By Nairah Ahmed, Local Journalism Initiative Reporter, Canada’s National Observer
New statistics on medical cannabis use raise questions about what qualifies as pain management and highlight the need for more open conversations between young people and health professionals, researchers and mental health experts say.
Last month, Statistics Canada released data showing more than 60 per cent of 15- to 19-year-olds who use cannabis for medicinal purposes are treating symptoms of anxiety or depression.
Matthew Prebeg, a youth engagement specialist at the Centre for Addiction and Mental Health (CAMH), was not surprised by the findings. Instead, he was more surprised by the study’s definition of pain management, which did not include treating symptoms of depression or anxiety.
“I would argue that young people using cannabis for anxiety and depression is still pain management. It’s interesting they are using pain management to only refer to physical pain; there’s a bit of nuance there,” Prebeg said.
Prebeg said the statistics on cannabis use may have been conflated since older people have higher rates of chronic physical pain to treat while younger people have higher rates of anxiety and depression.
The definition of pain management could be expanded to include anxiety and depression, Prebeg said. “When we are talking about chronic pain and how mental health intersects with that, it would be really important to consult people with lived experience on how that’s defined,” Prebeg explained. “Especially when we are talking about Health Canada — that definition has impacts.”
Dr. Jo Henderson, executive director at the Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health and a senior scientist at CAMH, echoes this statement. “It’s really important for researchers and system planners to be engaging youth with lived or living experience and expertise around mental health and substance use to ensure the voices of young people are present in these important conversations.”
Henderson can’t emphasize enough that health professionals across the country need to get better at starting productive conversations with young people about cannabis use.
“Health-care providers, family doctors and mental health professionals need to ask young people about their substance use in ways that create safety for young people to be honest about their cannabis use,” Henderson said. “Then we can start to have conversations about cannabis use in the context of mental health that are accurate and lead us to working with young people to figure out the best plan for symptom management.”
Henderson pointed out that cannabis use is still illegal for those under 18. While the brain changes throughout our lives, Henderson said peak brain development happens particularly through adolescence and early adulthood.
“We know that cannabis use, especially high-frequency cannabis use, can impact brain structure and function,” Henderson said. “It’s important young people have accurate information about the potential impacts of cannabis on their brain development and functioning.”
The problem is access to user-friendly and developmentally appropriate mental health services in Canada, Henderson said. “That is where we need to focus much attention, ensuring that every young person across Canada has timely access to appropriate mental health services.
“No young person should be left to their own devices to address their mood and anxiety concerns,” Henderson said. “They should have access to support when they need it, in the places they need it, to help them manage those symptoms.”
Rather than looking at the StatCan data in a negative way, Prebeg said it shows an opportunity to explore alternative pain management or coping strategies for young people.
Henderson referred to a document called The Blunt Truth, made for youth, by youth to help young people become aware of the low-risk use guidelines for cannabis. “It provides useful tips about safer ways to use cannabis so young people have access to quality information to help them make good decisions.”
Although the guide is helpful, Henderson said the priority is for young people to have access to good mental health services so they can talk about their individual situations with health-care professionals to figure out the best plan for them.
“We need to continue to grow our commitment to working collaboratively with young people on the issues that affect them,” Henderson said.
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