Lessons from 20 years of medical cannabis use in Canada

<h4>Background</h4> Canada was one of the first countries to regulate the medical use of cannabis. However, literature on Canada’s medical cannabis program is limited. <h4>Methods</h4> We use administrative data from the medical cannabis program, and licensed cannabis vendor...

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Main Authors: Minsup Shim, Hai Nguyen, Paul Grootendorst
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035846/?tool=EBI
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author Minsup Shim
Hai Nguyen
Paul Grootendorst
author_facet Minsup Shim
Hai Nguyen
Paul Grootendorst
author_sort Minsup Shim
collection DOAJ
description <h4>Background</h4> Canada was one of the first countries to regulate the medical use of cannabis. However, literature on Canada’s medical cannabis program is limited. <h4>Methods</h4> We use administrative data from the medical cannabis program, and licensed cannabis vendor catalog data to describe a) the participation of patients, physicians, and cannabis vendors in the program from its inception in 1999 to 2021, and b) trends in medical cannabis consumption, prices and potency. We also use national surveys conducted over the last several decades to estimate trends in regular cannabis use (medical or otherwise) and how it changed during the medical cannabis access regimes. <h4>Results</h4> In 2001, the Canadian government granted access to those with physician-documented evidence of a severe health problem that could not be managed using conventional therapies. Most patients accessed cannabis grown under a personal production license. By 2013, authorized daily cannabis dosages were very high. In 2014, the government, concerned over illegal diversion, required that cannabis be purchased from a licensed commercial grower; personal production was banned. Physicians were given responsibility for authorizing patient access. To fill the regulatory void, the physician regulatory bodies in Canada imposed their own prescribing restrictions. After these changes, the number of physicians who were willing to support patient cannabis use markedly decline but the number of patients participating in the program sharply increased. Medical cannabis use varied by province–rates were generally lower in provinces with stricter regulations on physician cannabis prescribing. Most varieties of cannabis oil available for sale are now high in CBD and low in THC. Dry cannabis varieties, conversely, tend to be high in THC and low in CBD. Inflation adjusted prices of most varieties of medical cannabis have declined over time. We find that rates of daily cannabis use (medical or otherwise) increased markedly after the 2014 policy regime. The fraction of Canadians using cannabis daily increased again after the 2018 legalization of recreational cannabis; at the same time, participation in the medical access program declined. <h4>Conclusion</h4> The implications for patient health outcomes of changes in the medical cannabis program and legalization of recreational use remains an important area for future research.
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spelling doaj.art-d79289194e4f4e708a61f2df798e7b832023-03-26T05:32:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01183Lessons from 20 years of medical cannabis use in CanadaMinsup ShimHai NguyenPaul Grootendorst<h4>Background</h4> Canada was one of the first countries to regulate the medical use of cannabis. However, literature on Canada’s medical cannabis program is limited. <h4>Methods</h4> We use administrative data from the medical cannabis program, and licensed cannabis vendor catalog data to describe a) the participation of patients, physicians, and cannabis vendors in the program from its inception in 1999 to 2021, and b) trends in medical cannabis consumption, prices and potency. We also use national surveys conducted over the last several decades to estimate trends in regular cannabis use (medical or otherwise) and how it changed during the medical cannabis access regimes. <h4>Results</h4> In 2001, the Canadian government granted access to those with physician-documented evidence of a severe health problem that could not be managed using conventional therapies. Most patients accessed cannabis grown under a personal production license. By 2013, authorized daily cannabis dosages were very high. In 2014, the government, concerned over illegal diversion, required that cannabis be purchased from a licensed commercial grower; personal production was banned. Physicians were given responsibility for authorizing patient access. To fill the regulatory void, the physician regulatory bodies in Canada imposed their own prescribing restrictions. After these changes, the number of physicians who were willing to support patient cannabis use markedly decline but the number of patients participating in the program sharply increased. Medical cannabis use varied by province–rates were generally lower in provinces with stricter regulations on physician cannabis prescribing. Most varieties of cannabis oil available for sale are now high in CBD and low in THC. Dry cannabis varieties, conversely, tend to be high in THC and low in CBD. Inflation adjusted prices of most varieties of medical cannabis have declined over time. We find that rates of daily cannabis use (medical or otherwise) increased markedly after the 2014 policy regime. The fraction of Canadians using cannabis daily increased again after the 2018 legalization of recreational cannabis; at the same time, participation in the medical access program declined. <h4>Conclusion</h4> The implications for patient health outcomes of changes in the medical cannabis program and legalization of recreational use remains an important area for future research.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035846/?tool=EBI
spellingShingle Minsup Shim
Hai Nguyen
Paul Grootendorst
Lessons from 20 years of medical cannabis use in Canada
PLoS ONE
title Lessons from 20 years of medical cannabis use in Canada
title_full Lessons from 20 years of medical cannabis use in Canada
title_fullStr Lessons from 20 years of medical cannabis use in Canada
title_full_unstemmed Lessons from 20 years of medical cannabis use in Canada
title_short Lessons from 20 years of medical cannabis use in Canada
title_sort lessons from 20 years of medical cannabis use in canada
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035846/?tool=EBI
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