The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes
BackgroundIneffective cannabis regulatory frameworks such as prohibition have sparked interest in alternative solutions to reduce individual and societal harms. While it has been suggested that the recreational legalization process has yielded early successes, the relatively recent implementation of...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1060656/full |
| _version_ | 1797956019304792064 |
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| author | Maria Athanassiou Maria Athanassiou Alexandre Dumais Alexandre Dumais Alexandre Dumais Inès Zouaoui Inès Zouaoui Stéphane Potvin Stéphane Potvin |
| author_facet | Maria Athanassiou Maria Athanassiou Alexandre Dumais Alexandre Dumais Alexandre Dumais Inès Zouaoui Inès Zouaoui Stéphane Potvin Stéphane Potvin |
| author_sort | Maria Athanassiou |
| collection | DOAJ |
| description | BackgroundIneffective cannabis regulatory frameworks such as prohibition have sparked interest in alternative solutions to reduce individual and societal harms. While it has been suggested that the recreational legalization process has yielded early successes, the relatively recent implementation of the novel policies has provided a modest time frame for a truly thorough establishment and assessment of key population-level indicators. The following systematic review focuses on identifying the downstream public health sequelae of cannabis legalization policies, including parameters such as cannabis consumption rates, hospitalization rates, vehicular accidents and fatalities, criminal activity, and suicidal behaviors, as well as other substance use trends.MethodsAn exhaustive search of the MEDLINE and Google Scholar databases were performed to identify high-quality (1) longitudinal studies, which (2) compared key public health outcomes between regions which had and had not implemented recreational cannabis legalization (RML) policies, (3) using distinct databases and/or time frames. Thirty-two original research articles were retained for review.ResultsAdult past-month cannabis consumption (26+ years) seems to have significantly increased following RML, whereas young adult (18–26 years) and adolescent (12–17 years) populations do not show a significant rise in past-month cannabis use. RML shows preliminary trends in increasing service use (such as hospitalizations, emergency department visits, or poisonings) or vehicular traffic fatalities. Preliminary evidence suggests that RML is related to potential increases in serious/violent crimes, and heterogeneous effects on suicidal behaviors. While the research does not illustrate that RML is linked to changing consumptions patterns of cigarette, stimulant, or opioid use, alcohol use may be on the rise, and opioid prescribing patterns are shown to be significantly correlated with RML.ConclusionThe current data supports the notion that RML is correlated with altered cannabis consumption in adults, potentially increased criminal activity, and a decline in opioid quantities and prescriptions provided to patients. Future work should address additional knowledge gaps for vulnerable populations, such as individuals with mental health problems or persons consuming cannabis frequently/at higher THC doses. The effects of varying legalization models should also be evaluated for their potentially differing impacts on population-level outcomes. |
| first_indexed | 2024-04-10T23:42:17Z |
| format | Article |
| id | doaj.art-21a7d1b98e1e460eae262acfe864f291 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-10T23:42:17Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-21a7d1b98e1e460eae262acfe864f2912023-01-11T05:57:51ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-01-011310.3389/fpsyt.2022.10606561060656The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomesMaria Athanassiou0Maria Athanassiou1Alexandre Dumais2Alexandre Dumais3Alexandre Dumais4Inès Zouaoui5Inès Zouaoui6Stéphane Potvin7Stéphane Potvin8Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, CanadaDepartment of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, CanadaCentre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, CanadaDepartment of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, CanadaPhilippe-Pinel National Institute of Legal Psychiatry, Montreal, QC, CanadaCentre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, CanadaDepartment of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, CanadaCentre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, CanadaDepartment of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, CanadaBackgroundIneffective cannabis regulatory frameworks such as prohibition have sparked interest in alternative solutions to reduce individual and societal harms. While it has been suggested that the recreational legalization process has yielded early successes, the relatively recent implementation of the novel policies has provided a modest time frame for a truly thorough establishment and assessment of key population-level indicators. The following systematic review focuses on identifying the downstream public health sequelae of cannabis legalization policies, including parameters such as cannabis consumption rates, hospitalization rates, vehicular accidents and fatalities, criminal activity, and suicidal behaviors, as well as other substance use trends.MethodsAn exhaustive search of the MEDLINE and Google Scholar databases were performed to identify high-quality (1) longitudinal studies, which (2) compared key public health outcomes between regions which had and had not implemented recreational cannabis legalization (RML) policies, (3) using distinct databases and/or time frames. Thirty-two original research articles were retained for review.ResultsAdult past-month cannabis consumption (26+ years) seems to have significantly increased following RML, whereas young adult (18–26 years) and adolescent (12–17 years) populations do not show a significant rise in past-month cannabis use. RML shows preliminary trends in increasing service use (such as hospitalizations, emergency department visits, or poisonings) or vehicular traffic fatalities. Preliminary evidence suggests that RML is related to potential increases in serious/violent crimes, and heterogeneous effects on suicidal behaviors. While the research does not illustrate that RML is linked to changing consumptions patterns of cigarette, stimulant, or opioid use, alcohol use may be on the rise, and opioid prescribing patterns are shown to be significantly correlated with RML.ConclusionThe current data supports the notion that RML is correlated with altered cannabis consumption in adults, potentially increased criminal activity, and a decline in opioid quantities and prescriptions provided to patients. Future work should address additional knowledge gaps for vulnerable populations, such as individuals with mental health problems or persons consuming cannabis frequently/at higher THC doses. The effects of varying legalization models should also be evaluated for their potentially differing impacts on population-level outcomes.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1060656/fullcannabislegalizationrecreationalreviewlongitudinal |
| spellingShingle | Maria Athanassiou Maria Athanassiou Alexandre Dumais Alexandre Dumais Alexandre Dumais Inès Zouaoui Inès Zouaoui Stéphane Potvin Stéphane Potvin The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes Frontiers in Psychiatry cannabis legalization recreational review longitudinal |
| title | The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes |
| title_full | The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes |
| title_fullStr | The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes |
| title_full_unstemmed | The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes |
| title_short | The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes |
| title_sort | clouded debate a systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes |
| topic | cannabis legalization recreational review longitudinal |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1060656/full |
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