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Following the legalization of nonmedical cannabis use, its commercialization has been associated with a rise in hospital admissions due to cannabis-related health issues, including cannabis-induced psychosis, as revealed by recent research.
In a repeated cross-sectional analysis involving approximately 26.9 million individuals, researchers observed a 1.62-fold increase in cannabis-related hospitalizations between 2015 and 2021.
The most significant surge in hospitalizations occurred post-commercialization, with a 40% spike in cases of cannabis-induced psychosis. Study author Dr. Daniel T. Myran, MD, MPH, emphasized the public health concerns surrounding criminal convictions linked to cannabis, cautioning against conflating legalization or decriminalization with full-scale commercialization.
Published on October 5 in JAMA Network Open, the study delves into Canada’s universal healthcare system, utilizing health administrative databases covering the four most populous provinces. Hospitalizations due to cannabis totaled 105,203 during the study period, with a majority occurring in males and a third in adolescents and young adults aged 15 to 24.
The age- and sex-standardized hospitalization rate due to cannabis surged from 3.99 per 100,000 individuals in January 2015 to 6.46 per 100,000 individuals in March 2021. The most dramatic increase was seen in cannabis-induced psychosis, rising by 40% during the commercialization phase compared to the pre-legalization period.
Dr. Myran emphasized that while legalizing cannabis eliminates a significant cause for incarceration, the shift to commercialization requires careful consideration. Pre-legalization, it became easier to access cannabis, with gray market stores facing less police intervention. With the introduction of legalization under strict restrictions, hospitalizations for cannabis use actually decreased.
Dr. Myran advocates for legalization without full-scale commercialization, noting that cannabis use can be particularly detrimental to some individuals, especially adolescents and young adults predisposed to psychosis.
Dr. Simon Sherry, a psychology professor, underscored the study’s importance in revealing the government’s role in fostering a culture of cannabis misuse. He pointed out that increased commercialization widens accessibility, potentially leading to higher rates of abuse.
Sherry highlighted that most revenue from cannabis sales comes from frequent or addicted users, indicating that commercialization primarily benefits heavy consumers. He cautioned that this approach could lead to more cannabis-related problems in society.
Sherry urged for a shift in the approach to cannabis marketing, advocating for increased awareness of associated risks, similar to the campaign against tobacco. He suggested adopting a stance of cautious tolerance, acknowledging cannabis’s presence and emphasizing the need to discourage its consumption as a public health concern.
The study received support from the Canadian Centre on Substance Use and Addiction, along with fellowships from the Canadian Institutes of Health Research and the University of Ottawa Department of Family Medicine. Dr. Myran disclosed grants from the Canadian Institutes of Health Research during the study, while Dr. Sherry reported no relevant financial relationships.
