Some Nova Scotia doctors are concerned young people are receiving prescriptions to smoke medical marijuana, despite the effects marijuana has on the developing brain.
Currently, there are no laws in Canada regarding the age at which people can receive prescriptions for marijuana and different organizations have different recommendations.
The College of Family Physicians of Canada says cannabis is not appropriate for anyone under the age of 25, while the Canadian Paediatric Society and Health Canada both recommend cannabis not be consumed by anyone under the age of 18.
Risks of youth cannabis use
The brain isn't fully developed until 25 and frequent cannabis use can have serious consequences for youth.
Dr. Selene Etches, a child and adolescent psychiatrist at the IWK Health Centre in Halifax, says cannabis affects a young person's brain differently than an adult's brain. It affects brain development and cognition, among other factors.
"We also know that there's an increased risk of addiction when use starts in adolescence," she said. "There's also evidence that regular use in adolescence is linked to risky behaviour, such as unsafe sexual practices and driving while intoxicated.
"From a psychiatric perspective, regular use of cannabis in adolescence is associated with the development of psychotic disorders, depression, anxiety disorders and an increased risk of suicidal thoughts."
'Questions have not been answered'
Etches says she has been approached by her patients asking for a medical marijuana prescriptions. Since she treats children and teenagers who already have substance abuse issues, she says she would never prescribe one to them.
Dr. Allen Finley, the medical director of the pediatric pain program at the IWK, has received similar requests from both patients and their parents. He says the patients are often self-medicating with cannabis for chronic pain problems and he is reluctant to issue a prescription.
"We've had a number of teenagers who say that even if we were able to stop their pain with other techniques, that they would still keep using cannabis," he said.
"The questions have not been answered as to the safety of marijuana in adolescence."
Getting a 'green card'
Natasha, a 22-year-old student at Dalhousie University, received her "green card" several years ago from a clinic in Vancouver that prescribes and dispenses cannabis. She was already smoking cannabis to relieve stress and for relaxation.
To get the prescription, Natasha had a brief Skype interview in B.C. with a doctor.
"From that 10 minutes, he was able to gauge if I was qualified for a medicinal prescription," she said.
Natasha estimates about 80 per cent of her friends in B.C. have green cards; she says it's more difficult to obtain one in Nova Scotia.
"You basically need to be very ill to obtain it here," she said.
"It's not worth the hassle of getting it here just because, for a symptom like stress, they don't belive that's a good enough symptom for it."
Risk versus benefit
Family doctors and hospitals can prescribe marijuana, but are sometimes reluctant because the guidelines from Health Canada are vague.
The Cannabinoid Medical Clinic is one of only a handful of clinics in the Halifax area that specializes in treating patients with cannabis.
Dr. Mark Fletcher, who works at the clinic one day a week, says the overall demand for cannabis is increasing but there has not been much demand from people under 25. He has prescribed medical marijuana to young people mainly for chronic pain and post-traumatic stress disorder.
"You have to weigh the risk versus benefit and have a good discussion with the patient so that they're aware of some unknown risks on their developing brain," said Fletcher.
In Natasha's case, her doctor didn't go over the risks with her. She says she simply was given a pamphlet in the waiting room.
Natasha says she tried obtaining medical marijuana legally because it is safer.
"You know what's in the marijuana that you're buying. It's cleaner, it's just an all-around better way of obtaining it. It's better than meeting someone in like a back alley and getting weed," she said.
"You know it's been screened for fungus and heavy metal and they're highly regulated, versus getting it off the street," he said.
Etches worries that public opinion on the "natural" or "organic" nature of marijuana shields people from understanding the risks of cannabis.
On the flip side, medical experts agree that little research has been done into the positive effects of medical marijuana in any age group.
While the federal government has promised to legalize marijuana, it raises the question of setting a minimum age for consumption.
Health Canada said it's too early to speculate on that and said the federal government is "committed to legalizing, regulating and restricting access to marijuana to keep it out of the hands of children."