In some areas the reviews are positive. Legalization has resulted in the emergence of a multibillion dollar industry, new jobs and tax revenues. There have also been fewer cannabis-related convictions among youth. But despite some positive signs, some health experts fear that the rapid growth of the industry combined with a lack of recent data on potential public health impacts means we may be missing some warning signs.
“Legalization is not a switch that has happened,” said Dr. Daniel Myran, a public health physician in Ottawa. “The retail market has matured over time, but at the same time, much of the data we have on what happens after legalization is from a very early period. “
Cannabis use is on the rise
On October 17, 2018, cannabis became legal in all provinces and territories for adults 18 years of age and older, making Canada the second country to legalize the recreational use of the drug.
The Cannabis Act, introduced by the government of Prime Minister Justin Trudeau, had several objectives. These included keeping drugs out of the hands of young people, withdrawing profits from criminals and protecting public health.
Since then, more and more Canadians appear to be using cannabis.
According to the most recent government survey, 27% of participants said they had used marijuana in the previous year, an increase from 22% in the first cannabis survey conducted in 2017.
Statistics Canada data suggests retail sales in 2020 were just over $ 2.6 billion, which is a 120% increase from 2019.
Although there are indications that marijuana use has increased, criminal convictions for cannabis-related crimes among youth fell dramatically.
Akwasi Owusu-Bempah, assistant professor of sociology at the University of Toronto, says the effects of legalizing cannabis in this area are significant.
“From a criminologist’s perspective, legalization has been successful in reducing the criminalization of people for cannabis offenses,” said Owusu-Bempah, who is also an advisor to the Canadian Civil Liberties Association and director of research for Cannabis Amnesty.
However, there are still areas of concern, he said.
The economic benefits of legalized cannabis are not shared equally, as the industry is disproportionately white and male. Eighty-four percent of directors and executives in the industry are white, he said in research conducted in 2020, and women make up just 14 percent.
And many of those with criminal records for offenses committed before legalization are people of color, he said, and he wants more records to be cleared.
Impact on public health
Russell Callaghan, professor in the northern medicine program at the University of Northern British Columbia, studies the impacts of legalization on a range of public health indicators. He says research in this area is still in its early stages.
What has held him back so far, however, is that many of the concerns about the legalization of cannabis – including the potential increase in potential cases of cannabis-induced psychosis and schizophrenia, and driving under the influence of cannabis. the influence of drugs – did not materialize.
Callaghan says his research on road crashes in Ontario and Alberta doesn’t suggest legalization has had a significant effect, at least not yet.
A recent report from Mothers Against Drunk Driving Canada (MADD) indicates that the number of drug-impaired driving charges is “extremely low” – accounting for just 11% of the 5,506 impaired driving charges in Canada in 2019.
Some provinces, like Ontario and Quebec, saw a significant increase in drug-impaired driving charges that year, but the report attributes this primarily to new laws and enforcement powers.
Some experts warn that it may be too early to call legalized marijuana a global success.
“The research is still fairly recent, so there is a caveat,” Callaghan said of his work.
Another goal of the Cannabis Act is to protect public health, and to that extent, increasing consumption can bring new challenges.
“When we see increased rates of use, it starts to be a warning sign in terms of public health because we don’t want to see more people consuming,” said Rebecca Jesseman, director of policy at the Canadian Center. on Substance Abuse and Substance Abuse (CCSA), an Ottawa-based non-governmental organization.
Callaghan says his ongoing research suggests that youth emergency room visits due to poisoning or overuse of marijuana may have a “significant” upward trend. This reflects American trends in states that have legalized marijuana, he said.
But what we know may not be as much of a concern as what we don’t know, Jesseman said.
“To be honest, it’s just too early,” she said of assessing the effects of legal marijuana on public health.
“The retail system is still stabilizing and growing very quickly, if you look at provinces like Ontario, where we’ve seen over 1,000 new stores in less than a year introduced. So I think we really need to keep monitoring health and safety and fit impacts as we go. “
This is a concern shared by Myran, who is a fellow in the Department of Family Medicine at the University of Ottawa.
That’s because almost all of the research available on legal marijuana comes from the first six months after legalization, he said. The industry in many provinces and territories looks very different today than it was then, both in terms of the commercial availability of cannabis and the range of cannabis products available.
Data is still limited and the COVID-19 pandemic has straddled much of the time when marijuana was legal.
Myran led a study published in June which revealed that the number of cannabis retail stores in Canada had increased from 158 in November 2018 to 1,792 in April 2021.
“The problem this creates is that we have a lot of data on the first phases after legalization, at the exact moment when there was hardly any legal market,” he said.
“The problem is, now, as the market matures and you see a surge in cannabis sales, will we see an associated increase in cannabis use and harms? “
Edible products are not taken into account in most of the available data. This is remarkable, Myran says, because edibles present difficult public health concerns compared to other cannabis products such as flowers and oils.
“One of the main drawbacks is that it’s much easier for people to take too much cannabis,” he said.
Myran adds that some provinces and territories have allowed edibles that look a lot like candy or baked goods when taken out of their packaging, which may seem appealing to children.
Industry wants change
Now that the third anniversary of legalization has arrived, the statutory review of the Cannabis Act is about to begin.
The Cannabis Council of Canada (C3), which represents more than 700 licensed cannabis producers and processors in Canada, wants the government to make certain changes to its policy.
In a legalization newsletter released this week, C3 gives governments a B rating for keeping cannabis out of young hands and protecting public health – but it’s as high as the ratings.
The C3 gives governments a failing grade in four areas: tackling the illicit market, tax policy, consumer education and awareness, and financial sustainability.
“We cannot be too excited in a circumstance where the illicit market remains with at least 50 percent of the business,” said George Smitherman, President and CEO of C3
“If the illicit market still sells billions of dollars in cannabis, that’s a lot of tax revenue that governments don’t get. “
Despite the many bad ratings, Smitherman does not qualify the overall execution of cannabis legalization as a failure.
“I think it might be better to present it as a missed opportunity,” said the former Ontario health minister.
To this end, C3 hopes to work with policymakers on a number of changes in the industry, including reducing regulations and taxes. Smitherman says the excise tax puts significant financial pressure on producers.
“There are regulations weighing down on us, which some people have referred to as state nanny regulations,” Smitherman said. “Including, as an example, that you are limited in the amount of cannabis as an individual you can have at 30 grams. “
But it is these types of proposed changes that concern Myran, the public health physician the most.
He predicts that the government will come under heavy pressure from industry to rescind public health regulations, including items such as child-resistant packaging and restrictions on advertising. These are public health measures that have been shown to be effective in limiting the harms of tobacco and alcohol, he said.
“It’s sort of my big concern, that as we move forward, we will take this lack of evidence on damage in the first three years as evidence that legalization and commercialization don’t lead to an increase.” of use and damage, overrides some of the policies that are currently in place, and in a few years we will see a big increase in use … and damage and will have to deal with it. “