The impact of cannabis legalisation in Canada – a mixed picture?

Five years on from the legalisation of cannabis, Canada has seen ‘major societal benefits’ but the public health impact remains a mixed picture, say experts. 

Adult-use cannabis was legalised in Canada in October 2018, with the goal to improve cannabis-related public health and safety, and reduce youth access and illegal activities related to cannabis.

However, there was concern at the time among some health professionals that legalisation could lead to adverse health effects in Canadians.

In a new commentary published in the Canadian Medical Association Journal, researchers have reflected on the impact of the legislation change and report a ‘mixed picture’.

“Limited evidence exists to support benefits as they relate to the original stated policy objectives of improving cannabis users’ and public health,” writes Dr Benedikt Fischer, Simon Fraser University, Vancouver, BC, with co-authors. 

“At this stage, cannabis legalisation in Canada appears not to have been the public health disaster anticipated by some of its opponents, but it cannot be described as a comprehensive or unequivocal success for public health either.”

According to the paper, evidence indicates that cannabis use, cannabis-related emergency department visits and admissions, and cannabis-related impaired driving have either stayed the same or increased. 

On the other hand, most consumers now obtain their cannabis from legal, rather than illegal, sources, and cannabis-related arrests, along with personal burdens from stigma and possible criminal records among adults and youth have decreased substantially. 

“These major societal benefits of legalisation must be included in any systematic assessments of the policy reform’s impacts” the authors add, asserting that these are important social justice benefits that may have indirect positive health effects.

In order to better understand the impact of legalisation, ongoing monitoring of cannabis use in adults, young people and those who are high-risk, is needed, they say, as well as cannabis use disorder, cannabis-related injuries, hospital admissions or emergency department visits, and related crime and other socioeconomic indicators.

“A consideration of the evidence five years after implementation suggests that success in meeting policy objectives has been mixed, with social justice benefits appearing to be more tangibly substantive than health benefits,” the paper concludes.

“Robust ways to integrate diverse data when evaluating policy outcomes are also needed to inform evidence-based adjustments to regulatory parameters that may be necessary to more effectively serve and achieve the declared public health objectives of cannabis legalisation in Canada going forward.”

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