Citation

Fischer B, Lindner SR, Hall W. Lancet Public Health 2022; 7(10): e808-e809.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/S2468-2667(22)00205-5

PMID

36182229

Abstract

Cannabis, after alcohol and tobacco, is the most widely used psychoactive substance in the world, with increasingly liberal control approaches (eg, legalisation) in many places. Although approximately 4% (>200 million) of the global adult population use cannabis, in Canada (where non-medical cannabis was legalised in 2018) a fifth or more of adults report use in the past year. Most of the focus on cannabis-related harms in policy and science debates has been on the risks (primarily to health) to the user. The principal adverse consequences that can occur in association with cannabis use include: acute cognitive and psychomotor control impairment; cannabis use disorder (ie, dependence); mental health problems (eg, psychosis, depression, or suicide); driving impairments and fatal or non-fatal injuries from motor vehicle crashes; and pulmonary and cardiovascular problems. Some of these outcomes can be severe and require hospitalisation, but the overall risks are mostly moderate (eg, risk ratios of >1-3) and most often affect cannabis users who engage in high-frequency, high-volume, or high-potency (ie, tetrahydrocannabinol) forms of cannabis use.

Beyond the focus on possible health harms for users, an increasingly relevant public health perspective for reducing the harms of psychoactive substance use is the concept of harm to others. The harm-to-others perspective acknowledges that psychoactive substance use not only harms the user; it can also harm others, including non-users. This fact should be taken into account when designing policies and interventions for psychoactive drugs, and monitoring the effect of consumption. This perspective originally arose from the environmental health hazards of tobacco smoke. It has since been applied to alcohol, given the considerable potential for alcohol use to cause harm to others via injuries or deaths, violence, birth defects in newborns, or family or workplace problems directly affecting others...

Keywords: Ethanol impaired driving;Cannabis impaired driving

Language: en