Food Service & Nutrition - Summer 2018 - 9

increase their dose in order to minimize
the risk of over-consumption and adverse
effects. Vaporizing is sometimes used in
conjunction with the oral medications
on an as-needed basis for quick relief
of symptom exacerbations. Inhalations
should be spaced apart by 15-minute
intervals until desired symptom control
has been achieved.
RESULTS AND CAUTIONS
Response to cannabis is highly individualized and variable. Measurement of success
often relies on subjective improvement. A
treatment diary is suggested to document
administration times, dosages, response
and any adverse reactions in order to
facilitate adjustments to therapy.
Like all pharmacological agents, there
are side effects with medical cannabis.
Most are attributed to THC and are dosedependent and self-limiting. They can
be avoided by using low-THC products
at minimal doses and titrating slowly.
Dizziness, drowsiness and dry mouth
are among the most commonly reported
adverse effects. Other acute adverse
effects include alteration of short-term
memory, disorientation, confusion and
impaired judgement and coordination.
Patients should be cautioned about possible impairment and refrain from driving or operating dangerous equipment.
Concomitant use of medical cannabis with

other CNS depressants like sedatives and
hypnotics or alcohol should be avoided
due to potential drug interactions.
Cannabis has a favorable therapeutic index and safety profile relative to
many other medications. Because cannabinoid receptors are sparse in the brain
stem, which controls cardiovascular
and respiratory functions, cannabis
does not cause the lethal respiratory
depression seen with opioids. Signs of
cannabis overdose include acute psychotic episodes, shortness of breath,
pupil dilation and fast heart rate, but
there are no known reported fatalities
due to overdose.
Notably, there is a lower risk of physical or psychological dependence with
cannabis compared to other substances
such as tobacco, alcohol and opioids.
Nonetheless, addiction potential does
exist and it is estimated that 9 percent
of chronic recreational cannabis users
develop addiction, or what is referred
to as "cannabis use disorder." Past history of substance abuse and potential for
addiction must therefore be considered
before initiating therapy.
Similar to smoking and alcohol consumption, recreational and medical
cannabis use should be included in the
patient records. It is important to monitor for misuse or aberrant behavior, and
to take immediate action if identified.

Today, health care professionals are
challenged with developing policies and
procedures that optimize patient care and
also align with possession and handling
restrictions under the ACMPR. Medical
cannabis must be securely stored and
protected from unauthorized access. In
long-term care settings, this means a
double-lock system similar to that used
for narcotics. Regular inventory counts
are being conducted to monitor for diversion. Bottles containing cannabis oil are
precisely weighed for inventory tracking
purposes. Excess cannabis is rendered
unusable prior to safe disposal.
There is still much to be learned about
cannabis and its place in medicine.
Although the Canadian landscape is changing with nationwide legalization of cannabis, the existing ACMPR will remain
the framework for medical cannabis for
the time being. The safe, appropriate and
responsible use and handling of cannabis,
medical or otherwise, will be a priority for
all concerned.
Roxanne Tang is a pharmacist graduate of the
University of Saskatchewan. She has a diverse
background in retail, hospital and long-term
care pharmacy and has been actively involved
in management, operations and professional
services. Roxanne currently holds the position
of director of pharmacy practice with Medical
Pharmacies Group Limited.

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Table of Contents for the Digital Edition of Food Service & Nutrition - Summer 2018

President’s Message
The ABCs of Medical Cannabis
Press Pause…Press On: Sustaining Energy and Wellness in the Workplace and Beyond
Holding the Planet on Your Plate: Ideas for Promoting Sustainable Menus
Ask an Expert
Management Notebook
CSNM Corporate Member Profile
Industry News & CSNM News
Continuing Education Quizzes
Food Service & Nutrition - Summer 2018 - Intro
Food Service & Nutrition - Summer 2018 - cover1
Food Service & Nutrition - Summer 2018 - cover2
Food Service & Nutrition - Summer 2018 - 3
Food Service & Nutrition - Summer 2018 - President’s Message
Food Service & Nutrition - Summer 2018 - 5
Food Service & Nutrition - Summer 2018 - The ABCs of Medical Cannabis
Food Service & Nutrition - Summer 2018 - 7
Food Service & Nutrition - Summer 2018 - 8
Food Service & Nutrition - Summer 2018 - 9
Food Service & Nutrition - Summer 2018 - Press Pause…Press On: Sustaining Energy and Wellness in the Workplace and Beyond
Food Service & Nutrition - Summer 2018 - 11
Food Service & Nutrition - Summer 2018 - 12
Food Service & Nutrition - Summer 2018 - 13
Food Service & Nutrition - Summer 2018 - Holding the Planet on Your Plate: Ideas for Promoting Sustainable Menus
Food Service & Nutrition - Summer 2018 - 15
Food Service & Nutrition - Summer 2018 - 16
Food Service & Nutrition - Summer 2018 - 17
Food Service & Nutrition - Summer 2018 - Ask an Expert
Food Service & Nutrition - Summer 2018 - 19
Food Service & Nutrition - Summer 2018 - Management Notebook
Food Service & Nutrition - Summer 2018 - CSNM Corporate Member Profile
Food Service & Nutrition - Summer 2018 - Industry News & CSNM News
Food Service & Nutrition - Summer 2018 - 23
Food Service & Nutrition - Summer 2018 - 24
Food Service & Nutrition - Summer 2018 - Continuing Education Quizzes
Food Service & Nutrition - Summer 2018 - 26
Food Service & Nutrition - Summer 2018 - cover3
Food Service & Nutrition - Summer 2018 - cover4
http://www.nxtbook.com/naylor/CSNQ/CSNQ0418
http://www.nxtbook.com/naylor/CSNQ/CSNQ0318
http://www.nxtbook.com/naylor/CSNQ/CSNQ0218
http://www.nxtbook.com/naylor/CSNQ/CSNQ0118
http://www.nxtbook.com/naylor/CSNQ/CSNQ0417
http://www.nxtbook.com/naylor/CSNQ/CSNQ0317
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http://www.nxtbook.com/naylor/CSNQ/CSNQ0416
http://www.nxtbook.com/naylor/CSNQ/CSNQ0316
http://www.nxtbook.com/naylor/CSNQ/CSNQ0216
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