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Journal Article

Citation

Wootten JC, Rodrigues R, Gilliland J, Carter B, Shariff SZ, Zhong S, Archie S, Edwards J, Elton-Marshall T, Myran DT, Palaniyappan L, Perlman CM, Seabrook JA, Murray RM, Anderson KK. Int. J. Soc. Psychiatry 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, SAGE Publishing)

DOI

10.1177/00207640231206053

PMID

37886802

Abstract

BACKGROUND: Cannabis is associated with the onset and persistence of psychotic disorders. Evidence suggests that accessibility of substances is associated with an increased risk of use-related harms. We sought to examine the effect of residing in proximity to non-medical cannabis retailers on the prevalence of health service use for psychosis.

METHODS: We conducted a cross-sectional study using linked health administrative data, and used geospatial analyses to determine whether people in Ontario, Canada (aged 14-60 years) resided within walking (1.6 km) or driving (5.0 km) distance of non-medical cannabis retailers (open as of February-2020). We identified outpatient visits, emergency department (ED) visits, and hospitalizations for psychotic disorders between 01-April-2019 and 17-March-2020. We used zero-inflated Poisson regression models and gamma generalized linear models to estimate the association between cannabis retailer proximity and indicators of health service use.

RESULTS: Non-medical cannabis retailers were differentially located in areas with high levels of marginalization and pre-existing health service use for psychosis. People residing within walking or driving distance of a cannabis retailer had a higher rate of psychosis-related outpatient visits, ED visits, and hospitalizations, compared to people living outside these areas. This effect was stronger among those with no prior service use for psychosis.

CONCLUSIONS: Proximity to a non-medical cannabis retailer was associated with higher health service use for psychosis, even after adjustment for prior health service use. These findings suggest that opening of non-medical cannabis retailers could worsen the burden of psychosis on mental health services in areas with high-risk populations.


Language: en

Keywords

epidemiology; mental health; emergency department; Cannabis; mental health services; hospitalization; outpatient psychiatric services; psychotic disorders

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