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Benedikt Fischer and colleagues described changes in cannabis consumption and harms among adolescents following non-medical cannabis legalization in Canada. 1Fischer B. Jutras-Aswad D. Robinson T. How has non-medical cannabis legalization served the health and welfare of under-age (adolescent) youth in Canada? . Lancet Reg Health Am. 2024; 35100773https: //doi. org/10. 1016/j. lana. 2024. 100773Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar They fittingly recommended measures to reduce the persistently elevated and high-risk cannabis use. 1Fischer B. Jutras-Aswad D. Robinson T. How has non-medical cannabis legalization served the health and welfare of under-age (adolescent) youth in Canada? . Lancet Reg Health Am. 2024; 35100773https: //doi. org/10. 1016/j. lana. 2024. 100773Summary Full Text Full Text PDF PubMed Scopus (1) Google Scholar We want to emphasize that measures addressing high-risk cannabis use should be prioritized. Pertinently, comparative risk assessments have underscored that the cannabis-attributable burden of disease primarily stems from high-risk cannabis use in the form of cannabis use disorder. 2Imtiaz S. Shield K. D. Roerecke M. et al. The burden of disease attributable to cannabis use in Canada in 2012. Addiction. 2016; 111: 653-662Crossref PubMed Scopus (89) Google Scholar Lending additional support to our viewpoint are latest observations of students from the Ontario Student Drug Use and Health Survey. Our prior assessment indicated an increased likelihood of cannabis use (past month), daily cannabis use (past month), and cannabis dependence (past three months) following non-medical cannabis legalization based on surveys conducted between 2001 and 2019. 3Imtiaz S. Nigatu Y. T. Sanches M. et al. Effects of cannabis legalisation on patterns of cannabis consumption among adolescents in Ontario, Canada (2001-2019). Drug Alcohol Rev. 2024; 43: 764-774Crossref PubMed Scopus (2) Google Scholar The most recent iteration of the survey, conducted five years after non-medical cannabis legalization, suggests that the increased likelihood in the abovementioned patterns of consumption may have subsided in some and persisted in others. Indeed, cannabis use (14% vs. 11%; p < 0. 01) decreased while daily cannabis use (2% vs. 2%) and cannabis dependence (3% vs. 4%) remained stable between 2019 and 2023. 4Boak A. Hamilton H. A. Drug use among Ontario students, 1977–2023: findings from the Ontario student Drug use and Health survey (OSDUHS). 2024https: //www. camh. ca/-/media/research-files/osduhs-drug-use-report₂023. pdfDate accessed: June 14, 2024Google Scholar The initial spike observed in cannabis use may reflect experimentation, given the increased novelty and availability of cannabis products. However, the sustained daily cannabis use and cannabis dependence warrant additional measures. These entail a scale up of evidence-based interventions to facilitate access to treatment, and identification and application of policy levers to shift the distribution of consumption towards less harmful levels. SI: Writing-Original Draft; TE-M, HAH, SR, JR: Writing-Reviewing & Editing. The authors declare no conflicts of interest. The authors acknowledge funding from the Canadian Institutes of Health Research's Institute of Neurosciences, Mental Health and Addiction's Canadian Research Initiative on Substance Misuse Ontario Node Grant (Grant Number: REN-181677). The funding sources had no role in study design, data collection, analysis and interpretation, preparation of the manuscript or decision to publish the manuscript. How has non-medical cannabis legalization served the health and welfare of under-age (adolescent) youth in Canada? Cannabis is the most commonly used non-legal drug, especially among young people. In 2018, Canada implemented the legalization of non-medical cannabis use and supply for adults. 1 This policy reform was framed by multiple primary objectives, which included improved public health, public safety and youth protection, specifically pledging to "keep cannabis out of the hands of youth". Under the formal legalization umbrella ('Cannabis Act'), cannabis may be legally accessed and used by adults ages 19-and-up in most provinces (with Alberta 18 years and Quebec 21 years for exceptions). Full-Text PDF Open Access
Imtiaz et al. (Tue,) studied this question.