An article in the Canadian Medical Association Journal (CMAJ) notes that five years after cannabis was made legal, it has failed to achieve the stated goals of the legalization policy and has resulted in more children turning up in emergency rooms.
The article, titled “Outcomes associated with nonmedical cannabis legalization policy in Canada: taking stock at the 5-year mark” and published on Oct. 10, identified the goals of legalizing marijuana for personal consumption as being to improve the health and safety of those using the drug, reduce the ability of youth to access the drug, and reduce cannabis-related crime and illegal markets.
“Although trends in some primary public health indicators have suggested adverse effects of legalization, some others have remained stable,” authors Benedikt Fischer, Didier Jutras-Aswad, and Wayne Hall wrote.
“At this stage, cannabis legalization in Canada appears not to have been the public health disaster anticipated by some of its opponents, but it cannot be described as a comprehensive or unequivocal success for public health either.”
Cannabis was made legal in Canada in October 2018 and allows an individual to have up to 30 grams of dried cannabis. Use of the drug was restricted to non-public settings in most provinces, according to the article.
Over the past few years, the authors write, cannabis use has increased from 22 percent in 2017 to 27 percent in 2022, although they note the near-daily to daily use has remained stable at 24–25 percent.
“The observed proportions of consumers obtaining cannabis legally have steadily increased; most recently, data have shown that about two-thirds of cannabis users purchase from legal sources, with levels varying between 50 percent and 80 percent, depending on the cannabis product type,” the authors said.
Increased Hospitalizations
Studies over the past five years have seen an increase in cannabis-related emergency department visits and admission to hospitals, the article says.Researchers found a 12 percent to 20 percent increase in hospitalization over the past several years, the authors said.
The article said that there had been a significant increase in the number of cannabis poisonings of children.
“A recent repeated cross-sectional study reported an almost threefold increase in rates of emergency department visits related to cannabis poisoning among children (aged 0–9 yr) in 4 provinces in the year immediately after legalization, with further increases thereafter in those provinces allowing the sale of edible products.”
Data Challenges
The authors of the article noted that research on the trends in cannabis use may have been impacted by the COVID-19 pandemic.“Canada-wide data on important outcome indicators, such as on cannabis use disorders and their treatment demand, or the degree to which cannabis legalization may have effectively substituted for alcohol and other psychoactive substance use and related harm, are lacking.”
Various regulations in different provinces and territories may also have affected the data collected about cannabis use, they said.
“For example, Quebec has a lower prevalence or trends for some indicators than other provinces, possibly reflecting its more restrictive regulations (e.g., a public sales monopoly, limited range of cannabis products, no home cultivation, older minimum age [21 yr] at which cannabis can be legally purchased).”
The authors called for continued monitoring of how well the policies meet the goals.
In 2018, despite inconclusive data, Prime Minster Justin Trudeau posted on Twitter that his government had kept marijuana out of the hands of children by legalizing it.
“In 2018, our government legalized and regulated cannabis—to keep it out of the hands of kids and to take profits away from criminals. Promise made, promise kept,” Mr. Trudeau posted on April 20.
However, research at the time did not back up the prime minister’s comments.
The government’s Canadian Cannabis Survey showed an uptick in youth usage since legalization in October 2018, while its Canadian Student Tobacco, Alcohol and Drugs Survey showed stable usage rates.
Relaxing Regulations
In April, Health Canada published a Notice of Intent that it was considering dropping some regulations as it said the cannabis industry had matured and some of the regulations may not be necessary.At the time, it was seeking feedback from those in the industry that would identify amendments and reduce the regulatory burden.
Health Canada said it was looking for input in five areas: licensing, personnel and physical security measures, production requirements, packaging, and labelling requirements; and record keeping and reporting for cannabis licence holders.
“Health Canada is also interested in feedback on regulatory measures that may be duplicative, redundant, or particularly onerous, and where there are opportunities to promote efficiencies,” the Notice of Intent stated.
Earlier this year, a review of the legislation raised questions about how thorough and unbiased it would be. The report was released on Oct. 10.
Tara MacIsaac and Andrew Chen contributed to this report.
