Parenting and Cannabis
As a parent using cannabis, it is important to know the risks and your rights to keep you and your children safe! Here are some things to consider:
Cannabis use while parenting
Using cannabis while parenting can affect how you interact with and respond to your child. It may decrease your ability to pay attention and miss your baby or child’s cues for hunger, to play, to be comforted or signs of danger. Ultimately, cannabis use can affect how you respond to your child’s needs and your ability to keep them safe (Government of Canada, 2018). If you are using cannabis, make sure there is someone else who is not using cannabis who can help take care of your child (Government of Canada, 2018).
Smoke is harmful for all of us, especially while pregnant and for babies and young children. Second-hand cannabis smoke can lead to illness in infants and young children. It can also impact their alertness, understanding and judgement. To be safe, it is best not to smoke or vape cannabis in your home or around your baby or young children (CAMH, 2020).
Cannabis passes into breast milk through breastfeeding and it can be stored in your baby’s fat cells and brain for several weeks (Health Canada, 2018). As breastfeeding is the healthiest choice for your baby, if you are unable to stop using cannabis, try reducing your use. If you need help to reduce or stop using cannabis, talk to your health care provider (Health Canada, 2018). See other tips in the Harm Reduction and Pregnancy, Lactation and Fertility Section
Cannabis can make children very sick so it is important that they do not consume cannabis. Children may think edibles such as brownies, cookies or gummies are a treat. All regulated (legal) cannabis products come in child-resistant packaging and are prohibited from having any packaging design or product shapes/colours that appeal to children (Canada, 2019). This is why it’s important to purchase legal products and take steps to keep them away from children and put away in a locked area that children cannot see or reach.
Risks to children who consume cannabis
When children accidentally eat cannabis they may look fine at first but cannabis can be very harmful to a child. The reaction to the drug may not be immediate but show effects much later. Here are some things to look for:
- Difficulty breathing
- Lack of coordination
- Slurred speech (Public Health Agency of Canada, 2018).
Driving and using cannabis
It is important to know that driving while using cannabis is illegal. Using cannabis impairs your ability to drive a motor vehicle safely, even if you do not feel high. Using cannabis decreases your reaction time and thinking skills and makes it harder to determine distances (Public Health Agency of Canada, 2018). For more information see our section on Cannabis and Driving Laws
Talking with your children
Talking about cannabis with your kids can help prevent harms from cannabis use. Be sure to inform yourself before talking to your kids. It’s important to note that just because cannabis is legal, it does not mean it is harmless (CAMH, 2020). Legalization aims to keep cannabis away from youth and to protect public health and safety by allowing controlled cannabis access. Adults or youth who provide cannabis to minors is illegal and can result in fines and jail time (CAMH, 2020). In addition to issues with the law, it is important to talk to your children about the potential health impacts of cannabis use. Let your children know that while trying cannabis is not likely to cause serious problems, in some cases even occasional use can be harmful (CAMH, 2020). Youth who use cannabis often, long-term and at a young age, are at an increased risk for health and social problems (CAMH, 2020).
Making decisions about cannabis use as a parent
It is important to consider the impacts of cannabis use on not only yourself but consider the benefits and risks to your health, your children’s health, your relationships, your work or your finances. Just because cannabis is legal, it does not mean there are no risks involved. Inform yourself by taking a look at The Cannabis Act, which is designed to better protect the health and safety of Canadians, to keep cannabis out of the hands of youth, and to keep profits out of the hands of criminals and organized crime (Government of Canada, 2019). The Cannabis Act is currently available in the following Indigenous languages:
CAMH. 2020.Cannabis: What Parents/Guardians and Caregivers Need to Know. https://www.camh.ca/-/media/files/cannabis-parent-infosheet-pdf.pdf
Health Canada. (2018). Thinking about using cannabis while parenting? https://www.ontariopoisoncentre.ca/siteassets/pdfs/english/new—since-2021/english_health-canada_cannabis-while-parenting.pdf
Government of Canada. (2019). The Cannabis Act: Here is what you need to know. https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/resources/cannabis-act-what-you-need-to-know.html
Cannabis and Pregnancy, Lactation and Fertility
Cannabis is a natural plant that is legal in Canada for adult use. Therefore, many Canadians believe that cannabis is harmless and does not affect pregnancy, lactation, or the developing baby. In reality, the legal status of a substance does not mean there are no risks. Researchers are still figuring out the effects of cannabis use during pregnancy on babies, children, and youth. There is no known safe amount of cannabis use during pregnancy or breastfeeding, nor do we understand the risks associated with consuming different amounts or when it is consumed in relation to the pregnancy. Therefore, until we know more about the effects of cannabis on fetuses, babies, and pregnancies, experts advise people who are pregnant, thinking about getting pregnant, or are lactating to avoid it in all its forms (GoC, 2018). Furthermore, The Society of Obstetricians and Gynaecologists of Canada recommends using alternative therapies that are proven safe during pregnancy and lactation instead of medical cannabis (SOGC, 2017).
Why it is difficult to get the same answer
Many of the studies exploring cannabis during pregnancy and lactation have been done on animals due to ethical concerns of using human subjects. Those that use humans are very limited and have difficulty providing consistent and accurate information about the amount, type and timing of cannabis consumed during pregnancy and lactation. It is also difficult to determine the effects of other things on pregnancy, lactation, and the developing baby such as exposure to alcohol, tobacco, and other factors. While research is limited and sometimes inconsistent, it is important to note that evidence currently suggests that consuming cannabis while pregnant and lactating is not risk free and expert advice is to avoid using cannabis during this time.
Fertility, Conception and Cannabis Use
There is some evidence that using cannabis may affect fertility and may make getting pregnant more difficult (GoC, 2018). Long-term use of cannabis may affect the menstrual cycle and the hormones your body produces during reproduction. Similarly, cannabis has been linked to lower sperm count, sperm’s decreased ability to swim, and poorer sperm quality (GoC, 2018). Therefore, people who are thinking about or trying to get pregnant should avoid consuming cannabis.
Cannabis Use and Pregnancy
Some researchers have found that cannabis use may have some negative effects on pregnancy (Public Health Ontario, 2018; GoC, 2018). Cannabinoids, specifically THC, cross the placenta and reach the developing fetus.
There is concern that this leads to short and long-term health effects, preterm labour or stillbirth. It is important to understand that cannabinoids are stored in fat in our bodies and get slowly released from fat storage to the bloodstream. This release can continue for up to 30 days (Porath-Waller, 2015, Public Health Ontario, 2018). Therefore, even if you have stopped consuming cannabis, it can take up to a month for the cannabinoids to leave your system and they may still be passed to the fetus or nursing baby.
Some studies have found that smoking cannabis during pregnancy may increase carbon monoxide in the blood of both the pregnant person and developing fetus. This decreases the amount of oxygen the fetus receives and may lead to negative health outcomes (National Academies of Sciences, 2017). Learn about non-smoking methods of consuming cannabis.
As cannabis can decrease blood pressure, this can lead to dizziness and fainting, which can cause injury to both the pregnant person and fetus (GoC, 2018). Other studies have found that the more cannabis the pregnant person uses, the more likely pregnancy complications can occur (Porath-Waller, 2015). However, more research is needed to confirm whether these effects are due to cannabis rather than other risk factors.
Cannabis Use and Breastfeeding/Chestfeeding/Nursing/Lactating
Similar to how cannabinoids may pass to the baby in the fetus, there is a chance that cannabinoids may pass to the nursing baby through human milk. Since cannabinoids are stored in body fat, our body can store cannabinoids in human milk for up to six weeks. Therefore, pumping and dumping the milk after consuming cannabis may not be effective in preventing your baby from being exposed. Some studies have shown that there can be eight times more THC in human milk compared to the lactating person’s blood (GoC, 2018). Another found that the baby ingests about 2.5% of the THC in the lactating person’s dose (Porath-Waller, 2015). The THC that the baby potentially absorbs can be stored in their fat cells and brain for weeks. Furthermore, cannabis consumption can affect the success of lactation as it affects the hormone that tells your body to make milk (prolactin). Additionally, babies who are exposed to cannabis may be drowsy and have poor suckling. Therefore, experts recommend not consuming cannabis while lactating.
Potential Effects of Cannabis on Infants and Children
Although more research is needed, multiple studies have suggested that exposure to cannabis during pregnancy or in early childhood may affect your child (GoC, 2018; Public Health Ontario, 2018). These impacts may be more noticeable as your child grows older and may last throughout their life. Some of these effects include:
- Low birth weight
- Decreased muscle tone
- Poor suckling
- Irritability and decreased ability to self soothe
- Sleep disturbances
- Reduced memory function
- Difficulty paying attention and multitasking
- Poorer reasoning and problem-solving skills
- Increased hyperactive behavior
- More impulsive and aggressive
- Lower IQ and academic achievement
Adolescence and Adulthood:
- Continued impulsivity, attention difficulty, poor memory, decision making and problem-solving skills
- Increased risk of depression and/or anxiety
- Reduced school performance
- May be more likely to misuse substances
Harm Reduction: What if I can’t stop using Cannabis?
Experts recommend that anyone who is thinking about getting pregnant, currently pregnant, or lactating stop cannabis use. However, sometimes it is difficult or impossible to stop using it. Here are some things you can do to minimize the harms of cannabis while pregnant or lactating:
- If you can’t stop using cannabis while pregnant or lactating, try switching to cannabis products with less THC and consuming cannabis less often (CMNRP, 2019). The amount of cannabis your fetus or baby is exposed to depends on how often you use it and the amount of THC in the product. Evidence suggests that THC has the most negative health impacts. Learn about the differences between THC and CBD
- Try getting your cannabis products from regulated stores. Regulated products must be labeled and meet strict quality and safety standards. They are unlikely to have additives, mold, pesticides, or fungicides (CMNRP, 2019).
- Although all forms of cannabis (smoking, vaping, edibles, topical etc.) may impact your fetus or baby, try to avoid smoking. Learn about non-smoking methods of consuming cannabis!
- If you’re smoking cannabis, try doing it away from your infant to avoid second-hand smoke; wash your hands and change your clothes before contacting your baby to avoid third-hand smoke and reduce their exposure to cannabis (CMNRP, 2019).
- Avoid using cannabis with alcohol, tobacco, prescription and over the counter medication. When combined, there can be an increased risk of harmful effects to the baby as well as safety concerns due to parental intoxication (CMNRP, 2019).
- Speak to your healthcare provider about alternatives to cannabis or harm reduction to safely guide you through your conception, pregnancy and lactation journey.
Porath-Waller AJ. Clearing the smoke on cannabis. maternal cannabis use during pregnancy – an update. Canadian Centre on Substance Abuse; 2015 https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Cannabis-Maternal-Use-Pregnancy-Report-2018-en.pdf
GoC, 2018: https://www.cpha.ca/sites/default/files/uploads/resources/cannabis/evidence-brief-pregnancy-e.pdf
Society of Obstetrics and Gynecology of Canada, SOGC https://www.pregnancyinfo.ca/learn-more/
National Academies of Sciences (2017). Prenatal, Perinatal, and Neonatal Exposure to Cannabis. In The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK425751/
Public Health Ontario. (2018). Evidence Brief: Health Effects of Cannabis Exposure in Pregnancy and Breastfeeding. https://www.publichealthontario.ca/-/media/documents/E/2018/eb-cannabis-pregnancy-breastfeeding.pdf
Champlain Maternal Newborn Regional Program (CMNRP). (2019). Lactation and Cannabis Use: A Harm Reduction Approach. http://www.cmnrp.ca/uploads/documents//CMNRP_Cannabis_and_Lactation_Discussion_Guide_2019_11_06_FINAL.pdf
Cannabis Use with Other Substances
Cannabis is considered a much safer drug compared to other substances like alcohol, meth, cocaine, and opiates. While this is true, combining it with other substances can have negative consequences that can be undesirable and even dangerous.
Alcohol and Cannabis
Cannabis and alcohol are commonly consumed together. Combining cannabis and alcohol together can be more harmful than either substance alone (Public Health Ontario, 2018). For example, the effects of cannabis and alcohol can add up and result in nausea, anxiety, paranoia, sweating, panic attacks, short-term memory loss, loss of motor skills and even hallucinations (Public Health Ontario, 2018). Cannabis can also suppress your gag reflex, which may interfere with your ability to vomit when you have consumed too much alcohol making you more vulnerable to alcohol poisoning. This is especially troubling because when someone uses cannabis and alcohol at the same time, it often leads to increased alcohol intake. (Public Health Ontario, 2018). Alcohol poisoning is a life-threatening condition that requires hospitalization.
Tobacco and Cannabis
Similar to cannabis and alcohol, cannabis and tobacco are also commonly consumed together (McClure et al., 2019). Given the known health risks of smoking tobacco including cancer, heart disease, lung disease and addiction, combining cannabis and tobacco is concerning. People who smoke cannabis tend to inhale more deeply and hold the smoke in their lungs longer, which exposes their lungs to harmful chemicals longer (McClure et al., 2019). They are also more likely to have higher levels of carbon monoxide in their blood, which significantly interferes with ability for your blood to carry oxygen. Finally, a recent study concluded that people who use cannabis and tobacco together had significantly higher rates of cannabis addiction compared to those who used cannabis alone or tobacco alone (Tucker et al., 2019).
Cannabis and Cocaine
Mixing cocaine and cannabis is never a good idea, the effects of using them together can range from unpleasant to life threatening. For example, consuming cannabis and cocaine together can lead to increased levels of paranoia, anxiety, and cocaine withdrawal symptoms (Vertava Health, 2021). Cocaine and cannabis also both have impacts on your heart, like a fast heartbeat, heart attacks, blood clots and even strokes. When consumed together, these impacts can be magnified (Vertava Health, 2021). Cannabis can decrease the stimulant effect of cocaine, which may lead to an increased consumption of cocaine to achieve the same effect; this can increase the risk of cocaine addiction and even an overdose (Vertava Health, 2021). Therefore, these two drugs should never be mixed as it is dangerous and life threatening.
Cannabis and Opioids
Recent studies show that combining cannabis and opioids can be helpful for people suffering from chronic pain when monitored closely by a medical professional. They found that when combined, people suffering from chronic pain had pain relief with lower doses of opioids and their pain tolerance improved. This decreased the risk and likelihood of opioid addiction and overdose (Cooper et al., 2018). That said, because cannabis and opioids are both depressants, when not done correctly, this combination can suppress the central nervous system to life threatening levels and can result in decreased brain function, low blood pressure, sedation, coma, and even death (Rogers et al., 2019). Furthermore, using opioid and cannabis at the same time increases symptoms of anxiety, depression, and substance use problems (Rogers, 2019). Therefore, these drugs should never be combined recreationally and should only be done under the strict supervision of a medical professional. Learn about medical cannabis.
Cannabis and Prescription Medication
It is often thought that because cannabis is a natural plant, it is safe to use with prescribed medications. This is not true. Cannabinoids are active chemicals and can affect the way prescription drugs work in your body (Antoniou et al., 2020). For example, cannabis can increase or decrease the level of a drug in our system; it can add to the effects of a drug or mask it (Antoniou et al., 2020). On the other hand, certain prescription drugs can also increase or decrease the effects of cannabis itself (Antoniou et al., 2020). Therefore, before using cannabis, make sure you speak to a medical professional to make sure it doesn’t interact with your medication and potentially put your life at risk. Learn about medical use of cannabis and how to get a medical cannabis document.
Cannabis and Prescription Medication
A common statement used when referring to the harms of cannabis is that it is a gateway drug. A gateway drug is a substance that leads to the use of more dangerous “hard” drugs like cocaine, heroin, opioids etc. Animal studies have shown that exposure to cannabis was more likely to lead to addiction-like behaviours (Panlilio et al., 2013) and usually alcohol, tobacco, and cannabis use occurred before other drug use (Secades-Villa et al., 2015). However, it is important to note that the majority of people who use cannabis don’t go on to use more dangerous drugs (Public Health Ontario, 2019). The exact cause of drug use and addiction is complicated, involving genetics, social environment, and other factors. Many experts argue that the risk factors that make it more likely for you to consume cannabis also increase the likelihood of using other substances and therefore, it makes sense that cannabis is commonly used with other drugs. Therefore, it is hard to decipher whether cannabis triggers the use of other drugs or its concurrent use with other substances is due to a complicated combination of genetics and environment.
Public Health Ontario. (2018). Evidence Brief: Risk Factors for Simultaneous Use of Alcohol and Cannabis. https://www.publichealthontario.ca/-/media/documents/e/2018/eb-risk-factors-alcohol-cannabis.pdf?sc_lang=en&hash=D3084089F64BB2F0B98B0CA8FC95DBA8
McClure, E. A., Tomko, R. L., Salazar, C. A., Akbar, S. A., Squeglia, L. M., Herrmann, E., Carpenter, M. J., Peters, E. N. (2019). Tobacco and cannabis co-use: Drug substitution, quit interest, and cessation preferences. Experimental and Clinical Psychopharmacology, 27(3), 265–275. http://dx.doi.org/10.1037/pha0000244
Tucker, J. S., Pedersen, E. R., Seelam, R., Dunbar, M. S., Shih, R. A., & D’Amico, E. J. (2019). Types of cannabis and tobacco/nicotine co-use and associated outcomes in young adulthood. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 33(4), 401–411. https://doi.org/10.1037/adb0000464
Vertava Health. (2021). The Dangers Of Mixing Marijuana And Cocaine. https://vertavahealth.com/polysubstances/marijuana-and-cocaine/
Cooper, Z. D., Bedi, G., Ramesh, D., Balter, R., Comer, S. D., & Haney, M. (2018). Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 43(10), 2046–2055. https://doi.org/10.1038/s41386-018-0011-2
Rogers, A. H., Bakhshaie, J., Buckner, J. D., Orr, M. F., Paulus, D. J., Ditre, J. W., & Zvolensky, M. J. (2019). Opioid and Cannabis Co-Use among Adults With Chronic Pain: Relations to Substance Misuse, Mental Health, and Pain Experience. Journal of Addiction Medicine, 13(4), 287–294. https://doi.org/10.1097/ADM.0000000000000493
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