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Kourgiantakis T, Vicknarajah R, Logan J, Edwards T, Lee E, Craig S, Kaura A, Williams CC, Marshall S. Understanding youth and young adult cannabis use in Canada post-legalization: a scoping review on a public health issue. Subst Abuse Treat Prev Policy 2024; 19:30. [PMID: 38886804 PMCID: PMC11184772 DOI: 10.1186/s13011-024-00615-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Canada legalized recreational cannabis in 2018, and one of the primary objectives of the Cannabis Act was to protect youth by reducing their access to cannabis and providing public education. Canada has the highest prevalence of cannabis use worldwide, particularly among youth and young adults under the age of 25. Cannabis use is linked with many adverse effects for youth and young adults including psychosis, anxiety, depression, respiratory distress, cannabinoid hyperemesis syndrome, and impaired cognitive performance. Despite the high prevalence of cannabis use and the evolution of policies in Canada and globally, significant knowledge and research gaps remain regarding youth and young adult cannabis use. The aim of this scoping review is to map the extent, nature, and range of evidence available on youth and young adult cannabis use in Canada since its legalization, in order to strengthen policies, services, treatments, training, and public education strategies. METHODS Using a scoping review framework developed by Arksey and O'Malley, along with the PRISMA-ScR guidelines, we conducted a rigorous search in five academic databases: MEDLINE, Embase, APA PsycINFO, CINAHL and Web of Science Core Collection. We included empirical studies that collected data in Canada after the legalization of recreational cannabis (October 2018) and focused on youth or young adults < 30. Two reviewers independently screened articles in two stages and extracted relevant information from articles meeting the inclusion criteria. RESULTS Of the 47 articles meeting our inclusion criteria, 92% used quantitative methods, 6% were qualitative, and 2% used a mixed-methods approach. Over two-thirds (68%) used secondary data. These studies were categorized into six focus areas: (1) prevalence, patterns, and trends, (2) cannabis-related injuries and emergency department (ED) visits, (3) rates and patterns during the pandemic, (4) perceptions of cannabis use, (5) prevention tools, and (6) cannabis-related offenses. Key findings from the studies reviewed include an increase in cannabis use among 18-24-year-olds post-legalization, with mixed results for youth under 18. ED visits for intentional and unintentional cannabis-related injuries have increased in young children and teens. Perception studies show a mix of concern and normalization of cannabis use. Though limited, prevention studies are promising in raising awareness. A decline in cannabis-related offenses was noted by one study. The review highlights several research gaps, including the need for more qualitative data, disaggregation of demographic data, intervention research, and comprehensive studies on the physical and mental health impacts of cannabis use among youth and young adults. CONCLUSION Maintaining a public health approach is critical, with a focus on reducing the high prevalence of cannabis use among youth and young adults. This involves implementing prevention strategies to minimize harms, enhancing public education, minimizing commercialization, reducing youth access to cannabis, promoting guidelines for lower-risk cannabis use and harm reduction strategies, and increasing training for healthcare providers.
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Affiliation(s)
- Toula Kourgiantakis
- École de travail social et de criminologie, Université Laval, 1030, avenue des Sciences-Humaines, Pavillon Charles-De-Koninck (local 6489), Québec, QC, G1V 0A6, Canada.
| | - Ragave Vicknarajah
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Judith Logan
- John P. Robarts Library, University of Toronto, Toronto, ON, Canada
| | - Travonne Edwards
- School of Child and Youth Care, Toronto Metropolitan University, Toronto, ON, Canada
| | - Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Shelley Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Ashima Kaura
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Charmaine C Williams
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Savannah Marshall
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
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Carnide N, Chrystoja BR, Lee H, Furlan AD, Smith PM. Cannabis use motives and associations with personal and work characteristics among Canadian workers: a cross-sectional study. J Occup Med Toxicol 2024; 19:25. [PMID: 38872177 DOI: 10.1186/s12995-024-00424-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Research on cannabis use motives has focused on youth. Little is known about motives among working adults, including how work may play a role. This study aimed to describe cannabis use motives and their connection to work, and identify the personal and work correlates of work-related motives among a sample of workers. METHODS A national, cross-sectional sample of Canadian workers were queried about their cannabis use. Workers reporting past-year cannabis use (n = 589) were asked their motives for using cannabis and whether each motive was related to work or helped them manage at work (i.e., work-related). Multinomial logistic regression analyses were conducted to estimate the associations of personal and work characteristics with work-related cannabis use motives (no work-related motives, < 50% of motives work-related, ≥ 50% of motives work-related). RESULTS Use for relaxation (59.3%), enjoyment (47.2%), social reasons (35.3%), coping (35.1%), medical reasons (30.9%), and sleep (29.9%) were the most common motives. Almost 40% of respondents reported one or more of their cannabis use motives were work-related, with coping (19.9%) and relaxation (16.3%) most commonly reported as work-related. Younger age, poorer general health, greater job stress, having a supervisory role, and hazardous work were associated with increased odds of reporting at least some cannabis use motives to be work-related, while work schedule and greater frequency of alcohol use were associated with reduced odds of motives being primarily work-related. CONCLUSIONS Cannabis use motives among workers are diverse and frequently associated with work. Greater attention to the role of work in motivating cannabis use is warranted.
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Affiliation(s)
- Nancy Carnide
- Institute for Work & Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON, M5T 3M7, Canada.
| | - Bethany R Chrystoja
- Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Hyunmi Lee
- Institute for Work & Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Andrea D Furlan
- Institute for Work & Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, room 7- 141, Toronto, ON, M5G 2A2, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, C. David Naylor Building, 6 Queen's Park Crescent West, 3rd floor, Toronto, ON, M5S 3H2, Canada
| | - Peter M Smith
- Institute for Work & Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON, M5T 3M7, Canada
- Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Kim C, Bai Y, Allin S, Kirst M, O'Campo P, Ienciu K, Xia X, MacMaster F, Rittenbach K, Chum A. Cannabis legalization and hospitalizations in Alberta: Interrupted time series analysis by age and sex. J Addict Dis 2024:1-4. [PMID: 38764209 DOI: 10.1080/10550887.2024.2355370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
OBJECTIVES Recent research has focused on the effects of legalization on cannabis-related emergency department visits, but the considerable healthcare costs of cannabis-related hospitalizations merit attention. We will examine the association between recreational cannabis legalization and cannabis-related hospitalizations. METHODS A cohort of 3,493,864 adults from Alberta was examined (October 2015-May 2021) over three periods: pre-legalization, post-legalization of flowers and herbs (phase one), and post-legalization of edibles, extracts, and topicals (phase two). Interrupted time series analyses were used to detect changes. RESULTS The study found an increase in hospitalization rates among younger adults (18-24) before legalization, yet no increased risk was associated with cannabis legalization, for either younger (18-24) or older adults (25+). CONCLUSIONS Clinicians should be aware of the increased risk in younger groups and may benefit from early identification and intervention strategies, including screening and brief interventions in primary care settings.
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Affiliation(s)
- Chungah Kim
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Yihong Bai
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Sara Allin
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Maritt Kirst
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Patricia O'Campo
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kristine Ienciu
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Xiaoyang Xia
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
| | - Frank MacMaster
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Antony Chum
- School of Kinesiology and Health Science, York University, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Di Ciano P, Wickens C, Paul EM, Mahmood R, Crépault JF, Rueda S, Boileau I. The Cannabis Act: implications for human participant research with cannabis. J Psychiatry Neurosci 2024; 49:E212-E217. [PMID: 38889952 PMCID: PMC11192575 DOI: 10.1503/jpn.240049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024] Open
Affiliation(s)
- Patricia Di Ciano
- From the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ont. (Di Ciano, Wickens, Paul, Rueda); the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Boileau); the Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Crépault); the Campbell Family Mental Health Research Institute, Toronto, Ont. (Di Ciano, Wickens, Rueda, Boileau); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Rueda); the Department of Psychiatry, University of Toronto, Toronto, Ont. (Wickens, Boileau); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Mahmood, Rueda, Boileau); the Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ont. (Mahmood, Boileau); the Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Boileau); Communications and Partnerships, Centre for Addiction and Mental Health, Toronto, Ont. (Crépault)
| | - Christine Wickens
- From the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ont. (Di Ciano, Wickens, Paul, Rueda); the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Boileau); the Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Crépault); the Campbell Family Mental Health Research Institute, Toronto, Ont. (Di Ciano, Wickens, Rueda, Boileau); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Rueda); the Department of Psychiatry, University of Toronto, Toronto, Ont. (Wickens, Boileau); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Mahmood, Rueda, Boileau); the Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ont. (Mahmood, Boileau); the Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Boileau); Communications and Partnerships, Centre for Addiction and Mental Health, Toronto, Ont. (Crépault)
| | - Elvin M Paul
- From the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ont. (Di Ciano, Wickens, Paul, Rueda); the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Boileau); the Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Crépault); the Campbell Family Mental Health Research Institute, Toronto, Ont. (Di Ciano, Wickens, Rueda, Boileau); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Rueda); the Department of Psychiatry, University of Toronto, Toronto, Ont. (Wickens, Boileau); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Mahmood, Rueda, Boileau); the Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ont. (Mahmood, Boileau); the Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Boileau); Communications and Partnerships, Centre for Addiction and Mental Health, Toronto, Ont. (Crépault)
| | - Raesham Mahmood
- From the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ont. (Di Ciano, Wickens, Paul, Rueda); the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Boileau); the Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Crépault); the Campbell Family Mental Health Research Institute, Toronto, Ont. (Di Ciano, Wickens, Rueda, Boileau); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Rueda); the Department of Psychiatry, University of Toronto, Toronto, Ont. (Wickens, Boileau); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Mahmood, Rueda, Boileau); the Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ont. (Mahmood, Boileau); the Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Boileau); Communications and Partnerships, Centre for Addiction and Mental Health, Toronto, Ont. (Crépault)
| | - Jean-François Crépault
- From the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ont. (Di Ciano, Wickens, Paul, Rueda); the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Boileau); the Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Crépault); the Campbell Family Mental Health Research Institute, Toronto, Ont. (Di Ciano, Wickens, Rueda, Boileau); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Rueda); the Department of Psychiatry, University of Toronto, Toronto, Ont. (Wickens, Boileau); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Mahmood, Rueda, Boileau); the Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ont. (Mahmood, Boileau); the Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Boileau); Communications and Partnerships, Centre for Addiction and Mental Health, Toronto, Ont. (Crépault)
| | - Sergio Rueda
- From the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ont. (Di Ciano, Wickens, Paul, Rueda); the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Boileau); the Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Crépault); the Campbell Family Mental Health Research Institute, Toronto, Ont. (Di Ciano, Wickens, Rueda, Boileau); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Rueda); the Department of Psychiatry, University of Toronto, Toronto, Ont. (Wickens, Boileau); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Mahmood, Rueda, Boileau); the Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ont. (Mahmood, Boileau); the Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Boileau); Communications and Partnerships, Centre for Addiction and Mental Health, Toronto, Ont. (Crépault)
| | - Isabelle Boileau
- From the Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ont. (Di Ciano, Wickens, Paul, Rueda); the Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Boileau); the Dalla Lana School of Public Health, University of Toronto, Toronto, Ont. (Di Ciano, Wickens, Crépault); the Campbell Family Mental Health Research Institute, Toronto, Ont. (Di Ciano, Wickens, Rueda, Boileau); the Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ont. (Rueda); the Department of Psychiatry, University of Toronto, Toronto, Ont. (Wickens, Boileau); the Institute of Medical Science, University of Toronto, Toronto, Ont. (Mahmood, Rueda, Boileau); the Addiction Imaging Research Group, Centre for Addiction and Mental Health, Toronto, Ont. (Mahmood, Boileau); the Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, Ont. (Boileau); Communications and Partnerships, Centre for Addiction and Mental Health, Toronto, Ont. (Crépault)
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Manthey J, Armstrong MJ, Hayer T, Myran DT, Pacula RL, Queirolo R, Rehm J, Wirth M, Zobel F. How to interpret studies on the impact of legalizing cannabis. Addiction 2023; 118:2242-2243. [PMID: 37544768 DOI: 10.1111/add.16314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Jakob Manthey
- Centre of Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Michael J Armstrong
- Department of Finance, Operations and Information Systems, Brock University, St Catharines, Canada
| | - Tobias Hayer
- Institute of Public Health and Nursing Research, Department for Health and Society, University of Bremen, Bremen, Germany
| | - Daniel T Myran
- Bruyère Research Institute, Ottawa, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Canada
| | - Rosalie Liccardo Pacula
- Price School of Public Policy and Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, California, Los Angeles, USA
| | - Rosario Queirolo
- Department of Social Sciences, Universidad Católica del Uruguay, Montevideo, Uruguay
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- World Health Organization/Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Centre of Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute of Medical Science, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Program on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| | - Marielle Wirth
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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