Cannabis-related Hospitalizations Among Youth in Canada Before and After Cannabis Legalization

Auger, Nathalie; Luu, Thuy Mai; Ayoub, Aimina; Bilodeau-Bertrand, Marianne; Lo, Ernest; Low, Nancy

doi:10.1097/adm.0000000000000747

Cited by 24 publications

(42 citation statements)

References 10 publications

(33 reference statements)

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“…In contrast, a recent study of youth hospitalizations in Quebec, Canada, found no difference in cannabis-related hospitalizations from prelegalization to postlegalization in adolescents aged 15e19 years but observed an increase among boys aged 10e14 years [9]. Differences between study findings could, in part, reflect the policy, implementation, and regulatory differences between jurisdictions.…”

contrasting

confidence: 72%

Contextualizing Cannabis Legalization Outcomes

Johnson

Doonan

2021

Journal of Adolescent Health

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contrasting

confidence: 72%

Contextualizing Cannabis Legalization Outcomes

Johnson

Doonan

2021

Journal of Adolescent Health

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“…One possible explanation is that recreational legalization has blossomed in recent years without a commensurate development in cannabis-related medical education. Moreover, several researchers have reported spikes in cannabis-related hospitalizations following recreational legalization (Auger et al 2020 ; Zvonarev et al 2019 ). Therefore, despite the general public’s more lenient views towards recreational legalization in recent years, physicians may continue to harbor reservations—especially as cannabis-related hospitalizations climb in the absence of proportionate developments in cannabis-related medical research.…”

Section: Discussionmentioning

confidence: 99%

“… “Do you have a patient who you agree would benefit from medical cannabis?” (Karanges et al 2018 ). “Are you certain about MMJ’s therapeutic value?” (Auger et al 2020 ; Ziemianski et al 2015 ). “Cannabis has a role in palliative care” (Crowley et al 2017 ).…”

Section: Appendix Amentioning

confidence: 99%

A systematic review of medical students’ and professionals’ attitudes and knowledge regarding medical cannabis

Weisman

Rodriguez

2021

J Cannabis Res

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Background Recently, the renewed global interest in cannabis’ therapeutic properties has resulted in shifting attitudes and legislative policies worldwide. The aim of this systematic review is to explore the existing literature on medical professionals’ and students’ attitudes and knowledge regarding medicinal cannabis (MC) to assess any relevant and significant trends. Methods This systematic review was conducted in accordance with PRISMA guidelines. Using PubMed and Google Scholar, a literature search was performed to identify studies pertaining to healthcare professionals’ and medical students’ knowledge and attitudes regarding MC. There were no search limits on the year of publication; however, studies without primary data (e.g., abstracts, systematic reviews, meta-analyses) and non-English language papers were excluded. Studies were coded according to the following research questions: (1) Do respondents believe that cannabis should be legalized (for medicinal and/or recreational purposes)? (2) Are respondents confident in their level of knowledge regarding cannabis’ clinical applications? (3) Are respondents convinced of cannabis’ therapeutic potential? 4) What current gaps in knowledge exist, and how can the medical community become better informed about cannabis’ therapeutic uses? and (5) Are there significant differences between the knowledge and opinions of healthcare students versus healthcare professionals with respect to any of the aforementioned queries? Chi-square tests were used to assess differences between medical students and medical professionals, and Pearson’s bivariate correlations were used to analyze associations between survey responses and year of publication—as a proxy measurement to assess change over time. Results Out of the 741 items retrieved, 40 studies published between 1971 and 2019 were included in the final analyses. In an evaluation of 21 qualified studies (8016 respondents), 49.9% of all respondents favored legalization (SD = 25.7, range: 16–97%). A correlational analysis between the percentage of survey respondents who support MC legalization and year of publication suggests that both medical students’ and professionals’ support for MC legalization has increased from 1991 to 2019 (r(19) = .44, p = .045). Moreover, medical professionals favor the legalization of MC at a significantly higher rate than students (52% vs. 42%, respectively; χ2 (1, N = 9019) = 50.72 p < .001). Also, respondents consistently report a strong desire for more education about MC and a substantial concern regarding MC’s potential to cause dependence and addiction. Pearson’s correlations between year of publication and survey responses for both of these queried variables suggest minimal changes within the last decade (2011–2019 for addiction and dependence, 2012-2019 for additional education; r(13) = − .10, p = .713 and r(12) = − .12, p = .678, respectively). Conclusion The finding that both medical students’ and professionals’ acceptance of MC has significantly increased in recent decades—in conjunction with their consistent, strong desire for more educational material—suggests that the medical community should prioritize the development of MC educational programs. MC is far more likely to succeed as a safe and viable therapy if the medical professionals who administer it are well-trained and confident regarding its clinical effects. Limitations include a lack of covariate-based analyses and the exclusion of studies published after the literature search was performed (June 2019). Future research should analyze studies published post-2019 to draw temporal comparisons and should investigate the effect of numerous covariates (e.g., gender, religiosity, prior cannabis use) as newer studies gather data on these factors [PROSPERO Registration: CRD42020204382].

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“…the frequency of the event within age, gender, and region-specific subgroups for each month of the study period). Using the National Ambulatory Care Reporting System, Discharge Abstract Database, and Ontario Mental Health Reporting System, records were included with at least one of the following ICD-10 codes for either the primary or supplemental diagnosis: F12 (cannabis-related disorders) and T40.7 (cannabis poisoning), following the conventions from prior studies(6,7,16).…”

Section: Methodsmentioning

confidence: 99%

“…Although prior research has shown that cannabis may be associated with fewer acute harm events compared to tobacco, alcohol, and opiates(3), problematic use can lead to anxiety, paranoia, suicidal ideation, cognitive impairment, induce temporary tachycardia and cannabinoid hyperemesis syndrome(4), or lead to cyclical emesis with chronic use (5). While emerging evidence suggests that legalization has led to modest increases in cannabisattributable emergency department (ED) visits (6)(7)(8)(9), these studies have a number of limitations. First, these studies focus only on the general population or the pediatric population, which ignores the differential impact of legalization across gender and lifecourse (10).…”

Section: Introductionmentioning

confidence: 99%

Associations between recreational cannabis legalization and cannabis-related emergency department visits by age, gender, and geographic status in Ontario, Canada: an interrupted time series study

Kim

Chum

Nielsen

et al. 2022

Preprint

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Legalization of recreational cannabis in Ontario included the legalization of flower and herbs (Phase 1, October 2018), and was followed by the deregulation of cannabis retailers and sales of edibles (Phase 2, February 2020). Research on the impact of cannabis legalization on acute care utilization is nascet; no research has investigated potential age, gender, and geographically vulnerable subgroup effects. Residents living in Northern Ontario not only have higher levels of substance use problems, but also have inadequate access to primary healthcare. Our study investigated the impact of Ontario’s recreational cannabis policy (including Phase 1 and 2) on cannabis-attributable emergency department (ED) visits, and estimated the impact separately for different age and gender groups, with additional analyses focused on Northern Ontarians. We created a cohort of adults (18 and over) eligible for provincial universal health insurance with continuous coverage from 2015-2021 (n=14,900,820). An interrupted time-series was used to examine the immediate impact and month-to-month changes in cannabis-related ED visits associated with Phase 1 & 2 for each subgroup. While Northern Ontario has higher rates of cannabis-related ED visits, both Northern and Southern Ontario show similar patterns of changes. Phase 1 was associated with significant increases in adults 25-64, with the strongest increases seen in women 45-64. Month-to-month trends were flattened in most groups compared to pre-legalisation. Phase 2 was associated with significant immediate increases for adults aged 18-44 in both genders, but the increases were larger in women than men. No significant month-to-month changes were detected in this period. While current preventive efforts are largely focused on reducing cannabis-related harms in youths and younger adults, our results show that adults 25-64, particularly women, have been significantly impacted by cannabis policies. Further research on gender-specific cannabis dosage and targeted interventions for adult women should be investigated. Legalization did not appear to have a differential impact on Northern versus Southern Ontario, but higher rates of ED visits in the North should be addressed.

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Cannabis-related Hospitalizations Among Youth in Canada Before and After Cannabis Legalization

Cited by 24 publications

References 10 publications

Contextualizing Cannabis Legalization Outcomes

Contextualizing Cannabis Legalization Outcomes

A systematic review of medical students’ and professionals’ attitudes and knowledge regarding medical cannabis

Associations between recreational cannabis legalization and cannabis-related emergency department visits by age, gender, and geographic status in Ontario, Canada: an interrupted time series study

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