The association between recreational cannabis legalization, commercialization and cannabis‐attributable emergency department visits in Ontario, Canada: an interrupted time–series analysis.
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 e...
| Published in: | Addiction Vol. 117; no. 7; pp. 1952 - 1961 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Jul2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157443570&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157443570 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Jul2022 vid: 117 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 157443570 155299125 157443570 157443570 10.1111/add.15834 157443570 ppf: 1952 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: The association between recreational cannabis legalization, commercialization and cannabis‐attributable emergency department visits in Ontario, Canada: an interrupted time–series analysis. aug: au: Myran, Daniel T. Pugliese, Michael Tanuseputro, Peter Cantor, Nathan Rhodes, Emily Taljaard, Monica affil: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa Ontario,, Canada sug: subj: Cannabis Legislation and Jurisprudence Recreational Drug Use Legislation and Jurisprudence Emergency Service Office Visits Human Ontario Female Male Adolescence Young Adult Adult Middle Age Aged Aged, 80 and Over Cross Sectional Studies Repeated Measures Time Series Poisson Distribution Regression Outcomes (Health Care) Descriptive Statistics Confidence Intervals Odds Ratio Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Female Male ab: 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. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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