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Abstract
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Cannabis is the most commonly used non-legal drug, especially among young people. In 2018, Canada implemented the legalization of non-medical cannabis use and supply for adults.1
This policy reform was framed by multiple primary objectives, which included improved public health, public safety and youth protection, specifically pledging to "keep cannabis out of the hands of youth". Under the formal legalization umbrella ('Cannabis Act'), cannabis may be legally accessed and used by adults ages 19-and-up in most provinces (with Alberta [18 years] and Quebec [21 years] for exceptions). While extensive youth cannabis prevention and education campaigns have been launched, underage youth may be criminally charged for possession of small (>5 g) of dried cannabis or equivalents.
Underage (adolescent) youth are a distinctly important and vulnerable group for cannabis-related risks for several reasons. First, Canadian cannabis use rates traditionally have been high (e.g., 25-45% among ages 16-17). Second, adolescents, beyond general substance use-related susceptibilities, are well-documented to be at elevated risk for severe adverse (e.g., cognitive, mental health, psycho-social) health outcomes especially from intensive (e.g., frequent/high-potency) and/or long-term cannabis use. On this basis, it has been questioned how well legalization policy and its implications would serve the health and welfare of underage youth, or how to best design it with these essential good interests in mind.
More than 5-years following the implementation of legalization policy in Canada, select--while limited--empirical data document main cannabis-related outcomes for adolescents in health and socio-legal domains. For key examples, in the national Canadian Cannabis Survey (CCS), the prevalence of cannabis use (in the past 12-months) among ages 16-19 years increased from 36% in 2018 to 43% in 2023. Somewhat differently, general cannabis use prevalence among secondary students (grades 7-12) remained steady in the national Canadian Student Tobacco, Alcohol and Drugs Survey (18% in both the 2018/19 & 2021/22 waves) and in the provincial Ontario Student Drug Use and Health Survey (19% in 2017 and 17% in 2021), while however with both surveys indicating use rates >30% among students in grades 11 and 12. Complementary data indicate that the initial implementation of cannabis legalization (2018-2019), compared with pre-legalization (2001-2017) was associated with a 31% increased likelihood of any cannabis use, a 40% increased likelihood of daily cannabis use and a 98% increased likelihood of cannabis dependence among Ontario secondary students. Among under-age youth in Alberta (<18 years) and Ontario (<19 years), legalization was associated with a 20% increase-equivalent (2015-2019) for emergency department visits involving cannabis-related disorder/poisoning, and there were (moderate) increases in cannabis-related (e.g., for psychosis, poisoning, withdrawal, harmful use) hospitalizations among young individuals (ages 15-24) in Canada's four largest provinces, specifically during legalization's 'commercialization' (2020-2021) compared with the pre-legalization (2015-2018) period...
Language: en |