The DOI matches its Crossref record; 3 of the 3 references it cites were found in a registry or an index.
The association between recreational cannabis legalization, commercialization and cannabis‐attributable emergency department visits in Ontario, Canada: an interrupted time–series analysis
Abstract
Background and aims: Recreational cannabis was legalized in Canada in October 2018. Initially, the Government of Ontario (Canada’s largest province) placed strict limits on the number of cannabis retail stores before later removing these limits. This study measured changes in cannabis‐attributable emergency department (ED) visits over time, corresponding to different regulatory periods. Design: Interrupted time–series design using population‐level data. Two policy periods were considered; recreational cannabis legalization with strict store restrictions (RCL, 17 months) and legalization with no store restrictions [recreational cannabis commercialization (RCC), 15 months] which coincided with the COVID‐19 pandemic. Segmented Poisson regression models were used to examine immediate and gradual effects in each policy period. Setting: Ontario, Canada. Participants: All individuals aged 15–105 years (n = 13.8 million) between January 2016 and May 2021. Measurements: Monthly counts of cannabis‐attributable ED visits per capita and per all‐cause ED visits in individuals aged 15+ (adults) and 15–24 (young adults) years. Findings: We observed a significant trend of increasing cannabis‐attributable ED visits pre‐legalization. RCL was associated with a significant immediate increase of 12% [incident rate ratio (IRR) = 1.12, 95% confidence interval (CI) = 1.02–1.23] in rates of cannabis‐attributable ED visits followed by significant attenuation of the pre‐legalization slope (monthly slope change IRR = 0.98, 95% CI = 0.97–0.99). RCC and COVID‐19 were associated with immediate significant increases of 22% (IRR = 1.22, 95% CI = 1.09–1.37) and 17% (IRR = 1.17, 95% CI = 1.00–1.37) in rates of cannabis‐attributable visits and the proportion of all‐cause ED visits attributable to cannabis, respectively, with insignificant increases in monthly slopes. Similar patterns were observed in young adults. Conclusions: In Ontario, Canada, cannabis‐attributable emergency department visits stopped increasing over time following recreational cannabis legalization with strict retail controls but then increased during a period coinciding with cannabis commercialization and the COVID‐19 pandemic.
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The monthly rate of cannabis-attributable ED visits was increasing before legalization, but there was a statistically significant 18% decline in the monthly rate 17 months after legalization with strict retail control (February 2020).
“The monthly rate of cannabis‐attributable ED visits was increasing before legalization, but there was a statistically significant 18% decline in the monthly rate 17 months after legalization with strict retail control (February 2020)”
From The implementation and public health impacts of cannabis legalization in Canada: a systematic review (2023) · cites this paper as [35]
In all time-periods, people aged 15-24 years had a higher rate of cannabis-attributable ED visits than older age groups.
“In all time‐periods, people aged 15–24 years had a higher rate of cannabis‐attributable visits than older age groups.”
From The implementation and public health impacts of cannabis legalization in Canada: a systematic review (2023) · cites this paper as [35]
When data for the first 2 months of COVID-19 were excluded, cannabis-attributable ED visits significantly increased by 22% after commercialized retail sales compared to the period when strict retail store controls were in place.
“When data for these 2 months were excluded, cannabis‐attributable ED visits significantly increased by 22% after commercialized retail sales compared to the period when strict retail store controls were in place.”
From The implementation and public health impacts of cannabis legalization in Canada: a systematic review (2023) · cites this paper as [35]
Cannabis-attributable ED visits decreased during the first 2 months of the COVID-19 pandemic because of lower than usual ED use.
“Cannabis‐attributable ED visits decreased during the first 2 months of the COVID‐19 pandemic because of lower than usual ED use.”
From The implementation and public health impacts of cannabis legalization in Canada: a systematic review (2023) · cites this paper as [35]
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Cited by
Sorted by citations
Farrelly, K. N., Wardell, J. D., Marsden, E., Scarfe, M. L., Najdzionek, P., Turna, J., & MacKillop, J. (2023) · Substance Abuse Research and Treatment · doi:10.1177/11782218231172054 · Cited by 162
The implementation and public health impacts of cannabis legalization in Canada: a systematic review
Hall, W., Stjepanović, D., Dawson, D., & Leung, J. (2023) · Addiction · doi:10.1111/add.16274 · Cited by 112
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Metadata
- Authors
- Myran, D. T., Pugliese, M., Tanuseputro, P., Cantor, N., Rhodes, E., & Taljaard, M.
- Affiliations
- University of Ottawa (CA)
- Institute for Clinical Evaluative Sciences (CA)
- Ottawa Hospital Research Institute (CA)
- Corresponding author
- Myran, Daniel T.
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2022-02-17
- Volume
- 117
- Issue
- 7
- Pages
- 1952-1960
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W4212945528
- Cited by
- 86
- References
- 3
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 23 · 2023: 29 · 2022: 9
- FWCI
- 11.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- Institute of Population and Public Health (452360)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- recreational cannabis legalization, cannabis commercialization, emergency department utilization, cannabis policy, COVID-19 pandemic, young adults, cannabis harm
- MeSH terms
- COVID-19, Canada, Cannabis, Carcinoma, Renal Cell, Emergency Service, Hospital, Humans, Kidney Neoplasms, Legislation, Drug, Ontario, Young Adult, Pandemics
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