The three-year anniversary of the legalization of recreational, or non-medical, cannabis in Canada falls on October 17th. It also marks the beginning of the Canadian government’s mandatory review of its health effects.
Unfortunately, the slow roll-out of Canada’s cannabis retail market combined with the glacial pace of academic research means that everything you and the government are hearing about the health effects of legalization is outdated and often Based on irrelevant data.
There are three major limits to our understanding of the health impact of legalization.
First, almost all studies examining the effect of legalization on cannabis use and harm have only looked at changes during the first year after legalization.
Yes, these results are reassuring: a modest increase in cannabis use across Canada, and a slight or no increase in ER visits or hospitalizations due to cannabis in Ontario, Alberta, and Quebec. However, we need to keep in mind that the transition from cannabis being illegal to being widely available for legal purchase and use is not a switch that was flipped overnight.
Remember, Ontario didn’t have a single legal cannabis store for the first six months after legalization, Quebec had just 14 and the rest of the country didn’t do much better. The limited stores that were often open did not have much cannabis to sell due to a major product shortage.
But the cannabis retail market today looks very different. I lead a team that has tracked the massive increase in the number of cannabis stores since legalization. Our current data shows a more than 10-fold increase in stores between November 2018 and April 2021 (from 158 to 1,792).
During the same time, the amount Canadians spend a month on legal cannabis increased by 428 percent from $9.50 per person age 15 and older to $1.80. There are currently so many authorized cannabis stores in Ontario — 1,175 of them — that experts predict major store closures.
Data from Statistics Canada suggests that the maturing market may be starting to impact overall cannabis use. For the first year and a half following legalization, legal market expansion essentially corresponds to illegal market contraction. However, since the beginning of 2020, an increase in legal sales has led to a dramatic reduction in illegal sales, resulting in an increase in overall spending.
Second, a variety of cannabis products, including commercially produced foods such as THC-containing candies, desserts and drinks, only became available for sale in January 2020. These types of products have been implicated in a large increase in cannabis poisoning in young children. United States of america. A study in Alberta reported an increase in cannabis poisoning in children after legalization. However, the study did not examine the time period after commercial foods were introduced – exactly the time when we would expect the greatest increase based on the American experience.
So while current studies support that there was no increase in harm in the early months of the heavily restricted and limited retail market, we have almost no data on the health effects of our current, far more mature, cannabis market.
Little we know is concerning. While the number of people using cannabis almost every day in Canada did not increase significantly immediately after legalization, by the end of 2020 it was 46 percent (5.4 percent in early 2018, 6.1 percent in early 2019 and 7.9 percent). end of 2020).
An estimated 16.3 percent of Canadians aged 18-24 now report daily cannabis use, an increase of 65 percent since legalization. The number of emergency department visits and hospitalizations due to cannabis in Canada also increased by eight percent and five percent between 2019 and 2020, respectively.
Which brings us to the third limit. For anyone wondering, “Wait, what about the COVID-19 pandemic?” You’re right, it’s a big problem. More than half the time since legalization has been during the pandemic.
There is no easy way to separate the effects of the pandemic versus the mature cannabis market on the recent increase in cannabis use. More data is coming — the federal government has invested millions of dollars in research — but we’ll have to wait to see those results.
The legalization of recreational cannabis, which has resulted in major reductions in societal harms such as heavily discriminatory police charges for cannabis offenses, has had major public health benefits.
My concern is that a rapidly commercializing cannabis market could lead to increased cannabis use and harm. Groups with financial interests in selling cannabis are already claiming that current regulations such as a cannabis tax, child-resistant packaging and a ban on cannabis advertising, including social media, are restricting innovation. They argue that these should be updated – meaning removed or reduced – to compete with the illegal market.
During the upcoming regulatory review, we need to remember that these rules were deliberately designed. Decades of research on alcohol and tobacco, and emerging cannabis-specific evidence, suggest that these measures are highly effective in reducing cannabis use among youth and young adults.
The federal government recommends that people start low and go slow to avoid potential adverse effects from cannabis. The rapid expansion of the cannabis retail market over the past year is due to the regulatory counterpart of our country, which has witnessed a huge cannabis consumption for the first time. We don’t know how high we are going to rise. While we wait to find out it’s probably not a good idea to have another food item.
My advice to the government during the forthcoming review is to listen to their own recommendations and go slow on any changes to cannabis regulations.