in, Inuinnaqtun, Inuvialuktun, North Slavey, South Slavey, and Tlicho.

Please send me any questions or suggestions you have about Indigenous peoples & communities and cannabis legalization.
Shelley@womenwarriors.club