The number of reports received by Health Canada of adverse reactions associated with cannabis has declined for the third year in a row. 

The majority of those reports are associated with legal cannabis products, which also declined in the past year after an increase in 2021.

Of the 159 reports received in 2022, 92 were unique cases associated with legal cannabis products. In 2021, there were 260 reports, 174 of which were associated with legal cannabis products. In 2020, there were 287 reports, 159 of which were associated with legal cannabis products. 

In 2019 (October 17, 2018-December 31, 2019), there were 219 adverse reaction reports to Health Canada’s Canada Vigilance Database, with 151 associated with legal cannabis products from the medical and non-medical supply chains. 

The majority of reports in 2022 come from the cannabis licence holder.

Of the adverse report cases related to cannabis in 2022, 40% involved males and 28% involved females, while 51% involved cannabis used for medical purposes (self-reported). As in previous years, the majority of cases (53%) involved ingestible cannabis liquid extracts (that is, ingestible cannabis oils and softgels).

However, when looking at only reports associated with legal products, 47% were associated with inhalation, while 46% were associated with oral consumption. 

Three-quarters of these reports were considered serious. According to Health Canada, a “serious adverse reaction” is an adverse reaction that requires inpatient hospitalization or prolongation of existing hospitalization, causes congenital malformation, results in persistent or significant disability or incapacity, is life-threatening, or results in death.

The most commonly reported symptoms were headache, seizure, hallucination, trouble breathing, and drug effectiveness. 

There was also one suspected case of vaping-associated lung injury (VALI) that was reported as involving a legal cannabis product in 2022. 

There were two cases in 2022 associated with legal cannabis products that resulted in fatal outcomes, although one of these was connected to a case in 2021.

That case from 2021, also reported as part of 2022’s results, involved two cannabis vaping products “with other concomitant medications in a patient with complex medical history and several risk factors who experienced seizures which led to hospital admission then death.”

Health Canada notes that while the use of the cannabis vape may have caused an initial seizure in the patient, it was less likely to be the cause of death, which was most likely due to a staphylococcal infection, of which the source was the temporary hemodialysis line placed in the patient to address deteriorating kidney function.

The second fatal case report received in 2022 was connected to a single ingestible cannabis oil product used for medical purposes, with an authorization, to treat symptoms related to arthralgia (joint stiffness). Health Canada notes that the individual had a complex medical history and was using multiple concomitant health medications in addition to the cannabis product, and assessed the event of seizure as “possibly related to the cannabis product while the outcome of death was assessed as unlikely.”

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