Legalization In Canada Research Articles

Reimagining Research with Pregnant Women and Parents Who Consume Cannabis in the Era of Legalization: The Value of Integrating Intersectional Feminist and Participatory Action Approaches.

Research on women who consume cannabis has predominantly focused on the perinatal period whereby cannabis consumption is problematized, linked to negative perinatal outcomes, and related to substance use and mental health challenges. When this historical literature and research about cannabis consumption is considered through a sociolegal and intersectional lens, questions emerge about how cannabis legalization may benefit and harm women, particularly women who experience marginalization along various axes of identity such as gender, race, and class. Questions also emerge about how women who consume cannabis may be perceived, represented, and treated as part of health and social care practices, particularly while pregnant and parenting. This commentary seeks to untangle what could be at stake for pregnant women and mothers, and what could be emphasized in future research endeavors, in the new era of cannabis legalization in Canada. The authors encourage research initiatives that attend to and reimagine harm reduction philosophies, and that integrate intersectional, feminist, and participatory action research approaches.

Recreational Cannabis Use Before and After Legalization in Women With Pelvic Pain.

To evaluate the prevalence and characteristics of recreational cannabis use in women with pelvic pain, and to examine the influence of cannabis legalization on these parameters. We conducted a retrospective analysis of a prospective registry of women with self-reported moderate-to-severe pelvic pain referred to a tertiary care clinic in Vancouver, Canada, 2013-2019. We excluded patients aged 18 years or younger and those with unknown data on cannabis use. Demographic, clinical, and validated questionnaire data were extracted for two main analyses: 1) comparison of current cannabis users with current nonusers, and 2) comparison of current cannabis users who entered the registry before cannabis legalization (October 17, 2018) with those who entered the registry on or after legalization. Overall, 14.9% (509/3,426) of patients were classified as current cannabis users. Compared with nonusers, cannabis users were younger (P<.001), had lower levels of education (P<.001) and lower household income (P<.001), were taking opioids (P<.001), antiinflammatories (P=.003), neuromodulators (P=.020), and herbal medications (P<.001) more frequently. They had worse questionnaire scores for depression, anxiety, pain catastrophizing, quality of life, and pelvic pain severity (P<.001 for all). After cannabis legalization, prevalence of current cannabis use increased from 13.3% (366/2,760) to 21.5% (143/666) (P<.001). Compared with prelegalization, postlegalization users were associated with higher levels of education (P<.001), worse anxiety (P=.036), and worse pain catastrophizing (P<.001) scores. They were taking fewer antiinflammatories (P<.001), neuroleptics (P=.027) and daily opioids or narcotics (P=.026), but more herbal medications (P=.010). Recreational cannabis use increased among patients with pelvic pain after legalization in Canada. Cannabis users had worse pain-related morbidities. Postlegalization, cannabis users were less likely to require daily opioids compared with cannabis users before legalization. The role, perceived benefits, and possible risks of cannabis for pelvic pain require further investigation. ClinicalTrials.gov, NCT02911090.

The genetics of Cannabis-genomic variations of key synthases and their effect on cannabinoid content.

Despite being a controversial crop, Cannabis sativa L. has a long history of cultivation throughout the world. Following recent legalization in Canada, Cannabis is emerging as an important plant for both medicinal and recreational purposes. Recent progress in genome sequencing of both cannabis and hemp varieties allow for systematic analysis of genes coding for enzymes involved in the cannabinoid biosynthesis pathway. Single-nucleotide polymorphisms in the coding regions of cannabinoid synthases play an important role in determining plant chemotype. Deep understanding of how these variants affect enzyme activity and accumulation of cannabinoids will allow breeding of novel cultivars with desirable cannabinoid profiles. Here we present a short overview of the major cannabinoid synthases and present the data on the analysis of their genetic variants and their effect on cannabinoid content using several in-house sequenced Cannabis cultivars.

Understanding cancer survivors' reasons to medicate with cannabis: A qualitative study based on the theory of planned behavior.

BackgroundPrior to nonmedical cannabis legalization in Canada, individuals were only able to access cannabis legally through licensed producers with medical authorization. Now with an additional legal access system designed for nonmedical purposes, it is unclear what factors influence cancer survivors’ decisions to medicate or not medicate cannabis as a complementary therapy to alleviate their cancer symptoms.MethodsWe recruited cancer survivors via social media. Interested individuals were purposively sampled to ensure maximization in terms of age, sex, and province of residence. Constructs of the Theory of Planned Behavior were explored during the telephone interviews as participants described what influenced their decisions to medicate or not medicate cannabis to manage their symptoms.ResultsInterviews were conducted with 33 cancer survivors. All individuals believed that cannabis would manage their cancer symptoms. Those that chose to medicate with cannabis provided a variety of reasons, including that cannabis was a more natural alternative; that it reduced their overall number of prescription drugs; and that safer products had become available with the legalization of nonmedical cannabis. Some individuals also indicated that support from physicians and validation from family and friends were important in their decision to medicate with cannabis. Individuals who opted not to medicate with cannabis raised concerns about the lack of scientific evidence and/or possible dependency issues. Some also felt their physician's disapproval was a barrier to considering cannabis use.ConclusionsThe findings revealed that recreational legalization made using cannabis appear safer and easier to access for some cancer survivors. However, physicians’ censure of cannabis use for symptom management was a barrier for survivors considering its use.

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

We investigated trends in cannabis-related hospitalizations among youth before and after legalization of recreational cannabis in Canada on October 17, 2018. We computed rates of cannabis-related hospitalizations and the proportion of substance-related hospitalizations involving cannabis by age and sex in the months before and after legalization in Quebec, Canada. In boys aged 10 to 14 years, cannabis-related hospitalization rates increased from 5.2 per 100,000 one year before legalization [95% confidence interval (CI) 2.9-9.3] to 9.5 per 100,000 after legalization (95% CI 6.2-14.6), although the increase was not statistically significant. Cannabis was reported in 39.3% of substance-related hospitalizations in boys aged 10 to 14 years before legalization, compared with 70.0% after legalization, representing a difference of 30.7% (95% CI 2.8-58.6). There was no increase in cannabis-related hospitalizations among girls or boys aged 15 to 19 years. This study suggests that cannabis legalization in Canada did not increase the risk of short-term cannabis-related hospitalization among girls and older boys. However, legalization may have contributed to an increase in the risk in boys under 15 years. Further data are needed to clarify trends after legalization for younger adolescents.

Are School Substance Use Policy Violation Disciplinary Consequences Associated with Student Engagement in Cannabis?

Schools are increasingly concerned about student cannabis use with the recent legalization in Canada; however, little is known about how to effectively intervene when students violate school substance use policies. The purpose of this study is to assess the disciplinary approaches present in secondary schools prior to cannabis legalization and examine associations with youth cannabis use. This study used Year 6 (2017/2018) data from the COMPASS (Cannabis use, Obesity, Mental Health, Physical Activity, Alcohol use, Smoking, Sedentary behavior) study including 66,434 students in grades 9 through 12 and the 122 secondary schools they attend in British Columbia, Alberta, Ontario, and Quebec. Student questionnaires assessed youth cannabis use and school administrator surveys assessed potential use of 14 cannabis use policy violation disciplinary consequences through a (“check all that apply”) question. Regression models tested the association between school disciplinary approaches and student cannabis use with student- (grade, sex, ethnicity, tobacco use, binge drinking) and school-level covariates (province, school area household median income). For first-offence violations of school cannabis policies, the vast majority of schools selected confiscating the product (93%), informing parents (93%), alerting police (80%), and suspending students from school (85%), among their disciplinary response options. Few schools indicated requiring students to help around the school (5%), issuing a fine (7%), or assigning additional class work (8%) as potential consequences. The mean number of total first-offence consequences selected by schools was 7.23 (SD = 2.14). Overall, 92% of schools reported always using a progressive disciplinary approach in which sanctions get stronger with subsequent violations. Students were less likely to report current cannabis use if they attended schools that indicated assigning additional class work (OR 0.57, 95% CI (0.38, 0.84)) or alerting the police (OR 0.81, 95% CI (0.67, 0.98)) among their potential first-offence consequences, or reported always using the progressive discipline approach (OR 0.77, 95% CI (0.62, 0.96)) for subsequent cannabis policy violations. In conclusion, results reveal the school disciplinary context in regard to cannabis policy violations in the year immediately preceding legalization. Various consequences for cannabis policy violations were being used by schools, yet negligible association resulted between the type of first-offence consequences included in a school’s range of disciplinary approaches and student cannabis use.

An emerging allergen: Cannabis sativa allergy in a climate of recent legalization

Considering its recent legalization in Canada, the health implications of Cannabis sativa exposure, including allergy, are coming to the forefront of medical study and interest. C. sativa allergy is an issue that affects recreational users of the substance, processors, agricultural workers, and contacts of Cannabis aeroallergens and secondhand product. Allergies to C. sativa are heterogenous and span the spectrum of hypersensitivity, from dermatitis to rhinoconjunctivitis to life-threatening anaphylaxis. Due to its recent legalization, sensitized individuals will have increasing exposure from direct contact to agricultural pollens. Diagnosis and treatment of Cannabis allergy are developing fields that are already showing promise in the identification of culprit antigens and the potential for immunotherapy; however, much responsibility still falls on clinical diagnosis and symptom management. Hopefully, given the current explosion of interest in and use of Cannabis, C. sativa allergy will continue to garner awareness and therapeutic strategies.

Setting the baseline: a description of cannabis poisonings at a Canadian pediatric hospital prior to the legalization of recreational cannabis.

This study describes the events and circumstances preceding children aged 16 years or younger being treated for cannabis poisoining in the emergency department (ED) of a Canadian pediatric hospital. We extracted cannabis poisoning treated in the ED at British Columbia Children's Hospital (BCCH) between 1 January, 2016 and 31 December, 2018, from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database. The poisonings were distinguished by the inadvertent or intentional ingestion of cannabis. We reviewed the hospital's electronic health information system and the patients' health records to obtain additional information on the context, including spatial and temporal characteristics. Of the 911 poisonings treated at BCCH, 114 were related to intentional cannabis use (12.5%). Fewer than 10 poisonings resulted from inadvertent ingestions by children and the median age for these was 3 years. All inadvertent ingestion occurred at home and involved cannabis belonging to the patient's family. The vast majority of poisonings resulted from the intentional use of cannabis only (28.9%) or cannabis use with other psychoactive substances (co-ingestions; 71.1%). The median patient age was 15 years. Most patients reported consuming cannabis through inhalation with peers. Cannabis and co-ingestion poisonings were more often reported on weekdays than weekends. The consumption of cannabis leading to poisoning more often occurred in private residences. Patients with cannabis poisoning more often sought medical treatment themselves or were helped by their family. The characteristics of cannabis poisonings among children are described for the three-year period prior to recreational cannabis legalization in Canada in order to set a baseline for future comparisons. Implications for improving injury prevention initiatives and policies are discussed.

Age Demographics Influences Cannabis Use Pre and Post Federal Legalization in Canada and Implications for Clinical Trial Application in Healthy Populations

IntroductionCannabis has been used effectively as a medical drug for many years. With the recent federal legalization of cannabis in Canada and hemp in the United States, there is growing consumer interest in how cannabinoids can be efficacious in improving quality of life. The objective of this study was to examine how age influences cannabis use in Southwestern Ontario before and after federal legalization in Canada.MethodsA 31 question, online survey was conducted from March 2018 to October 2019 and designed as a market research project to engage with Canadians on past and present medical and recreational cannabis use. The data were used to investigate how age influences self‐reported reasons for use, life stage when started, and method, frequency and component of cannabis most frequently used. Respondents were stratified into age groups (&lt;19 (n=199), 19–24 (n=1182), 25–34 (n=1362), 35–44 (n=1166), 45–54 (n=569), 55–64 (n=537), 65+ (n=82)).Possible differences in cannabis consumption between groups pre and post federal legalization was assessed by the Chi Square test or Fisher’s Exact (2‐tail) test, as appropriateResultsThere were 2,667 and 2,430 survey respondents’ pre and post‐legalization, respectively.There were significant effects of age group on the cannabinoid consumed, the primary reason for using cannabis, the life stage when started using cannabis, and both the frequency and mode of consumption (p&lt;0.01).There was a demographic shift in those who reported using cannabis for “social/relaxation” purposes following legalization. Prior to legalization, social/relaxation was the most frequently reported reason for use in those &lt;19–24 years. Reducing anxiety was the most frequently reported reason for use for users aged 25–34 and controlling pain was most frequent amongst users aged 35–65+. Following legalization, social/relaxation became the most frequently reported reason for use across a greater age range of &lt;19–45 years. Across all age groups, since legalization, 18–68% reported using cannabis to reduce anxiety, 23–60% to control pain, and 4–27% for digestion/ISB/IBD. These are important findings for consumers of translational research in these areas.Daily users across groups was similar before and after legalization. Prior to legalization, 40–73% reported daily use compared to 48–72% post‐legalization. There were significant differences in use of inhalation (vapor, smoke) and ingestion (oral, sublingual) routes of administration between age groups. Across groups, the most frequently reported route of administration was smoking. There were no differences in suppository (0–9%) and topical (0–18%) use.ConclusionAge influences how and why cannabis is consumed, both before and after federal legalization. Most clinical trials on cannabis have not been completed in healthy populations, which confounds the literature available to inform formulation of investigational products for trails in this population. Moving forward with effective clinical trial design for efficacious use in healthy populations requires an understanding of the needs, perceptions and barriers of consumers, making surveys such as this critical in advancing this choice of treatment modality.

Cannabis cessation among youth: rates, patterns and academic outcomes in a large prospective cohort of Canadian high school students.

Following cannabis legalization in Canada, a better understanding of the prevalence of unprompted cannabis use reduction and subsequent effects on youth academic outcomes is needed to inform harm reduction and health promotion approaches. We analyzed a longitudinally linked sample (n = 91774) from the COMPASS prospective cohort study of Canadian high school students attending Grades 9-12 in Ontario and Alberta between 2013-2014 and 2016-2017. We investigated the prevalence of spontaneous cannabis use reduction and cessation between grade transitions (Grades 9-10, 10-11, 11-12) and the effect of cessation on academic achievement (current or recent math and English course marks) and rigour (usual homework completion and past-month truancy). Only 14.8% of cannabis users decreased their use between grades. Of these, two-thirds made only incremental downward changes, a pattern which held true for all three transitions. Cessation rates from daily and weekly use decreased every year. After cessation, students had better odds than continuing users (OR = 1.23, 95% CI: 1.03- 1.48) and worse odds than never-users (OR = 0.55, 95% CI: 0.31-0.97) for some subcategories of math performance. Students who quit cannabis universally improved class attendance (OR = 2.48, 95% CI: 1.93-3.19) and homework completion (OR = 2.32, 95% CI: 1.85-2.92) compared to continuing users. Increased academic rigour may underlie any improvements seen in academic performance after cannabis cessation. High school students who use cannabis likely need targeted support to facilitate reduction or cessation and subsequent academic recovery. This indicates that a school-based focus on cannabis harm reduction is justified.

What Can we Learn from the English-Language Media Coverage of Cannabis Legalization in Canada?

Background: In October 2018, Canada became the second country in the world to legalize cannabis. However, at this stage in the implementation process, it can be challenging to get a sense of the outcomes of this policy shift – hence why we turned to media. Purpose/objectives: We present the results of a qualitative content analysis conducted on the media coverage between October 2018 and April 2019. Methods: We used Google News and ProQuest database to complete our search. We included online media articles published between October 2018 and April 2019 in English. This left us with 81 eligible articles. These articles were analyzed by blending deductive and inductive approaches. Results: The articles were grouped into 5 categories: 1) housing, 2) access, 3) workplace, 4) driving, and 5) public consumption. Each category was then analyzed to identify emerging themes across news stories. Overall, we found that non-governmental actors such as landlords and employers were given a great deal of flexibility to introduce overly broad and restrictive regulations that disproportionately impact various communities. We also found that emphasis was placed on banning cannabis in various spheres of life as opposed to adapting to the new reality that cannabis is now legal. Conclusion: Real-time observations are critically needed to better understand the impact of policy implementation across the three levels of government: federal, provincial and territorial, and municipal. Our findings suggest that media coverage analysis can help us understand and track issues as they arise.

Prevalence and correlates of youth poly-substance use in the COMPASS study

Background and AimsYouth poly-substance use, associated with long-term negative health and social outcomes, is of increasing concern following the rise of e-cigarette vaping and cannabis legalization in Canada. This work aimed to investigate current evidence on correlates of this behaviour to inform effective prevention and harm reduction programming. DesignCross-sectional sample taking part in a cohort study. SettingCanadian high schools (AB, BC, ON, QC) Participants74,501 Canadian high school students who completed the COMPASS student questionnaire in 2018/2019. MeasurementsSelf-report data on use of five substances (alcohol, cigarettes, e-cigarettes, cannabis, and opioids) alongside demographic factors, social and school support, and mental health-related measures. ResultsOf the 39% of youth who reported current substance use, 53% reported using two or more. E-cigarette vaping was most prevalent (28%) and most often combined with other substances. Feeling supported by friends and having no problem with seeking help at school were associated with higher levels of poly-substance use. Family support, school connectedness, and school support to resist drugs decreased the risk of substance co-use. ConclusionsThe evidence presented here suggests that interventions for youth poly-substance use should rely on joint efforts between parents, schools, and communities to focus on structural factors rather than problematizing the individual.

Initial indicators of the public health impacts of non-medical cannabis legalization in Canada

Initial indicators of the public health impacts of non-medical cannabis legalization in Canada

The Impact of Cannabis Legalization in Canada on Adolescents’ Perceptions

Since the legalization of cannabis in Canada in October 2018, research has not reached a clear conclusion on how legalization impacts adolescents’ perceptions of the substance. This study sought to examine how the nationwide legalization of recreational cannabis in Canada impacted youth opinions of legalization. Surveys were administered to 398 Grade 8 students in May 2017 (pre-legalization) and 377 Grade 8 students in December 2018 (post-legalization). Participants completed an open-ended question regarding their opinion on cannabis legalization and a ranking of whether legalization of cannabis was very good (1), good (2), bad (3), or very bad (4). Analyses revealed that young adolescents primarily hold negative views toward cannabis legalization. No significant difference existed between theme frequencies or ratings when comparing responses prior to and following legalization. These results suggest that legalization of recreational cannabis use in Canada had little effect on youth perceptions of cannabis legalization.

Evaluating the impacts of cannabis legalization: The International Cannabis Policy Study

An increasing number of jurisdictions have legalized non-medical cannabis use, including Canada in October 2018 and several US states starting in 2012. The policy measures implemented within these regulated markets differ with respect to product standards, labelling and warnings, public education, retail policies, marketing, and price/taxation. The International Cannabis Policy Study (ICPS) seeks to evaluate the impacts of these policy measures as well as the broader population-level impact of cannabis legalization using a quasi-experimental research design. The objective of this paper is to describe the ICPS conceptual framework, methods, and baseline estimates of cannabis use. The ICPS is a prospective cohort survey conducted with national samples of 16–65-year-olds in Canada and the US. Data are collected via an online survey using the Nielsen Consumer Insights Global Panel. Primary survey domains include: prevalence and patterns of cannabis use; purchasing and price; consumption and product types; commercial retail environment; problematic use and risk behaviours; cannabis knowledge and risk perceptions; and policy-relevant outcomes including exposure to health warnings, public educational campaigns, and advertising and promotion. The first annual wave was conducted in Aug-Oct 2018 with 27,169 respondents in three geographic ‘conditions’: Canada (n = 10,057), US states that had legalized non-medical cannabis (n = 7,398) and US states in which non-medical cannabis was prohibited (n = 9,714). The ICPS indicates substantial differences in cannabis use in jurisdictions with different regulatory frameworks for cannabis. Future waves of the study will examine changes over time in cannabis use and its effects associated with legalization in Canada and additional US states.

Cannabis labelling and consumer understanding of THC levels and serving sizes

ObjectiveAs part of cannabis legalization in Canada and several US states, regulations specify how THC levels should be labelled on products; however, there is little evidence on the extent to which consumers understand and use THC labelling to inform consumption amounts. The current study was designed to assess comprehension of cannabis-related information including communication of dose and strength of product on different labelling designs among young Canadians. MethodsTwo experiments were conducted in October 2017 among Canadian youth and young adults aged 16–30 years as part of an online cross-sectional survey (N = 870). Experiment 1 randomized respondents to one of three labelling conditions (1=No Label, 2=mgTHC, 3=Doses). Respondents interpreted a recommended serving and number of servings contained in the package. Experiment 2 randomized respondents to one of four labelling conditions communicating THC level (1=No Label, 2=%THC, 3=mgTHC, 4=Traffic Light System). Respondents determined level of THC in the product. ResultsLabelling the number of doses per package was associated with the greatest proportion of correct responses (54.1 %) when respondents had to determine a recommended serving compared with the no-label control condition (7.4 %) and THC mg condition (13.4 %). When cannabis products were labelled using a traffic light system, participants were more likely to identify THC level: low THC (85.1 %) or high THC (86.4 %) than the control condition (2.0 % and 5.2 % respectively). ConclusionFew consumers can understand and apply quantitative THC labelling; in contrast, THC labels that provide ‘interpretive’ information, such as descriptors, symbols, or references to servings have greater efficacy.

Co-use and Mixing Tobacco With Cannabis Among Ontario Adults.

The legalization of nonmedical cannabis in 2018 may have important implications for tobacco use in Canada. There is a risk of renormalizing tobacco use with co-use of tobacco and cannabis introducing nontobacco users to tobacco. Co-use is the use of both substances by the same individual at the same time or on different occasions, as well as mixed together. This study assessed the prevalence of co-use and mixing of tobacco and cannabis among Ontario adults and the characteristics of the users. Data from the 1996 to 2017 cycles of the Centre for Addiction and Mental Health Monitor (n = 4481) were used to examine trends in prevalence and the proportion of Ontario adults co-using and mixing tobacco and cannabis. Logistic regression was used to study associations between user characteristics and co-use and mixing. Co-use of cigarettes and cannabis among cannabis users declined from 59.8% in 1996 to 41.7% in 2017. Past-year e-cigarette use was the only predictor of co-use. From 2015 to 2017, 31.1% (95% confidence interval 27.0, 35.9) of Ontario adults who used cannabis reported mixing it with tobacco in the past year. Being white, past-year e-cigarette use, having moderate or high nicotine dependence, and having moderate or high risk for cannabis problems were significant predictors of mixing among cannabis users. Given the well-established negative health effects associated with tobacco use, alongside a growing evidence base for negative health effects of cannabis smoking, co-use and mixing could pose a considerable public health concern in the context of legalization. Considerable effort has been expended to reduce tobacco smoking. However, current efforts to reduce tobacco smoking may be diminished since this study found the prevalence of mixing tobacco and cannabis among cannabis users in Ontario to be higher than expected. Mixing tobacco and cannabis may introduce nontobacco smokers to tobacco, exposing them to health risks associated with both cannabis and tobacco smoke. Therefore, there is a need to monitor changes in tobacco use and understanding implications for tobacco control and cessation programs within the changing environment of cannabis legalization in Canada and other jurisdictions.

Mental Health and Medical Cannabis Use among Youth and Young Adults in Canada

Background: In October 2018, Canada became the second country to legalize non-medical cannabis. However, medical cannabis has been legally available in Canada since 2001 and, in 2015, approximately 800,000 Canadians reported using cannabis for medical purposes. Mental health is a common reason reported for using medical cannabis. Objectives: The current study examined perceived mental health among four groups: (1) Non/ex-users; (2) Recent non-medical users; (3) Recent unauthorized medical users; and (4) Recent authorized medical users. Methods: A total of 867 Canadian cannabis users and nonusers aged 16 to 30 were recruited through an online consumer panel in 2017, one year before non-medical cannabis legalization. Logistic and multinomial regression models were fitted to examine differences among cannabis use status and mental health measures. All estimates represent weighted data. Results: Self-reported emotional and mental health problems were higher among unauthorized (83.9%) and authorized medical cannabis users (83.2%) compared to non-medical users and non/ex-users (44.5% and 39.5%, respectively). Medical users were more likely to report using cannabis to manage or improve mental health problems than non-medical users (p < .001). There were few differences between unauthorized and authorized medical users, and between non/ex-users and non-medical users. Conclusions: The findings highlight a discrepancy between the recommendation that individuals with some mental health problems should avoid cannabis and the widespread practice of using cannabis to manage mental health. Education and reduced stigma around using cannabis after legalization in Canada may help address users coming forwards regarding use of cannabis for mental health problems.

Differences in self-reported cannabis prices across purchase source and quantity purchased among Canadians

Background: In October 2018, Canada legalized non-medical cannabis. A primary goal of legalization is to reduce illicit market transactions; however, there is little ‘baseline’ data on the price and purchase sources of cannabis prior to legalization in Canada. This study examined the self-reported price of dried cannabis, quantity purchased, and sources used before retail stores opened.Methods: Data come from the baseline wave of the International Cannabis Policy Study (ICPS), a prospective cohort survey conducted in August–October 2018, immediately before legalization. Respondents were 1227 Canadians aged 16–65 years who reported purchasing dried cannabis in the past 12 months. Respondents were recruited using the Nielsen Consumer Insights Global Panel. A linear regression model examined price-per-gram by quantity purchased, source used, and socio-demographics.Results: Overall, the mean self-reported price-per-gram among cannabis users was C$9.56 (standard errors of the mean [SEM] = 0.2). The price-per-gram of cannabis significantly decreased as quantity purchased increased. For example, the mean price of cannabis purchased in smaller quantities (<3.5 g) ($12.81/g, SEM = 0.5) was more than double the price of cannabis purchased in larger quantities (>28 g) ($5.60/g, SEM = 0.2). The estimated quantity discount elasticity was −0.21 (95% CI: −0.25, −0.18). The most common purchase sources used were family member/friends (53.0%) and illicit street dealers (51.7%). Price-per-gram varied across sources; however, variation was largely accounted for by consumers purchasing different quantities at different sources.Conclusions: Variations in the price of dried cannabis were largely determined by the quantity purchased. The findings highlight the importance of accounting for purchase quantity when assessing cannabis prices, particularly in illicit markets.

Marijuana use in undergraduate students: the short-term relationship between motives and frequency of use

ABSTRACTBackground: Prior to legalization in October 2018, marijuana was the most commonly used illicit drug in Canada, with 60-73% of undergraduate students reporting use over their lifetime. Research consistently links marijuana use to negative outcomes such as physical and mental health problems and social, educational, and occupational impairments. Changes in substance use ensue rapidly in emerging adults, which makes understanding the link between motives and frequency important.Methods: A sample of 410 participants was recruited to complete self-report measures of marijuana motives and frequency of marijuana use at Baseline and Follow-Up (two weeks later). Of the initial sample, 247 reported prior use of marijuana and were included in the analyses. Hierarchical regression analyses were performed to test the relationships between the Baseline marijuana motives and frequency of use at Follow-Up while controlling for Baseline frequency of use.Results: The coping motive was the only motive significantly associated with a greater frequency of future marijuana use after controlling for prior frequency of use.Conclusion: Findings from this study help clarify the link between reasons for using marijuana and the frequency of use – an important area of research given recent legalization in Canada.