IS THAT WHAT WE NEEDED?

I've recently written a few rants about cannabis legalization in Canada and harm reduction in BC. Exploring these themes further, I just came across three new papers investigating mental health emergencies induced by cannabis consumption. All super interesting.

The first study is titled Association between non-medical cannabis legalization and emergency department visits for cannabis-induced psychosis. Led by Dr Myran, a family physician with the Ottawa Hospital Research Institute, the researchers examined changes in emergency department visits for cannabis-induced psychosis in Ontario over the last decade. To try and understand what changes have taken place, they looked at the number of occurences in the period just prior to marijuana legalization, during restricted legalization, and since commercialization. For control, they compared these cannabis-related incidences with ER visits for coke- and meth-induced psychosis. Their research concluded that the period following commercialization saw an immediate and dramatic increase in hospital visits, particularly among youth. Critically, those folks were found to be both men and women and only above the legal age of purchase, in the 19-24 age cohort. The increase in emergency room visits for cannabis-induced psychosis at that time, between 2014 and 2021, jumped by 220% to 1,400 cases. So what did other research tell us?

Some of the same researchers, again led by Dr Myran, followed this up with an investigation of substance use, psychosis, and the development of schizophrenia spectrum disorders. Previous studies had only associated substance-induced psychosis with developing schizophrenia. There was a void of evidence, however, quantifying the risk of transitioning to schizophrenia after a trip to hospital for substance use, with and without a bout of psychosis. This retrospective population-based study looked at almost ten million people, aged 14 to 65, with no prior history of psychosis. Researchers found cannabis use had the highest transition risk among hospital visits with psychosis and that both male sex and younger age were associated with higher risk of transition to schizophrenia. For men aged 14 to 24, the risk of developing schizophrenia was greater than 40% within three years of having a cannabis-induced psychotic episode. Interestingly, these researchers also found that “although substance-induced psychoses had a greater relative transition risk, substance use without psychosis was far more prevalent and resulted in a greater absolute number of transitions.”

More recently, Myran et al published a paper showing cannabis-induced visits to the ER are associated with increased risk of developing anxiety disorders, particularly for young males. Looking at a similar population to that of the above study, they showed that within three years of a cannabis-induced hospital visit, more than 12% of individuals were hospitalized or visited an ER for an anxiety disorder. That contrasts strongly with the rate among the general population of about 1%. In a secondary analysis, the evidence suggests more than 23% of individuals who had a cannabis-induced ER visit also had an outpatient visit, ER visit, or were hospitalized for an anxiety disorder within three years, compared to roughly 5% of those within the general population.

None of the above information was available prior to the legalization and then commercialization of cannabis in Canada. Given that we now know the proponents of legalization wildly exaggerated the economic potentials and health benefits while downplaying or concealing the known risks and harms, I would love to hear from those same folks today. How do they feel, in hindsight — given our simultaneous and ever-worsening crises in healthcare, mental health, substance abuse, housing, employment, and cost of living — was it a great time to explode the population of people suffering from serious anxiety, psychosis, and schizophrenia in every city in the country? Too, if the selling points were sound, shouldn't the population have markedly less anxiety? And shouldn't we all be just a little healthier and richer, particularly those growing, selling, and using cannabis-related products? Why have hospital visits for cannabis-related problems in Canada doubled and then doubled again in just ten years? And what will the next decade bring?

I’d love to hear any arguments and research that could possibly defend weed generally and legalization in Canada specifically in light of what we've observed. If the marketing was accurate, it seems to me, the ads would have read: "Want to significantly increase the rates of anxiety and psychosis in the population in just a few years? Legalize cannabis today!"