Cannabis In Canada Research Articles

Conversations on Cannabis and Mental Health: Recommendations for Health and Social Care Providers from Indigenous 2SLGTBQQIA+ People in Canada

With the recent legalization of cannabis in Canada, there is an urgent need for information about its effects on Indigenous populations due to the impact of cannabis on the mental health of Indigenous Peoples in Canada being largely unknown. Using the guiding principles of Etuaptmumk (Two-Eyed Seeing), Sharing Circles were held to hear the needs and experiences of Indigenous People in relation to their mental health and cannabis use. From these engagements and using gender-based and distinctions-based analysis, four recommendations were developed for academic institutions, medical regulatory authorities and health and social care providers (HSCPs) to consider when caring for Indigenous People living with mental health issues. The findings point to the disconnection between recent research on medical cannabis and its availability to Indigenous People through accessible mediums, HSCPs, and the lack of cultural safety in health and social services. The four recommendations provided are helpful to both educate frontline HSCPs about the needs and experiences of Indigenous People and improve access to current information and best practices for Indigenous People who use cannabis for mental health from the regulatory and representation perspective.

Cannabis Use: A New Risk Behaviour Among Adults With Congenital Heart Disease

BackgroundCannabis use has increased in Canada and can be associated with adverse cardiovascular events. Given increased use and accessibility to cannabis, there is a need among clinicians to better understand cannabis use in adults with congenital heart disease. MethodsA cross-sectional survey (May to September 2018) was used to investigate cannabis use among 252 patients with adult congenital heart disease in a quaternary care centre. ResultsOf the 252 patients, 53 (21%) reported using cannabis. The majority of cannabis users were men (62%), between the ages of 25 and 39 years (mean age = 32 ± 16 years), and more likely to use tobacco (n = 9, 17%; P = 0.001) and alcohol (n = 37, 60%; P = 0.001). Significant differences (P = 0.011) were found between the age of onset for tobacco use among cannabis users (mean age: 16 ± 8 years) and non-cannabis users (mean age: 20 ± 3 years). Users reported consuming cannabis for recreational purposes (n = 29, 55%), anxiety (n = 22, 42%), depression (n = 15, 28%), and pain management (n = 4, 8%). ConclusionsThis study supports our clinical experience that a high proportion of patients with adult congenital heart disease use cannabis. Cannabis users represent a patient population who may demonstrate less optimal health behaviours, including tobacco and alcohol use. Assessment of cannabis use should be an integral part of risk behaviour and cardiovascular risk profile at each clinic visit. Given the current legalization of cannabis in Canada and the growing increase of cannabis use, educational support should be provided to patients and caregivers.

An interrupted time series evaluation of the effect of cannabis legalization on intentional self-harm in two Canadian provinces: Ontario and Alberta.

Despite the association between cannabis use and higher prevalence of suicidal ideation and attempt, the effect of cannabis legalization and regulation in Canada on intentional self-harm has not been determined. We used an interrupted time series of population-based rates of emergency department (ED) visits and hospitalizations for intentional self-harm per 100 000 in Ontario and Alberta from January/April 2010 to February 2020. Aggregate monthly counts of ED visits and hospitalizations for intentional self-harm (ICD-10 codes X60-X84, R45.8) were obtained from the National Ambulatory Care Reporting System and Discharge Abstract Database, respectively. The legalization and regulation of cannabis in Canada was not significantly associated with a change in rates of ED visits for intentional self-harm in Ontario (level = 0.58, 95% CI: -1.14 to 2.31; trend = -0.17, 95% CI: -0.35 to 0.01) or Alberta (level = -0.06, 95% CI: -2.25 to 2.12; trend = -0.07, 95% CI: -0.27 to 0.13). Hospitalizations for intentional self-harm also remained unchanged in Ontario (level = -0.14, 95% CI: -0.48 to 0.20; trend = 0.01, 95% CI: -0.03 to 0.04) and Alberta (level = -0.41, 95% CI: -1.03 to 0.21; trend = -0.03, 95% CI: -0.08 to 0.03). Legalization and regulation of cannabis in Canada has not increased rates of ED visits or hospitalizations for intentional self-harm in Ontario and Alberta. Individual-level analyses that account for demographic characteristics and include other provinces and territories are needed.

Baccalaureate nursing students' knowledge, attitudes, educational needs, and use of medical and non-medical cannabis at five institutions in Manitoba, Canada: A cross-sectional analysis

BackgroundWith the legalization of non-medical cannabis in Canada, cannabis is commonly used in the community and nurses and nursing students are likely to engage in clinical practice discussions around cannabis use for both medical and non-medical purposes. However, whether having previous experience using cannabis influences nursing students' knowledge and attitudes towards cannabis remains unclear. ObjectiveThe aim of this study was to describe nursing students' knowledge, attitudes, educational needs, and use of cannabis. DesignCross-sectional survey. SettingFive academic undergraduate nursing programs in Manitoba, Canada. ParticipantsNursing students in Manitoba. MethodsStudents were asked about their use of cannabis, knowledge and attitudes regarding cannabis, clinical experiences and educational needs related to cannabis. Students' current knowledge was compared to their desired knowledge using paired t-tests. Using t-tests, attitudes towards cannabis were compared between students who had ever taken cannabis versus those with no experience. Descriptive statistics were utilized for all other questions. ResultsA total of 327 nursing students participated in the survey with 220 students (67.3 %) reporting they had used cannabis in the past, and 123 students (37.6 %) reporting monthly use of cannabis. Students who previously used cannabis held more positive attitudes towards both medical and non-medical cannabis use in comparison to those with no experience. Students recognised that their current knowledge around cannabis was insufficient and indicated the need for greater knowledge on both medical and non-medical cannabis-related topics. Only 37.7 % of students reported receiving any education on cannabis in their nursing program. Nearly all students (92.2 %) agreed if they had more education on medical cannabis use that they would feel more comfortable discussing this in their clinical practice. ConclusionEducation on both medical and non-medical cannabis is needed to support future nurses addressing cannabis use in their clinical practice. Nursing institutions must implement and evaluate curricula to ensure nursing students are adequately prepared to address cannabis use in their clinical practice and their own fitness to practice.

Canadian cannabis education resources to support youth health literacy: A scoping review and environmental scan.

The 2018 legalisation of cannabis in Canada sparked concern and conversation about the potential negative impacts of youth cannabis use. It is clear that young people are already engaging in cannabis use for a variety of reasons; therefore, youth cannabis education is desirable to promote harm reduction and reduce the risk of adverse physical and mental health outcomes. To identify and categorise Canadian cannabis education resources using a social-ecological approach informed by the youth health literacy framework, considering multiple factors at the micro-, meso- and macro-levels that influence health literacy and impact behaviour. In line with scoping review methodology, database searches and an environmental scan of materials were completed. Specific inclusion criteria were identified to encompass all Canadian cannabis education resources directed towards young people aged 9-18 years and adults in contact with youth. A total of 60 resources were identified and categorised using the youth health literacy framework in terms of their focus on (1) micro influences (resources for youth); (2) meso influences (resources for teachers, parents, mentors); and (3) macro influences (resources for indigenous communities and medical professionals). While many resources were identified, issues exist with the accessibility, quality and multicultural considerations of such resources, warranting the development of comprehensive, evidence-based and harm reduction-focused cannabis education for youth.

Perceptions of cannabis use risk to mental health among youth in Canada, England and the United States from 2017 to 2021

BackgroundThere is little research examining perceptions of cannabis use risk to mental health in countries with differing cannabis regulations. This study therefore examines such perceptions among youth between 2017 and 2021 in Canada (non-medical cannabis legalized in October 2018), England (highly-restricted medical cannabis legalized November 2018), and the US (non-medical cannabis legal in some states). MethodsSeven repeat cross-sectional online surveys were conducted between July 2017 to August 2021 among youth aged 16–19 in Canada (N=29,420), England (N=28,155), and the US (N=32,974). Logistic regression models, stratified by country, were used to examine perceptions of cannabis use risk to mental health over time, adjusting for age group, sex, race/ethnicity, cannabis use and, for the US only, state-level cannabis legalization. ResultsPerceptions that cannabis use posed “no risk” to mental health decreased between July 2017 and August 2021 in Canada (6.1–4.4%; AOR=0.64, 95% CI=0.52–0.78) and the US (14.0–11.3%; AOR=0.74, 0.65–0.84) but not England (3.7–4.5%; AOR=1.21, 0.97–1.52). No significant changes were observed from immediately before (August 2018) to after (August 2019) legalization of non-medical cannabis in Canada (AOR=0.99, 0.83–1.20) or highly-restricted medical cannabis in England (AOR=0.90, 0.70–1.17). In the US, perceptions of “no risk” were more likely in states where cannabis use was illegal (15.0%) compared with legal non-medical (12.2%) (AOR=0.68, 0.63–0.74). ConclusionThere were modest decreases in perceptions that cannabis use poses no risk to mental health in Canada and the US between 2017 and 2021 but no clear association with cannabis legalization status.

Evaluating the Supporting Evidence of Medical Cannabis Claims Made on Clinic Websites: Cross-Sectional Study.

Since the legalization of medical cannabis in Canada in 2013, prescription of cannabis for medical purposes has become commonplace and a multibillion dollar industry has formed. Much of the media coverage surrounding medical cannabis has been positive in nature, leading to Canadians potentially underestimating the adverse effects of medical cannabis use. In recent years, there has been a large increase in clinic websites advertising the use of medical cannabis for health indications. However, little is known about the quality of the evidence used by these clinic websites to describe the effectiveness of cannabis used for medical purposes. We aimed to identify the indications for medical cannabis reported by cannabis clinics in Ontario, Canada, and the evidence these clinics cited to support cannabis prescription. We conducted a cross-sectional web search to identify all cannabis clinic websites within Ontario, Canada, that had physician involvement and identified their primary purpose as cannabis prescription. Two reviewers independently searched these websites to identify all medical indications for which cannabis was promoted and reviewed and critically appraised all studies cited using the Oxford Centre for Evidence-Based Medicine Levels of Evidence rubric. A total of 29 clinics were identified, promoting cannabis for 20 different medical indications including migraines, insomnia, and fibromyalgia. There were 235 unique studies cited on these websites to support the effectiveness of cannabis for these indications. A high proportion (36/235, 15.3%) of the studies were identified to be at the lowest level of evidence (level 5). Only 4 clinic websites included any mention of harms associated with cannabis. Cannabis clinic websites generally promote cannabis use as medically effective but cite low-quality evidence to support these claims and rarely discuss harms. The recommendation of cannabis as a general therapeutic for many indications unsupported by high-quality evidence is potentially misleading for medical practitioners and patients. This disparity should be carefully evaluated in context of the specific medical indication and an individualized patient risk assessment. Our work illustrates the need to increase the quality of research performed on the medical effects of cannabis.

Reasonable access: important characteristics and perceived quality of legal and illegal sources of cannabis for medical purposes in Canada

BackgroundThroughout the past two decades of legal medical cannabis in Canada, individuals have experienced challenges related to accessing legal sources of cannabis for medical purposes. The objective of our study was to examine the sources of cannabis accessed by individuals authorized to use medical cannabis and to identify possible reasons for their use of illegal sources.MethodsIndividuals who participated in the Cannabis Access Regulations Study (CANARY), a national cross-sectional survey launched in 2014, and indicated they were currently authorized to use cannabis for medical purposes in Canada were included in this study. We assessed differences between participants accessing cannabis from only legal sources versus from illegal sources in relation to sociodemographic characteristics, health-related factors, and characteristics of medical cannabis they considered important. A secondary analysis assessed differences in satisfaction with various dimensions of cannabis products and services provided by legal versus illegal sources.ResultsHalf of the 237 study participants accessed cannabis from illegal sources. Individuals accessing cannabis from illegal sources were significantly more likely to value pesticide-free products, access to a variety of strains, ability to select strain and dosage, ability to observe and smell cannabis, availability in a dispensary, and availability in small quantities than did individuals accessing cannabis from only legal sources (all p < 0.05). Additionally, participants gave significantly higher satisfaction scores to illegal sources than to legal sources on service-related dimensions of cannabis access (all p < 0.05).ConclusionOur findings contribute to an understanding of reasonable access to medical cannabis from a patient perspective and how to assess whether it has been achieved. Characteristics of cannabis products and services valued by patients and appropriate to their needs should be incorporated into legal medical cannabis programs to promote the use of legal medical sources. While pertaining specifically to medical use of cannabis in Canada, the findings of this study may also be instructive for understanding the use of illegal cannabis sources for non-medical purposes in Canada and provide insight for other jurisdictions implementing cannabis regulations for both medical and non-medical purposes.

Proximity to Legal Cannabis Stores in Canada and Use of Cannabis Sources in the First Three Years of Legalization, 2019-2021.

The accessibility of legal cannabis in Canada may influence how consumers source their cannabis. The aims of this study were to examine (a) the distance between respondents' homes and legal retail stores, (b) the cannabis sources used in the past 12 months, and (c) the association between cannabis sources used and distance to legal retail stores. Data were analyzed from Canadian respondents participating in the International Cannabis Policy Study from 2019 to 2021. Respondents were 15,311 past-12-month cannabis consumers of legal age to purchase cannabis. Weighted logistic regression models examined cannabis sources used and their association with the Euclidean distance to the nearest legal store, province of residence, and year (n = 12,928). Respondents lived closer to a legal retail store in 2021 (1.5 km) versus 2019 (6.8 km) as the number of retail stores increased. Respondents in 2020 and 2021 had higher odds of obtaining cannabis from legal sources (e.g., legal stores: 47.9% and 60.0% vs. 38.6%, respectively, adjusted odds ratio [AOR] range: 1.41-2.42) and lower odds of obtaining cannabis from illegal sources versus 2019 (e.g., dealers: 22.6% and 19.9% vs. 29.1%, respectively, AOR range: 0.65-0.54). Respondents who lived closest to legal stores had higher odds of sourcing from legal stores and lower odds of sourcing from legal websites or growing their own cannabis. Legal cannabis stores are increasingly accessible to people living in Canada 3 years after legalization. Household proximity to a legal cannabis store was associated with sourcing cannabis from legal retail stores, but only among those who live very close (<3 km). Findings suggest that proximity to legal cannabis stores may aid uptake of the legal market, yet there may be diminishing returns after a certain point.

Patterns of problematic cannabis use in Canada pre- and post-legalisation: Differences by neighbourhood deprivation, individual socioeconomic factors and race/ethnicity.

The legalisation of cannabis in Canada in 2018, and subsequent increase in prevalence of use, has generated interest in understanding potential changes in problematic patterns of use, including by socio-demographic factors such as race/ethnicity and neighbourhood deprivation level. This study used repeat cross-sectional data from three waves of the International Cannabis Policy Study web-based survey. Data were collected from respondents aged 16-65 prior to cannabis legalisation in 2018 (n = 8704), and post-legalisation in 2019 (n = 12,236) and 2020 (n = 12,815). Respondents' postal codes were linked to the INSPQ neighbourhood deprivation index. Multinomial regression models examined differences in problematic use by socio-demographic and socio-economic factors and over time. No evidence of a change in the proportion of those aged 16-65 in Canada whose cannabis use would be classified as 'high risk' was noted from before cannabis legalisation (2018 = 1.5%) to 12 or 24 months after legalisation (2019 = 1.5%, 2020 = 1.6%; F = 0.17, p = 0.96). Problematic use differed by socio-demographic factors. For example, consumers from the most materially deprived neighbourhoods were more likely to experience 'moderate' vs 'low risk' compared to those living outside deprived neighbourhoods (p < 0.01 for all). Results were mixed for race/ethnicity and comparisons for high risk were limited by small sample sizes for some groups. Differences across subgroups were consistent from 2018 to 2020. The risk of problematic cannabis use does not appear to have increased in the 2 years following cannabis legalisation in Canada. Disparities in problematic use persisted, with some racial minority and marginalised groups experiencing higher risk.

Canada’s cannabis legalization and police-reported cannabis-related criminal incidents among youth, 2015–2021

BackgroundWe previously reported that the 2018 Canadian Cannabis Act, allowing youth to possess up to 5 g dried cannabis or equivalent for personal use/sharing, was associated with short-term (76 days) post-legalization reduction in police-reported cannabis-related crimes among youth. To establish whether the change might be sustained, we now estimate this association during a much longer time period by including an additional three years of post-legalization data. MethodsUsing national daily police-reported criminal incident data from January 1, 2015–December 31, 2021 from the Canadian Uniform Crime Reporting Survey (UCR-2), the study employed Seasonal Autoregressive Integrated Moving Average (SARIMA) time series models to assess the associations between legalization and youth (12–17 years) cannabis-related offenses (male, n = 34,508; female, n = 9529). ResultsLegalization was associated with significant reductions in both male and female police-reported cannabis-related offenses: females, 4.04 daily incidents [95% confidence interval (CI), 3.08; 5.01], a 62.1% decrease [standard error (se), 34.3%]; males, 12.42 daily offenses (95% CI, 8.99; 15.86), a reduction of 53.0% (se, 22.7%). There was no evidence of associations between cannabis legalization and patterns of property or violent crimes. ConclusionsResults suggest that the impact of the Cannabis Act on reducing cannabis-related youth crimes is sustained, supporting the Act’s objectives to reduce cannabis-related criminalization among youth and associated effects on the Canadian criminal justice system.

The evolving culture of medical cannabis in Canada for the management of chronic pain.

Although used therapeutically for millennia, cannabis has been a prohibited substance worldwide for most of the 20th Century. With revision of prohibitive regulations in many jurisdictions during the past 2decades, cannabis is increasingly available to patients as a potential treatment option for various symptoms. Pain relief, sleep promotion and alleviation of distress, depression and anxiety are the most common reasons for cannabis use. Canada has been at the forefront of medical cannabis (MC) legislation revisions to enable and facilitate access for therapeutic use. Although initially viewed with caution and stigma, attitudes to cannabis in general have changed. Medical cannabis is identified as the herbal plant product sourced from a grower/producer and is not at present a regulated pharmaceutical product. Medical cannabis use is currently prevalent in Canada but has bypassed the rigorous study required for usual drug approval. Although uptake has been enthusiastic by patients, the medical community has voiced cautions and concerns. Access to medical cannabis is fairly easy once an approval document is obtained from a healthcare professional, but without obligation for medical or pharmacy oversight. The greatest concern is a dearth of sound clinical evidence for effects and harms. Emerging concerns include prevalent patient self-management with information based on personal research, an abundance of on-line information which may not always be accurate, the emergence of designated "cannabis clinics," potential risks to society due to accidents, and high cost of the legal medical product leading to access via the recreational market. With cannabis now entrenched in Canadian healthcare, physicians must be sufficiently knowledgeable to provide guidance that is evidence-based and will ensure personal and societal harm reduction. Examination of the changing culture of medical cannabis in Canada will provide insight for countries that may be anticipating similar revisions of cannabis regulations to allow cannabis access for their patient population and learn from the issues created by recreational legalization.

The “risk object” of cannabis edibles: perspectives from young adults in Canada

Young adults are the most prominent users of cannabis in Canada, which was legalised for recreational use in 2018. Edibles are a highly popular form of cannabis delivery for this age group, yet little qualitative research explores young adult perspectives on edibles, including how edibles function socially for them, or are viewed in terms of risk. This study fills this research gap, conducting focus groups with 57 young adults (ages-18–24) in Calgary, Alberta, Canada to explore the ‘risk object’ of cannabis edibles. Findings reveal that delivery mechanism of cannabis – that is, cannabis in food form compared to smoked/inhaled – significantly shifts perceptions of risk by young adults. Edibles were viewed as less risky than smoking cannabis, and participants stated they were more willing to consume edibles than in any other form (and especially in social settings). Risks associated with edibles were primarily short-term/related to over-consumption and were largely mitigated by legalisation. However, participants also emphasised risks for others (including children and inexperienced consumers). Overall, the ‘risk object’ of cannabis edibles shifts depending on the audience considered. Participants described individual consumers as shouldering primary responsibility for managing risks related to cannabis edibles, despite manufacturer and government roles in regulating product quality and protecting vulnerable populations.

Rollin’ papers: Newspaper coverage of cannabis legalization in Canada

With Canada becoming the first G20 country to legalize the recreational use of cannabis, there has been increasing interest in the emergence of this new marketplace. Newspaper framing helps to shape public opinion on legalization and news sources play a role in determining how the public perceives the use of cannabis. This research analyzes how mainstream newspapers reported on the legalization of recreational cannabis in Canada in the years before and after legalization (between 2016 and 2019). Using a content analysis of 1,390 cannabis-related articles, 11 dominant reporting themes are identified. Over time, there was a shift from negative and sensationalist cannabis news coverage toward more balanced and progressive framing. The findings identify the influence of editorial political stance on thematic coverage.

The impact of cannabis legalization for recreational purposes: The Canadian experience

AbstractCannabis Legalization for Recreational Purposes took place in Canada in October 2018. One of the federal government’s stated goals with this legalization was to protect Canadian youth from cannabis-related harms. The Canadian model differs from other jurisdictions that legalized recreational cannabis use, especially with regard to a higher degree of government regulation of the cannabis market. Another difference is the development and endorsement of lower-risk cannabis use guidelines to educate the public and health professionals. Here, we will present the changes in the regulation of the Canadian cannabis market. We will also present some changes in the epidemiology and parameters of cannabis use (modes of use, potency of cannabis) among adults and youths. Although it is clear that prevalence of use has increased in some groups (notably older adults), results for youth are mixed, with the majority of studies showing no pronounced increase. A trend of a decrease in youth cannabis use seen pre-legalization may have reversed. Data about changes in the age of initiation, the influence of legalization on sex and gender, and race/ ethnicity are limited, with evidence suggesting that the age of initiation slightly increased and the prevalence of use has become more similar between females and males. The development and utility of the lower-risk cannabis use guidelines will be also presented.Disclosure of InterestB. Le Foll Grant / Research support from: . Dr. Le Foll has in-kind donations of cannabis products from Aurora Cannabis Enterprises Inc. . Dr. Le Foll has obtained industry funding from Canopy Growth Corporation (through research grants handled by the Centre for Addiction and Mental Health and the University of Toronto)

Shifts in medical cannabis use in Canada during the COVID-19 pandemic.

The COVID-19 pandemic has had widespread secondary negative health impacts including loss of material security and exacerbation of mental illness in at-risk populations. While increases in the nonmedical use of certain substances, including cannabis, have been observed in samples of the Canadian population, no research has documented COVID-concurrent shifts in medical cannabis use in Canada. Data were derived from the 2021 Canadian Cannabis Patient Survey, an online survey administered in May 2021 to people authorized to use medical cannabis recruited from one of two Canadian licensed medical cannabis producers. McNemar tests assessed for changes in past 3-month medical cannabis frequency from before to during the pandemic. We explored correlates of increasing frequency of cannabis use since before the pandemic in bivariable and multivariable logistic models. In total, 2697 respondents (49.1% women) completed the survey. Daily medical cannabis use increased slightly but significantly from before the pandemic (83.2%) to during the pandemic (90.3% at time of survey; p < 0.001). Factors significantly associated with increasing frequency of medical cannabis use included female gender, younger age, pandemic-related job loss, primary cannabis use to manage mental health, prescription drug use and nonmedical cannabis use (p < 0.05). There were slight shifts towards higher frequency of medical cannabis use after the onset of the COVID-19 pandemic. While short- and long-term impacts of cannabis use on pandemic-related mental distress are unknown, clinicians working with patients who use medical cannabis should be aware of possible changes in use patterns during the pandemic.

Legal sourcing of ten cannabis products in the Canadian cannabis market, 2019–2021: a repeat cross-sectional study

BackgroundOne of the objectives of cannabis legalization in Canada is to transition consumers from the illegal to the legal market. Little is known about how legal sourcing varies across different cannabis product types, provinces, and frequency of cannabis use.MethodsData were analyzed from Canadian respondents in the International Cannabis Policy Study, a repeat cross-sectional survey conducted annually from 2019 to 2021. Respondents were 15,311 past 12-month cannabis consumers of legal age to purchase cannabis. Weighted logistic regression models estimated the association between legal sourcing (“all”/ “some”/ “none”) of ten cannabis product types, province, and frequency of cannabis use over time.ResultsThe percentage of consumers who sourced “all” their cannabis products from legal sources in the past 12 months varied by product type, ranging from 49% of solid concentrate consumers to 82% of cannabis drink consumers in 2021. The percentage of consumers sourcing “all” their respective products legally was greater in 2021 than 2020 across all products. Legal sourcing varied by frequency of use: weekly or more frequent consumers were more likely to source “some” (versus “none”) of their products legally versus less frequent consumers. Legal sourcing also varied by province, with a lower likelihood of legal sourcing in Québec of products whose legal sale was restricted (e.g., edibles).ConclusionLegal sourcing increased over time, demonstrating progress in the transition to the legal market for all products in the first three years of legalization in Canada. Legal sourcing was highest for drinks and oils and lowest for solid concentrates and hash.

Cannabis companies and the sponsorship of scientific research: A cross-sectional Canadian case study.

Corporations across sectors engage in the conduct, sponsorship, and dissemination of scientific research. Industry sponsorship of research, however, is associated with research agendas, outcomes, and conclusions that are favourable to the sponsor. The legalization of cannabis in Canada provides a useful case study to understand the nature and extent of the nascent cannabis industry's involvement in the production of scientific evidence as well as broader impacts on equity-oriented research agendas. We conducted a cross-sectional, descriptive, meta-research study to describe the characteristics of research that reports funding from, or author conflicts of interest with, Canadian cannabis companies. From May to August 2021, we sampled licensed, prominent Canadian cannabis companies, identified their subsidiaries, and searched each company name in the PubMed conflict of interest statement search interface. Authors of included articles disclosed research support from, or conflicts of interest with, Canadian cannabis companies. We included 156 articles: 82% included at least one author with a conflict of interest and 1/3 reported study support from a Canadian cannabis company. More than half of the sampled articles were not cannabis focused, however, a cannabis company was listed amongst other biomedical companies in the author disclosure statement. For articles with a cannabis focus, prevalent topics included cannabis as a treatment for a range of conditions (15/72, 21%), particularly chronic pain (6/72, 8%); as a tool in harm reduction related to other substance use (10/72, 14%); product safety (10/72, 14%); and preclinical animal studies (6/72, 8%). Demographics were underreported in empirical studies with human participants, but most included adults (76/84, 90%) and, where reported, predominantly white (32/39, 82%) and male (49/83, 59%) participants. The cannabis company-funded studies included people who used drugs (37%) and people prescribed medical cannabis (22%). Canadian cannabis companies may be analogous to peer industries such as pharmaceuticals, alcohol, tobacco, and food in the following three ways: sponsoring research related to product development, expanding indications of use, and supporting key opinion leaders. Given the recent legalization of cannabis in Canada, there is ample opportunity to create a policy climate that can mitigate the harms of criminalization as well as impacts of the "funding effect" on research integrity, research agendas, and the evidence base available for decision-making, while promoting high-priority and equity-oriented independent research.

Retrospective Review of Unintentional Pediatric Cannabis Poisonings in Saskatchewan after Federal Legalization

Background: With the legalization of cannabis in Canada, safety concerns for children should be considered. Despite packaging and dose regulations for edibles and inhaled cannabis, unintentional poisonings are a clinical risk, and its impact on pediatric healthcare resources have not been clearly delineated. Methods: This retrospective cross-sectional chart review evaluated all patients &lt; 19 years presenting to Saskatchewan’s only pediatric trauma center between January 1st, 2020 to June 30th, 2021 with unintentional poisoning. Cannabis and non-cannabis unintentional poisonings were compared using difference of squares and Fisher’s exact test. Results: There were fifty-two unintentional poisonings during the study period, with a mean age of 2.45 years (SD 2.11). Thirty one percent (n=16) were cannabis related, with edibles accounting for at least 63% (n=10) of those admissions. More than 40 percent were transferred from rural communities with an average transport distance of 160 kilometers. Over 18% (n=3) percent were admitted to PICU with no requirement for intubation or vasoactive medications. Conclusions: Since legalization, one third of Saskatchewan’s pediatric unintentional poisonings were due to cannabis, largely from edible ingestions. An increased public awareness and federal government initiatives may attenuate the risk of these ingestions.

Cannabis Use in Pregnancy and Downstream effects on maternal and infant health (CUPiD): a protocol for a birth cohort pilot study

IntroductionCannabis use in pregnancy and post partum is increasing. Accessibility to cannabis has expanded due to the legalisation of cannabis in Canada. Therefore, there is a critical need to monitor...