Cannabis-related hospitalizations highlight need for education, clinicians say

New research showing cannabis is outpacing alcohol as a cause of hospitalization among youth confirms the need for continuing government funding for drug education, Ottawa health-care advocates say.

The study,released last week by the Canadian Institute for Health Information (CIHI), found more than23,500 young people in Canada ages10 to 24 were hospitalized for harm caused by substance use in 2017-18, before the legalization of cannabis.

Cannabis wasresponsible for 40 per cent of those hospitalizations, while alcohol caused26 per cent.

"It says we can't take the foot off the gas," said Marino Francispillai, Ottawa Public Health's (OPH)program manager for school and community mental health.

Money hasn't materialized

When cannabis was legalized last year, the federalminister handling the filesaidrevenue generated from the excise tax onthe drug should be reinvested in research, preventativetreatment and rehabilitation.

But clinicians at CHEO, the Ottawa Hospital and OPH say little of that money has trickled down to communities to addressthe consequences of cannabis on young people.

"There is a good case for reducing our health-care costs by working upstream and preventing these issues from becoming something that requires hospitalization," Francispillai said.

OPHis about to launch a program developed by the federal government and geared toward students in Grade 8, one of the few resources the public health agency says it's received since legalization.

Linkto mental health

A complicating factor highlighted in the CIHI report is the fact that alarge majority of cannabis-related hospitalizations also involvedmental illness.

Sixty-nine per cent of the young people admitted to hospital for substance use also required care for mental illness; among those admitted for cannabis use, 81 per cent also required mental health care, nearly double the rate among adults 25 and older.

"This is also one of the really unique things about this analysis," said Geoff Hynes, a manager with CIHI."If we look at adults overall for similar reasons we tend not to see as common a link between the substance use and a mental illness."

CHEO psychiatrist Sinthuja Suntharalingamsaid cannabis seems to be bringing out mental illness for some of her patients, and for many it's also being used asa form of self-medication for an existing mental health problem despite evidence it makes issues like depression and anxiety worse.

Suntharalingam said the waitfortreatment after a hospital visit can take up to three months.

"[Youth] have a high risk of relapsing once they walk out of the hospital," Suntharalinghamsaid.The CIHI study found nearlyone in five patients had been hospitalized previously.

Suntharalinghamsaid while there aremodels for effective followupin other cities like Vancouver, they're "lacking"in Ottawa.

"It's great to see this report come out. It just makes us more aware of the problems that we are seeing as clinicians," she said.

Ottawa Hospital research

The Ottawa Hospital is also tracking the impact of cannabis on young people.

Researchers there have published findings on emergency room visits related to alcohol consumption datingto 2003, and the hospital is getting ready to publish an accompanying study on cannabis-related ER visits overthe same period.

ResearcherPeter Tanuseputro said the early findings support CIHI's results. He said the rate of hospitalization among for cannabis-related issues between 2003 and 2016 remained steady, except for a notable rise in ER visits by children under 14.

• Emergency departments see spike in young women binge drinking

That research, like the CIHI study, was carried out before legalization.

"What's happening now with increasing access to alcohol and cannabis, these harms will potentially increase," Tanuseputro said.

Where to get help:

Canada Suicide Prevention Service: 1-833-456-4566 (phone) | 45645 (text) |crisisservicescanada.ca(chat).

In Quebec (French):Association qubcoise de prvention du suicide: 1-866-APPELLE (1-866-277-3553).

Kids Help Phone: 1-800-668-6868 (phone),www.kidshelpphone.ca(live chat counselling).

Canadian Association for Suicide Prevention:Find a 24-hour crisis centre.