Pubdate: Thu, 08 Feb 2018
Source: Vancouver Sun (CN BC)
Copyright: 2018 Postmedia Network Inc.
Author: Pamela Fayerman
Page: A6


Overwhelming 'delayed symptoms' once again a worry as 4/20 event

Calls to the B.C. Drug and Poison Information Centre have surged on
the annual 4/20 cannabis event in Vancouver in recent years, according
to a report by provincial health officials.

"The 4/20 cannabis calls represent a real spike, way over what we see
on ordinary days," said Dr. Tom Kosatsky, medical director of
environmental health services for the B.C. Centre for Disease Control.

He acknowledged that the total number of calls remains small, but is
nevertheless growing. His report is published in the current B.C.
Medical Journal.

"People call because they may be desperate if they feel they're
experiencing complications from exposures," he said in an interview.
"They are surprised to have such unexpected symptoms, they are worried
about feeling high and want to know if this is normal and what will
happen. Sometimes it's parents calling about their children or their
dogs that have ingested something."

The centre receives a total of 70 calls a day, on average, related to
all kinds of poisonings.

It receives only one or two calls a day, on average, from an anxious
person worrying about their symptoms or calling on behalf of a
cannabis-intoxicated individual, Kosatsky said.

But the total number of calls on 4/20 days for the four years was 19,
including one call about a 14-year old. And the number has been
rising, hitting eight calls in 2016.

While the number of poison control callers is a small number, the
report does not include the dozens of people who were treated by
paramedics, charged or suspended because of impaired driving or taken
to hospital emergency departments.

According to Vancouver Coastal Health, 66 people at the event last
year were taken to Vancouver emergency departments (mostly St. Paul's)
for medical issues related to the 4/20 event, including 10 who were
under age 20 and one who was 14. None were serious enough to require

The study does provide public health officials with information about
who is more likely to encounter problems that cause them to call
poison control centres: Women and those who ingest edible cannabis
products like gummy bears. Psychoactive effects of edibles - unlike
smoked cannabis products - often creep up on users.

"Ingesting cannabis produces delayed symptoms, often more severe than
those experienced from inhalation. Delayed effects and lack of dosage
regulations contribute to a phenomenon observed in poison control
calls in which novice users consume successive servings ... while
waiting for the drug 's psychoactive effects to begin," the medical
journal for B.C. doctors says.

The 4/20 event last year drew crowds estimated up to 100,000 people
who gathered at Sunset Beach and throughout downtown. It will again
take place in a few months, so Kosatsky said the report provides some
guidance for civic and health professionals about the need for
stronger cautionary messages.

"When it comes to all the people selling and buying cannabis products
during the event, it's like a farmer's market, but it's not even
quasi-regulated. People buying from homemade producers don't know what
they are getting and dosing instructions are inadequate. It's not like
buying from a licensed vendor who maintains quality controls," he said.

Since some doctors and naturopaths are prescribing medicinal cannabis,
the take-away message is that they should remind their patients that
edibles are more slowly metabolized and users should not eat too much.

At the event, Kosatsky wants more warnings on signage and leaflets at
sales points and he plans to talk to organizers about that. Dana
Larsen, a founding director of the Vancouver Dispensary Society and an
organizer of the annual 4/20 event, said announcements are made over
loudspeakers about cautions to take with edible products "because we
don't want anyone to have a bad experience."

Larsen said the numbers in the report are small, but he's willing to
enter a dialogue with health officials because "we would prefer if not
one person has a problem."

B.C. Emergency Health Services is holding meetings with the City of
Vancouver next week to start the planning for the next 4/20. Last
year, 21 paramedics were assigned to the event.
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