Sale Of Cannabis Research Articles

Local Laws Regulating Cannabis in California Two Years Post Legalization: Assessing Incorporation of Lessons from Tobacco Control.

As cannabis legalization continues to spread, best regulatory practice remains ill-defined and elusive, exposing the population to potential harms. We conducted an annual, statewide, cross- sectional survey to assess cannabis-related laws in effect by January 1, 2020, in local California jurisdictions and at the state level and measured adoption of potential best practices. The current laws of all 539 jurisdictions were located; 276 jurisdictions allowed any retail sales (storefront or delivery) covering 58% of the population, an increase of 20 jurisdictions (8%) from year 1 of legalization (2018). Half allowed sales of medical cannabis, whereas slightly fewer jurisdictions (n = 225) allowed adult-use sales. Only 9 jurisdictions imposed any restrictions on products stricter than state regulations. Cannabis temporary special events were allowed in 22 jurisdictions, up from 14 in the year prior. Thirty-three jurisdictions required additional health warnings for consumers. Just over half of legalizing jurisdictions taxed cannabis locally and little revenue was captured for prevention. No new jurisdictions established a potency-linked tax. Of jurisdictions allowing storefront retailers (n = 162), 114 capped outlet licenses, and 49 increased the state-specified buffers between storefronts and schools. Thirty-six allowed on-site consumption, up from 29. As of January 2020, the state had not updated its regulations of key provisions addressed in this paper. In year 2 of legalized adult-use cannabis sales in California, the state remained split between retail bans and legal sale. Local policy continued to vary widely on protective measures, and State policy remained misaligned with protection of youth and public health.

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.

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-legalization. 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.

Shifts in therapeutic practices and decline of medicinal cannabis in Indian North-Eastern Frontier (1826–1925)

BackgroundThe emergence of colonial medicine in the North-Eastern Frontier witnessed different phases of consistent competition and resistance. Herbs such as cannabis provided native physicians with a coherent power to resist colonial medical intervention. Before British rule, cannabis assumed great significance in the socio-economic, cultural, and religious spheres. The colonizers’ bioprospection of cannabis shifted the production and use of cannabis from a medical and recreational plant to an industrial and commercial commodity. British policies on cannabis caused its ban leading to natives’ reliance on colonial cannabis products. As a result, the native medical practitioners resisted for reviving cannabis in the indigenous therapeutics. This paper mainly aims to investigate the decline of medicinal cannabis in indigenous therapeutics, causing subtle resistance of the native physicians of the North-Eastern Frontier.MethodsThis paper follows a nomadology method based on primary and secondary sources to understand the impact on native physicians after the ban on private use, cultivation, and sale of cannabis. The primary sources/data have been collected from the Directorate of Archives: Government of Assam and Directorate of State Archives and Research Centre, Kolkata, West Bengal. Secondary sources have been collected from books, articles, and theses accessed from various libraries and websites.ResultsBan on cannabis led to dual responses from the indigenous population of the frontier. First is the interest of the native physicians resisting the revival of cannabis in indigenous therapeutics. The second is the interest of the frontier’s elites, who viewed cannabis as a “dangerous drug.” The British policies of control and restrictions on cannabis, the rift of response from the natives, and the over-powering of the indigenous therapeutics by the colonial medical system led to the decline of medicinal uses of cannabis in the North-Eastern Frontier.DiscussionsVarious pre-colonial and colonial factors helped colonial medical practices to get the upper hand over indigenous therapeutics. Such a shift led to the decline of indigenous medicinal cannabis causing native resistance, which was patient and silent.ConclusionsBritish ban on cannabis resulted in a rift of native responses, resistance, and decline of cannabis in the indigenous therapeutics of the North-Eastern Frontier.

Association Between Markers of Vulnerability for Cannabis-Related Harms and Source of Supply: Secondary Analysis of a Representative Population Survey.

In 2018, the sale of non-medical cannabis was authorized in the province of Quebec in Canada, within a public monopoly under the Société Québécoise du Cannabis (SQDC). The objective of this study was to offer a description of the cannabis-using population regarding the sources of cannabis supply and to explore whether at-risk individuals are purchasing cannabis at SQDC. We used data from a cross-sectional, representative population survey (age >18 years, n = 1799), the Enquête Québécoise sur le Cannabis, which was completed between February and June 2019. Analyses involved adjusted binary logistic regressions, incorporating population weights, to assess 7 potential indicators of harm. The vulnerability profiles of SQDC consumers (47.8%) and those acquiring their cannabis elsewhere (52.2%) were similar in terms of frequency of cannabis use (adjusted odds ratio [aOR] = 0.46; 95% confidence interval [CI] = 0.12-1.67), motivation to use (aOR = 0.62; 95% CI = 0.16-2.46), concomitant consumption of other substances (aOR = 0.80; 95% CI = 0.14-4.75), cannabis-impaired driving behaviours (aOR = 0.93; 95% CI = 0.26-3.36), psychological distress (aOR = 0.99; 95% CI = 0.26-3.79), and problematic cannabis use (aOR = 0.46; 95% CI = 0.13-1.64). However, SQDC consumers were more likely to be aware of the cannabinoid content of the product purchased compared to those who acquired their cannabis from other sources (aOR = 4.12; 95% CI = 1.10-15.40). No association was detected between the source of cannabis supply and potential vulnerability indicators of cannabis-related harms, but SQDC consumers were more aware of the cannabinoid content of the products purchased. These results suggest that the regulated government supply in Quebec is reaching a substantial portion of those with potential high vulnerability to harm. Whether this knowledge translates into a reduction in the negative consequences related to consumption is still to be determined.

An analysis of cannabis home cultivation and associated risks in Canada, before and after legalization.

In 2018, Canada legalized the use and sale of non-medical cannabis, with most provinces also permitting home cultivation. To advance the knowledge of home cultivation patterns in Canada within the context of legalization, this study examines (1) the demographics and use patterns of cannabis home growers before and after legalization and (2) the relationship between home cultivation and cannabis-related risks, including workplace use and driving after cannabis use(DACU). The study is based on seven waves of the National Cannabis Survey, dating from 2018 to 2019. Descriptive statistics were used to analyze home cultivation across several individual and sociodemographic characteristics pre- and post-legalization. Logistic regression was used to examine whether home cultivation is correlated to selected cannabis-related risks. The rate and demographics of home cultivation remained relatively unchanged post-legalization. Those most likely to cultivate cannabis post-legalization were male; 35 years and older; not single; married, common law, divorced, separated or widowed; lived in the Atlantic provinces; consumed cannabis medically or medically and non-medically on a daily or almost daily basis; had more than a high school diploma; and reported "smoking" as their primary consumption method. Home cultivation was correlated to workplace use but not to DACU. The research provides early insights into home cultivation within a legalized framework. It also shows a relationship between home cultivation and certain cannabis-related risks (e.g., workplace use), suggesting a need for future research to determine whether tailored education and policy interventions are needed to target cannabis home growers.

An Overview of Cannabis Allergy

Cannabis refers to a genus of annual, herbaceous, dioecious flowering plants that are members of the family Cannabaceae, which include about 102 plant species.Although there is much debate, the most common taxonomy is that the genus Cannabis comprises one species, Cannabis sativa L (C. sativa)., which includes the highly polymorphic subspecies sativa, and indica. Hemp and cannabis both refer to the same species C. sativa; however, there is important distinction between the two. Whereas hemp (fiber-type) is grown for its cellulose-rich fiber in the stem, cannabis (drug-type) is cultivated for its flowers where the glandular trichomes produce the psychoactive delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC provides the analgesic and relaxing effects of cannabis, whereas CBD produces other effects such as antiemetic and soporific properties. Researchers have used the THC content to define C. sativa subspecies sativa as containing less than 0.3% THC in dried flowering tops of female plants and C. sativa subspecies indicaas containing ≥0.3% THC.This threshold has been used by regulatory bodies to legally differentiate hemp plants (<0.3% THC) and cannabis plants (≥0.3% THC). Canada legalized the production, distribution, sale and non-medical use of cannabis for adults in October 2018. Recent data from nation-wide surveys show that approximately 6.2 million people aged 15 or older, or 20% in this age group, reported using cannabis in the past 3 months. which represents an increase from 14% before legalization. Cannabis can be used and/or ingested in a variety of forms including capsules, oils, dried flower, vaporization and through the consumption of edibles. With the increased use of recreational cannabis in Canada, it is expected that there will be a concomitant increase in cases of cannabis hypersensitivity.

The Impact of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Substance Use in the United States.

The SARS-CoV-2 pandemic has been associated with dramatic increases in substance use, as marked by increased alcohol, nicotine and cannabis sales. Lethal opioid overdoses also increased dramatically, especially during the initial phases of the epidemic when lockdowns and social isolation combined with increasing fentanyl contamination of the illicit drug supply resulted in more overdoses and fewer opportunities for rescue. Substance use, and especially inhalational drug use, increases the likelihood of both transmission and severe infection. Youth are especially vulnerable to substance use and have increased risk of long-term problems. These outcomes highlight the need for greater access to substance use treatment. Virtual treatment, which emerged as a promising format during the pandemic, may reduce access barriers. This manuscript reviews trends in substance use during the pandemic, explores root causes of increased use and overdose and examines the potential to increase treatment through virtual care, especially during future periods of disruption.

Interrupted time series analysis of Canadian legal cannabis sales during the COVID-19 pandemic.

IntroductionThere were repeated reports of increased cannabis sales, use and health impacts in Canada during the COVID‐19 pandemic. However, it was unclear whether the increases were due to pandemic effects or industry expansion.MethodsWe performed interrupted time series regressions of monthly per capita legal cannabis sales from March 2019 to February 2021, first with national averages, then with provincial/territorial data after adjusting for store density. We considered two interruption alternatives: January 2020, when product variety increased; and March 2020, when pandemic restrictions began.ResultsThe provincial/territorial regression with the January interruption explained R 2 = 69.6% of within‐jurisdiction variation: baseline monthly per capita sales growth averaged $0.21 (95% confidence interval [CI] 0.15, 0.26), sales immediately dropped in January by $1.02 (95% CI −1.67, −0.37), and monthly growth thereafter increased by $0.16 (95% CI 0.06, 0.25). With the March interruption, the regression instead explained 68.7% of variation: baseline sales growth averaged $0.14 (95% CI 0.06, 0.22), there was no immediate drop and growth thereafter increased by $0.22 per month (95% CI 0.08, 0.35).Discussion and ConclusionsIncreasing cannabis sales during the pandemic was consistent with pre‐existing trends and increasing store numbers. The extra increased growth was more aligned with January's new product arrivals than with March's pandemic measures, though the latter cannot be ruled out. We found little evidence of pandemic impacts on Canada's aggregate legal cannabis sales. We therefore caution against attributing increased population‐level cannabis use or health impacts primarily to the pandemic.

Cannabis, corona and the latest morality developments in European trade mark law

What do the trade marks Northern Lights, Mango Kush and Green Gelato have in common? Perhaps they ring a bell, but most likely they do not. These European Union (EU) trade mark applications all refer to (the sale of) cannabis or cannabis-related products. During the past 3 years (2019–2021), these and several similar applications were (partially) refused on the same ground: they were deemed contrary to public policy, the absolute refusal ground in Article 7 (1)(f) of the EU Trade Mark Regulation (EUTMR).1 Opposed to controversial cannabis products, another spike in refusals based on Article 7 (1)(f) could be observed during the past year: the ‘corona’ trade marks. Amongst these refusals were, for example, Coronalux, Corona tracer, Mask Covid, Corona hero and several more. The trade marks were found to be contrary to accepted principles of morality, because using ‘corona’ would be too insensitive to people who have suffered from coronavirus disease 2019 (COVID-19). However, also, the EU trade mark application for Poul M. Volther’s famous Corona chair from 1964 was rejected, despite having been in production for more than half a century prior to the first appearance of COVID-19. Luckily for other ‘corona’-trade mark owners, this decision was reversed on appeal.2

In Case You Haven't Heard…

“Dollar‐for‐dollar” is key in the headline of an article in the current issue of pro‐drug‐use High Times, citing a Gallup poll showing that in Massachusetts, cannabis sales are outpacing those of alcohol. Maybe if alcohol excise taxes went up, more money would be spent on alcohol, and fewer people would drink. The article doesn't look at actual consumption, just at the dollars. Still, Massachusetts, with a thriving and robust cannabis economy that has drawn customers from neighboring states, collected more than $112 million in cannabis sales excise tax revenue in 2021, well over what the state's Cannabis Control Commission projected. For the High Times article, go to https://hightimes.com/news/weed‐sales‐outpace‐alcohol‐for‐first‐time‐in‐massachusetts/.

High Time for Change: Combatting the Black Market for Cannabis in Canada

On October 17, 2018, Canada legalized the recreational possession and use of cannabis federally under the Cannabis Act. The Cannabis Act states goals of protecting young people from cannabis, reducing and deterring illicit activities in relation to cannabis, and providing the public with access to a supply of legal, quality-controlled cannabis. Despite this, the black market for cannabis has remained strong and persistent, with research indicating that the black market accounted for approximately 71-86% of cannabis sales in the first year of legalization. This paper will explore how and why Canada’s criminal black market for cannabis continues to function after legalization, and what measures can be taken to counteract it. Canada’s illicit black market for cannabis continues to function as the by-product of a reprobate stew of mail-order and traditional cannabis dealers, who operate in a difficult-to-enforce periphery of the Cannabis Act. They continue to flourish by offering cheaper, higher quality, and more available cannabis, functioning as a better-run business outside of the stringent regulatory requirements of the licit market, particularly in packaging and marketing requirements. This paper will recommend that licit retailers and the government must take several decisive steps to combat this. First, amend the Canada Post Corporation Act. Second, be a better business generally by offering lower cost, higher quality cannabis that is consistently available in stores. Third, introduce affordable cannabis options to directly address price-sensitive consumers. Fourth, engage in consumer education. Fifth, loosen marketing restrictions on legal cannabis retailers. Sixth, pass legislation to better utilize the banking and financial sector to trace and flag bank accounts associated with illegal cannabis sales.

Associations between Local Jurisdiction Ordinances and Current Use of Cannabis Products in California Adolescents

Purpose Cannabis use among adolescents may have detrimental effects and use among this age group is increasing. It is important to understand how expansion of laws permitting cannabis sales may impact adolescent use. Much of the current research has explored how state-level policy decisions may impact adolescents’ use behaviors; however, there is a gap in the understanding of how differences in local jurisdictional policies may also influence underage cannabis use. Procedures: The present study cross-sectionally assesses local variation in cannabis policies to explore the potential effects of local policy on underage use behaviors. Data were collected from (N = 1,573) adolescents representing 120 different localities across California, collected as a part of Project Cal Teens. Linear regression models were used to assess associations between local jurisdiction’s allowance of retail sale of cannabis for adult-use and past 30-day use of non-medical (adult use) cannabis and perceived access to cannabis products. Findings Local policy allowing cannabis retail was associated with adolescents’ significantly higher past 30-day use of cannabis (β = 0.25 95% CI = 0.08, 0.42) and perceived access (β = 0.60 95% CI = 0.27, 0.94). Conclusions Results highlight the impact of local cannabis policies on adolescent cannabis use and perception. Considering the effects of cannabis use on adolescent development, this is an important public health concern because 14 states have already legalized recreational retail sales and growing numbers of local jurisdictions are allowing the retail sale of recreational cannabis.

On the money: characterizing banking and lending in the California cannabis industry

PurposeDespite 2016 legalization of recreational cannabis cultivation and sale in California with the passage of Proposition 64, many cannabis businesses operate without licenses. Furthermore, federal regulations disincentivize financial institutions from banking and lending to licensed cannabis businesses. The authors explore the impact of legal cannabis business activity on California financial institutions, the barriers to banking faced by cannabis businesses, and the nontraditional sources of financing used by the industry.Design/methodology/approachThe authors use a mixed methods approach. The authors utilize call data for banks and credit unions headquartered in California and state cannabis licensing data to estimate the impact of the extensive and intensive margins of licensed cannabis activity on key banking indicators using difference-and-difference and fixed effects regressions. The qualitative data come from interviews with industry stakeholders in northern California's “Emerald Triangle” and add important context.FindingsThe quantitative results show economically and statistically significant impacts of licensed cannabis activity on banking indicators, suggesting both direct and spillover effects from cannabis activity to the financial sector. However, cannabis businesses report substantial barriers to accessing basic financial services and credit, leading to nontraditional financing arrangements.Practical implicationsThe results suggest opportunities for cannabis businesses and financial institutions if regulations are eased and important avenues for further study.Originality/valueThe authors contribute to the nascent literature on cannabis economics and the literature on banking regulation and nontraditional finance.

Cannabis sales increases during COVID-19: Findings from Alaska, Colorado, Oregon, and Washington.

Following emergency declarations related to COVID-19 in the United States, many states issued stay-at-home orders and designated essential business categories. Most states allowed medical and/or non-medical adult-use cannabis retailers to remain open. This study assesses changes in cannabis sales across Alaska, Colorado, Oregon, and Washington before and during the pandemic. Pre-tax sales data from cannabis marketplaces in four states were analyzed to identify trends from January 2018-December 2020. Mean monthly sales and relative percent change in mean monthly sales were compared by state from April-December (coinciding with the pandemic) in 2018, 2019, and 2020. Differences were assessed using the nonparametric Mann-Whitney-U test. Mean monthly cannabis sales in all four states were higher during the pandemic period in 2020 compared to the same period in 2019. Sales reached a three-year peak in Washington in May 2020 and in Alaska, Colorado, and Oregon in July 2020. From April-December, the percent change in mean monthly sales from 2019 to 2020 was significantly higher than 2018-2019 in all four states, though Alaska saw similar increases between 2018-2019 and 2019-2020. To date, cannabis sales in Alaska, Colorado, Oregon, and Washington have increased more during the COVID-19 pandemic than in the previous two years. In light of these increases, data monitoring by states and CDC is warranted to understand how patterns of use are changing, which populations are demonstrating changes in use, and how such changes may affect substance use and related public health outcomes.

The Association of Cannabis Use and Cigarette Smoking with Psychological Distress Among Adults in California

Background In November 2016, California voters passed the Adult Use of Marijuana Act making recreational cannabis sales legal to adults aged 21and older starting January 1st, 2018. This study aims to understand the relationship of cannabis use and cigarette smoking with serious psychological distress (SPD) in California in light of the legalization of recreational cannabis sales. Methods This cross-sectional study included 42,313 adult participants from the 2017 to 2018 California Health Interview Surveys. We used the Kessler-6 (K6) scale to measure psychological distress in the past 30 days. Multiple logistic regression models were used to examine the association between cannabis/cigarette use and SPD. Results Cannabis use was positively associated with SPD (AOR = 2.48, 95% CI = 1.57, 3.91), but this association was not significantly different before and after recreational cannabis sales legalization in California (AOR = 0.82, 95% CI = 0.72, 2.05). Cigarette smoking was also positively associated with SPD (AOR = 2.76, 95% CI = 2.05, 3.71). Compared to those who used neither cannabis nor cigarettes, sole cannabis users (AOR = 2.51, 95% CI = 1.75, 3.60), sole cigarette smokers (AOR = 3.23, 95% CI = 2.28, 4.60), and dual users of cannabis and cigarettes (AOR = 5.65, 95% CI = 4.04, 7.89) were more likely to report SPD. Dual users were also more likely to report SPD than sole cannabis users (AOR = 2.25; 95% CI = 1.48, 3.43) and sole cigarette smokers (AOR = 1.75; 95% CI = 1.18, 2.59). Conclusions These findings provide evidence for the need to develop effective cessation intervention strategies targeting individuals with SPD to reduce their cannabis use and dual-use of cannabis and cigarettes.

A Ge.F.I. – ISFG European collaborative study on DNA identification of Cannabis sativa samples using a 13-locus multiplex STR method

Cannabis sativa is the most used controlled substance in Europe. With the advent of new and less restrictive European laws on cannabis sale for recreational use (including in Italy), an increase in indoor cannabis crops were observed. This increase was possible due to the availability of cannabis seeds through the internet market. Genetic identification of cannabis can link seizures and if in possession then might aid in an investigation. A 13-locus multiplex STR method was previously developed and validated by Houston et al. A collaborative exercise was organized by the Italian Forensic Geneticists – International Society of Forensic Genetics (Ge.F.I. – ISFG) Working Group with the aim to test the reproducibility, reliability and robustness of this multiplex cannabis STR kit. Twenty-one laboratories from three European countries participated in the collaborative exercise and were asked to perform STR typing of two cannabis samples. Cannabis DNA samples and the multiplex STR kit were provided by the University of Barcelona and Sam Houston State University. Different platforms for PCR amplification, capillary electrophoresis (CE) and genotyping software were selected at the discretion of the participating laboratories. Although the participating laboratories used different PCR equipment, CE platforms and genotyping software, concordant results were obtained from the majority of the samples. The overall genotyping success ratio was 96%. Only minor artifacts were observed. The mean peak height ratio was estimated to be 76.3% and 78.1% for sample 1 and sample 2, respectively. The lowest amount of −1 / + 1 stutter percentage produced, when the height of the parent allele was higher than 8000 RFU, resulted to be less than 10% of the parent allele height. Few common issues were observed such as a minor peak imbalance in some heterozygous loci, some artifact peaks and few instances of allelic drop-out. The results of this collaborative exercise demonstrated the robustness and applicability of the 13-locus system for cannabis DNA profiling for forensic purposes.

Towards social justice and economic empowerment? Exploring Jamaica’s progress with implementing cannabis law reform

The Dangerous Drugs Amendment Act (DDAA) 2015 positioned Jamaica at the forefront of international cannabis law reforms in the developing world. The DDAA legalised and regulated commercial cultivation and sale of cannabis for medicinal and therapeutic use, legalised home cultivation and decriminalised personal possession of cannabis. This dramatic policy change came after years of discriminatory drug law enforcement and multiple attempts at cannabis law reform motivated by social justice and cannabis activism. Drawing on ethnographic observations of the implementation of the DDAA and interviews with key cannabis policy stakeholders in Jamaica, we discuss the extent to which the social justice ideals behind the law have translated into practice on the ground. Our analysis focuses on two dimensions of social justice relevant in drug law reform: (1) penalisation and criminal record expungement policies, and (2) economic empowerment and the distribution of wealth (ie the diversity within the new cannabis industry and the transition of traditional illegal ganja farmers to the new legal cannabis economy). Reflecting on the first five years of implementing the DDAA in Jamaica, we explore social justice achievements under the DDAA and discuss persisting structural barriers to economic justice and how they could be addressed.

Emergency Department Pediatric Visits in Alberta for Cannabis After Legalization.

Canada legalized nonmedical cannabis possession and sale in October 2018. In the United States, state legalization has been tied to an increase in cannabis-related emergency department (ED) visits; however, little research exists on provincial changes in pediatric visits after nationwide legislation. We compared pre- and postlegalization trends in pediatric cannabis-related ED visits and presentation patterns in urban Alberta EDs. Retrospective National Ambulatory Care Reporting System data were queried for urban Alberta cannabis-related ED visits among patients aged <18 years from October 1, 2013, to February 29, 2020. Population subgroups included children (aged 0-11 years), younger adolescents (12 to 14 years), and older adolescents (15 to 17 years). We calculated interrupted time series, incident rate ratios (IRRs), and relative risk (RR) ratios to identify trend change. IRRs identified changes against growth-adjusted Alberta population, while RRs measured presentation pattern changes against prelegalization ED visits. Pediatric visit volume did not change postlegalization when accounting for preexisting volume trends. Unintentional ingestions increased in children (IRR: 1.77, 95% confidence interval [CI]: 1.42 to 2.20 and RR: 1.24, 95% CI: 1.05 to 1.47, respectively) and older adolescents (IRR: 1.36, 95% CI: 1.07 to 1.71 and RR: 1.48, 95% CI: 1.21 to 1.81, respectively). Presentation patterns remained similar, although older adolescent co-ingestant use decreased (RR: 0.77, 95% CI: 0.67 to 0.88), whereas hyperemesis cases increased (RR: 1.64, 95% CI: 1.13 to 2.37). Cannabis legalization has increased child and older adolescent unintentional cannabis ingestions, increasing child cannabis-related ED visits. Changes highlight need for public health interventions targeting pediatric exposures.

Relationships between increases in Canadian cannabis stores, sales, and prevalence

BackgroundThis study estimated the relationships between increases in legal cannabis stores, legal cannabis sales, and cannabis prevalence in Canadian provinces between 2018 and 2020. MethodGovernment data were used to calculate changes in licensed store numbers, retail sales dollars, and past-three-month users in 10 provinces across six time periods. The resulting N = 60 observations were standardized per million residents aged 15 and up, and then analyzed via linear regression. ResultsStore growth explained 46.3% of the variation in provincial sales growth; each added store was associated with added quarterly sales of $305 (95% CI: $208 to $402) thousand. By contrast, store growth explained only 7.7% of the variation in provincial user growth; each added store was associated with 696 (95% CI: 58–1334) added users. ConclusionFrom 2018 to 2020, Canada’s rapid cannabis retail expansion was strongly related to legal sales growth but only weakly related to prevalence growth. This implies prevalence growth during that period was related more to legalization’s other aspects and/or to the continuation of already-existing trends.

Using the 3I+E Framework to assess provincial policy decisions for the sale of cannabis in Ontario, Saskatchewan and Quebec

Objective: This paper examines policy decisions regarding public or private retail models chosen for the recreational use of cannabis in the provinces of Ontario, Saskatchewan and Quebec to demonstrate the application of the 3I+E framework for policy analysis.&#x0D; Methods: The 3I+E framework includes considerations of institutions, interests, ideas and external factors that play a role in adopting a particular policy. A retrospective comparative approach using this framework was conducted. Relevant newspaper articles, press releases, consultation reports and primary policy papers were reviewed.&#x0D; Results: Ontario employed a mixed model for the sale of cannabis while Saskatchewan chose to fully privatize cannabis retail within the province and Quebec decided to sell through the public sector. Government institutions, particularly the party in power and the number of seats they hold, as well as existing policy legacies for alcohol retail, appeared to have a strong ability to influence policy decisions in all three jurisdictions. Interest groups, including municipal and labor unions and private cannabis companies had a limited role in swaying government decisions toward a particular model. Beliefs and values of citizens regarding cannabis retail did not appear to play a large role. In Ontario particularly, an external factor, namely a major political shift towards a conservative government had a large role in the mixed model chosen in the jurisdiction.&#x0D; Conclusion: Overall, the policy decision for cannabis retail is multifactorial and the interaction between stakeholders and interest groups with the government influences which model was ultimately chosen in each jurisdiction.