\u201cWhere does the high road lead?\u201d Potential implications of cannabis legalization for pediatric injuries in Canada

Mojgan Karbakhsh,Mojgan Karbakhsh,Jennifer Smith,Ian Pike,Ian Pike,Ian Pike

doi:10.17269/s41997-018-0137-3

Abstract

The purpose of this commentary is to discuss how legalization of non-medical marijuana (LNMM) in Canada can potentially influence child and adolescent unintentional injuries based on evidence from states (American) and jurisdictions that have already legalized cannabis for recreational purposes. Although the evidence is still not conclusive, LNMM can bring about higher exposure, lower perceived harms, and higher prevalence of cannabis use by minors through role modeling and normalization of behaviour within the household and the community, and higher rates of driving under the influence of cannabis, which can contribute to a higher burden of road traffic injuries. Experience of American states with LNMM shows higher rates of emergency visits for pediatric poisoning due to unintentional ingestion of cannabis-containing foods and severe burns due to explosions during the course of home-based cannabis extraction. While the justification for legalization has created a strict legal framework for improved control of cannabis in Canada, the implications for health and safety of children and adolescents necessitate further study, communication with policy-makers and public health practitioners, and evidence-based education of parents, caregivers, and youth.

Highlights

Commencing October 2018, Canadians will witness a change in the national policy toward cannabis, which will see the legalization of non-medical marijuana (LNMM) with the passing of Bill C-45, The Cannabis Act (Task Force on Cannabis Legalization and Regulation 2016)
That valid comparative evidence does not exist to conclude that the current policy has been ineffective in promoting a safe community, as we are unable to predict the extent of cannabis use, nor the magnitude of consequences that would have occurred without current prohibitions
Drawing on the experience of other jurisdictions that have legalized recreational cannabis use, the purpose of this commentary is to discuss the implications of legalization of recreational cannabis in Canada for unintentional injuries among children and adolescents

Summary

Introduction

Commencing October 2018, Canadians will witness a change in the national policy toward cannabis, which will see the legalization of non-medical marijuana (LNMM) with the passing of Bill C-45, The Cannabis Act (Task Force on Cannabis Legalization and Regulation 2016). It is argued that the state-controlled cannabis supply may contribute to the growth of a black market that targets young users of limited means to provide them with less expensive and low-quality products In this latter perspective, major concerns regarding unfavourable public health impacts of legalization include lower perceived harm of use, higher rates of use, driving under the influence of cannabis (DUIC), road traffic injuries (RTIs), and healthcare utilization (Kalant 2015; Hajizadeh 2016). Drawing on the experience of other jurisdictions that have legalized recreational cannabis use, the purpose of this commentary is to discuss the implications of legalization of recreational cannabis in Canada for unintentional injuries among children and adolescents These potential implications and underlying mechanisms and pathways are discussed based on the review of published papers and reports

Implications of adult recreational cannabis use for pediatric injuries

Conclusion