Record of proceedings for the Science Advisory Committee on Health Products Containing Cannabis (SAC-HPCC): November 5, 2021

List of acronyms

Health Canada Directorates and Branches

November 5, 2021, 2:00pm-5:00pm Eastern Time

Welcome and introductory remarks

The Committee Co-Chairs, Dr. Paula Brown and Dr. Richard Huntsman, welcomed members to the meeting. The Committee Secretariat from the Policy, Planning and International Affairs Directorate (PPIAD) and representatives from the Therapeutic Products Directorate (TPD), Veterinary Drugs Directorate (VDD) and Natural and Non-Prescription Health Products Directorate (NNHPD) of the Health Products and Food Branch (HPFB) were in attendance, as well as members from the Controlled Substances and Cannabis Branch (CSCB). The external expert writer was also present.

Prior to the meeting, members provided input to the Secretariat on outstanding questions related to the Committee’s mandate objectives. Dr. Brown thanked members for their feedback and outlined that the input provided would help to guide meeting discussions and the development of the Committee’s recommendations.

Administrative items

The Secretariat sought member updates to Conflict of Interest (COI) declarations ahead of the meeting and, as an additional reminder, the Co-Chairs invited members to provide any new declarations of affiliations and interests to the external COI advisor. Information shared did not restrict member participation.

The Co-Chairs sought approval of the Record of Proceedings (RoPs) from the Committee’s October 4th meeting, as well as the agenda for the present meeting. Members approved these documents with no objections.

Review of input received from external experts

Facilitator: Dr. Richard Huntsman

During previous Committee meetings, members identified specific areas of expertise and knowledge for which additional perspectives would be helpful, as well as potential experts who could be consulted. Prior to the meeting, the Co-Chairs reached out to these experts, and requested their feedback on key questions related to their expertise. During this portion of the meeting,   Dr. Huntsman reviewed the input received from these external experts, and members then discussed the information received. The expertise of those consulted included cannabis-related research, public education and epidemiology.

The external experts provided input on a number of factors, including the potential public health risks associated with CBD and whether these potential risks identified could be mitigated by the supervision of a practitioner. They also discussed the importance of public education, for specific target audiences and the general public. As part of this feedback, they noted that, from a public health perspective, information should be provided to consumers pertaining to CBD to support informed-decision making. The external experts also shared strategies through which information on existing gaps in knowledge regarding the safety of CBD could be conveyed to the public. 

Members discussed current CBD-related training opportunities available for health care practitioners, as well as the importance of such education for all health care providers. Benefits of having effective and consistent cannabis education opportunities for health professionals were also noted.

Committee review and discussion on CBD safety

Facilitator: Dr. Paula Brown

Dr. Brown guided the next portion of the discussion, which focused on a review of Committee discussions to date regarding the safety of CBD. Members discussed a range of topics related to the safe use of CBD in humans, including: CBD tolerability in the context of determining a safe maximum daily dose, adverse reactions, uncertainties regarding the safety and tolerability of CBD use, considerations regarding problematic substance use and considerations for public health.

Members also identified uncertainties regarding potential drug-drug interactions between CBD and other drugs, and the related implications for dosing. Adverse reactions that have been reported at various doses of CBD were mentioned, as well as considerations for vulnerable and patient populations.

Committee review and discussion on CBD efficacy, related evidence requirements and suitability for use without practitioner oversight

Facilitator: Dr. Richard Huntsman

Dr. Huntsman guided the next portion of the discussion, which focused on a review of Committee discussions to date regarding the efficacy of CBD. Members discussed a range of topics related to the efficacy of CBD in humans, including potential conditions of use, the suitability for use without practitioner oversight, the quality of currently available evidence on the efficacy of CBD, and general and indication-specific dosing considerations. The discussion reflected the importance of restricting youth access to any potential products, as well as considerations associated with adverse event reporting, and packaging and labelling. Members also brainstormed ways through which consumers could be made aware of the unknowns regarding potential drug-drug interactions.

Evidence requirements for Natural Health Products (NHPs) were then considered and discussed by members. In particular, members noted the current safety and efficacy requirements for the different classes of NHPs.

Committee review and discussion on CBD quality considerations

Facilitator: Dr. Paula Brown

Dr. Brown guided the next item of discussion for the meeting, which focused on a review of Committee discussions to date regarding quality. Members discussed a range of quality considerations , including existing quality standards and CBD-specific quality considerations, such as the source of CBD and the method of extraction.

Lastly, members described and compared the different quality frameworks in place for various types of products, such as for drugs and cannabis products.

Committee discussion on evidence gaps and priorities of the research and medical community

Facilitator: Dr. Richard Huntsman

Dr. Huntsman guided the next portion of the discussion, which focused on the priorities of the research and medical community. Dr. Huntsman outlined current evidence gaps such as the lack of long-term studies regarding the safety of CBD, as well as the limited evidence on potential drug-drug interactions. Members also discussed unknowns related to the use of cannabis in children and young adults and  highlighted the importance of supporting clinical research to address these evidence gaps.

Wrap up and next steps

Presenter: Dr. Paula Brown

The Co-Chairs thanked members for their active participation, and adjourned the meeting.

Page details

Date modified: