By Alexandra Keeler

Experts warn surging THC levels are fuelling growing health risks — and say stronger regulation is urgently needed

More and more cannabis users are ending up in emergency rooms suffering from severe, repeated bouts of vomiting — a condition known as cannabis hyperemesis syndrome.

A new study found that emergency visits for cannabis hyperemesis syndrome increased 13-fold over eight years, accounting for more than 8,000 of the nearly 13,000 cannabis-related ER visits in that period.

Experts say the mounting health risks associated with cannabis use are due to rising THC levels in cannabis products. They urge stronger regulation, better labeling and more research — using Quebec’s approach as a potential model.

“I don’t think we have the perfect model in Quebec — there’s pros and cons,” said Dr. Didier Jutras-Aswad, a clinical scientist at the Centre hospitalier de l’Université de Montréal (CHUM) and a professor in the Department of Psychiatry and Addiction at Université de Montréal.

“But overall, the process of … progressively implementing changes, not wanting to be the first one in line to put all this new product on the market, I think is probably, in terms of public health, more prudent.”

THC levels

Tetrahydrocannabinol (THC) is the primary psychoactive compound in cannabis and what causes the “high.” It is one of more than 100 cannabinoids, or chemical compounds, naturally found in the cannabis plant.

Delta‑9‑THC is the most common and well-studied form, though other forms of THC exist and are less understood.

Federal drug laws place strict limits on delta-9-THC levels. They cap delta-9-THC at 10 milligrams per piece for edibles, and 1,000 milligrams per container for extracts and topicals. Dried cannabis flower and pre-rolled joints have no THC cap, but must disclose the THC level on their labels.

Other intoxicating cannabinoids — like delta-8-THC — are not regulated the same way. Some producers use these other cannabinoids to get around delta-9 limits to make their products more potent.

In 2023, Health Canada issued guidance warning against this practice, noting it could lead to inspections and regulatory action. Its guidance is not legally binding.

“Good weed”

Dr. Oyedeji Ayonrinde, a professor of psychiatry and psychology at Queen’s University, says “good weed” used to mean a product did not contain pesticides or contaminants. Now, it often means a product is high-THC — reinforcing the risky idea that stronger is better.

“We would say, Oh, man, that guy’s got good weed,’ because it’s 30 per cent [THC],” he said.

Today, THC levels average about 25 per cent — up from about four per cent in the 1960s. But some products go as high as 80 or 90 per cent THC.

“That’s ‘the good stuff,’” said Ayonrinde, referring to how consumers view products with these elevated levels of THC.

“One of the major [health] risk factors is the use of cannabis with higher than 10 per cent THC,” said Dr. Daniel Myran, a physician and Canada Research Chair at the University of Ottawa.

Myran led three Canadian studies this year linking heavy cannabis use to health risks such as schizophrenia, dementia and early death.

Chris Blair, a Canadian originally from Jamaica, says the cannabis he once smoked — natural, Jamaican, homegrown weed known as “sess” — was much milder than what is available through Ontario dispensaries today.

“We grew it, it was natural … the regular Mary Jane sess,” he said. “And then times changed … the sess was pushed to almost become the hydro[ponic] type of thing.”

Hydroponic growing methods produce more potent cannabis with higher THC levels. Blair says he could no longer go back to Jamaican sess, because he had built up a tolerance to it.

“Unfortunately, going back to sess was not the same, because it wasn’t the same high or same strength,” he said.

“Back when [I was] smoking [Jamaican sess] … I’d finished that spliff and we were ready to go hang out, we’re ready to party.

“Nowadays, after you smoke you’re mashed and you’re not doing anything.”

Greening out

Ayonrinde says higher THC levels can alter how the brain’s dopamine receptors work, which may induce paranoia.

“Being out of touch with reality, auditory hallucinogens, delusional thoughts, disorganized thinking — that’s part of the mechanism pathway for the development of a severe and enduring mental illness [like] schizophrenia,” he said.

High THC can also worsen anxiety, disrupt sleep, affect mood and trigger psychosis, he says. Other experts cited risks including cannabis use disorder, mental health issues, and dizziness or nausea — sometimes referred to as “greening out.”

Young people, whose brains are still developing until age 25, are most vulnerable to these harmful effects, Ayonrinde says.

During adolescence, the brain undergoes intense growth. “Think of the brain like a construction site,” he said. Frequent, high-dose THC use during this critical period can disrupt dopamine systems and increase the risk of building scaffolding for serious mental health conditions.

While some literature suggests that cannabidiol (CBD) — another major cannabinoid in most cannabis products — may act as a calming, non-psychoactive counterbalance to THC, Ayonrinde says this is only true at extremely high doses, around 6,000 mg.

Standard measurement

Experts say the diversity of cannabis products on the market is part of the challenge.

“When people say, ‘Weed helps me with my trauma,’ an example I often give is: cannabis is just like saying ‘dog’,” said Ayonrinde.

“What breed? Is it a chihuahua or a rottweiler or a great dane? Because without knowing exactly the THC, CBD … what are you talking about?

“There’s no single cannabis.”

Cannabis products lack clear dosage guidelines, and Ayonrinde says marketing messages push consumers to opt for high potency options.

Ruth Ross, a professor of pharmacology and toxicology at the University of Toronto, would like Canada to adopt a standard unit of measurement for THC levels, so consumers could easily understand what one unit means.

“Say a unit was one milligram; they could multiply that up — it’s easy math,” she said.

Myran agrees. “The way we sell alcohol in this country is not set up so that you pay the same amount for a litre of wine as you do for a litre of vodka,” said Myran.

“You have a minimum price per unit of ethanol … and there’s a really compelling reason to price cannabis according to its THC content … [to] financially discourage people from always moving to the highest potency THC products.”

Ross says there is also a need for more current cannabis research. Most cannabis research evaluates the effects of cannabis products with much lower THC levels than those seen on the market today. Long-term health effects can take decades to appear — similar to tobacco.

“Some of [the health harms] might emerge over many, many years, and we don’t know what those will be until data comes in,” she said.

Quebec’s approach

Ross points to Quebec as a unique model in cannabis regulation. It is the only province that caps THC potency and tightly controls how cannabis can be marketed. For example, edibles resembling candy or desserts are prohibited.

Jutras-Aswad, of the Université de Montréal, says overly strict rules can drive some consumers — especially those younger than the province’s legal age of 21 — to the black market.

Still, he says Quebec’s model offers benefits, including greater control over sales and a public health approach focused on harm reduction rather than profit.

Under Quebec’s Cannabis Regulation Act, the Société québécoise du cannabis (SQDC) is the only authorized cannabis retailer in the province.

SQDC employees are trained to offer science-based information, connect consumers with support services and promote safer use.

Researchers in Ontario are now studying how Quebec’s stricter THC limits may be affecting cannabis-related harms compared to other provinces.

“That’s going to be a really interesting within-Canada experiment,” said Ross.

Myran recommends adopting Quebec’s 30 per cent THC caps nationwide.

He also recommends better product labelling requirements and a pricing model that sets a minimum price per unit of THC — to discourage the purchase of high-potency products.

In a 2023 op-ed, Ross argued provinces should fund cannabis research to guide policy and public health.

In it, she notes that Quebec reinvested all $95 million of its 2022 revenue from cannabis sales into prevention and research. By contrast, Ontario set aside just 0.1% of its $170 million in cannabis revenue for a Social Impact Fund that has no clear public health focus.

“Canada can do so much better. We have world experts in cannabis research from coast-to-coast, and we are uniquely positioned to have high-quality, well-funded research on its medical use and potential harms,” she wrote.

“Five years from now, will we be dealing with major public health challenges that could have been avoided?”

This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

From LifeSiteNews

By Doug Mainwaring

Trump warned the leaders of Pfizer, AstraZeneca, and other Big Pharma corporations that his administration ‘will deploy every tool in our arsenal’ to end inflated drug prices.

President Donald J. Trump sent letters on Thursday to 17 leading pharmaceutical manufacturers outlining the steps they must take to bring down the prices of prescription drugs in the United States to match the lowest price offered in other developed nations.

Trump called on the pharmaceutical giants to provide most-favored-nation (MFN) prices available to overseas customers to U.S. consumers, specifically mentioning “to every single Medicaid patient.”

Looking to the future, his letter also requires MFN pricing for all newly-launched drugs.

The letters inform manufacturers that if they “refuse to step up,” the federal government “will deploy every tool in our arsenal to protect American families from continued abusive drug pricing practices.”

Identical letters were sent to AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, EMD Serono, Genentech, Gilead, GSK, Johnson & Johnson, Merck, Novartis, Novo Nordisk, Pfizer, Regeneron, and Sanofi.

Trump signed a sweeping executive order (EO) in early May, “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” in which he said that drug manufacturers “deeply discount their products to access foreign markets, and subsidize that decrease through enormously high prices in the United States.”

“The inflated prices in the United States fuel global innovation while foreign health systems get a free ride,” said Trump in his EO.

“This abuse of Americans’ generosity, who deserve low-cost pharmaceuticals on the same terms as other developed nations, must end,” he demanded.

“Right now, brand name drug prices in the United States are up to three times higher on average than elsewhere for the identical medicines,” began Trump in his letter to Big Pharma corporate heads. “This unacceptable burden on hardworking American families ends with my Administration.”

“Most proposals my Administration has received to ‘resolve’ this critical issue promised more of the same: shifting blame and requesting policy changes that would result in billions of dollars in handouts to industry,” wrote Trump.

“Moving forward, the only thing I will accept from drug manufacturers is a commitment that provides American families immediate relief from the vastly inflated drug prices and an end to the free ride of American innovation by European and other developed nations,” he explained.

The president demanded action from the pharmaceutical companies within 60 days.

“Make no mistake: a collaborative effort towards achieving global pricing parity would be the most effective path for companies, the government, and American patients. But if you refuse to step up, we will deploy every tool in our arsenal to protect American families from continued abusive drug pricing practices,” warned the president.

“Americans are demanding lower drug prices, and they need them today,” noted Trump.

“Other nations have been freeloading on U.S. innovation for far too long: it is time they pay their fair share.”