The legalisation of cannabis in Canada has sparked widespread discussion about its impact on public health. With recreational cannabis being readily available, questions arise about whether its use and misuse have significantly changed. This article explores findings from a five-year study following the legalisation of cannabis in Canada. The aim is to understand patterns of use, misuse, and preferences, as well as to highlight the need for prevention and education in addressing cannabis-related challenges.

Did Legalisation Increase Cannabis Use?

Legalisation has undoubtedly made cannabis more accessible, leading to modest increases in its use. According to a longitudinal study of 1,428 adults in Ontario, Canada, cannabis use frequency increased by 1.75% over five years. While this may seem like a small change, it underscores how legalisation can normalise cannabis consumption, particularly among individuals who were less frequent users before legalisation.

More concerning, however, is the heightened risk of normalising cannabis use among younger individuals and those new to using it. Increased access, combined with the perception that legal means “safe,” makes prevention and education more critical than ever. We must not underestimate the long-term risks associated with normalising any substance for recreational use.

Cannabis Misuse Declines, but Concerns Remain

Interestingly, the study found a slight decrease in cannabis misuse, as measured by the Cannabis Use Disorder Identification Test-Revised (CUDIT-R) scores. Over five years, the average misuse score dropped slightly (0.4 points on a 32-point scale). Individuals who were frequent users before legalisation exhibited notable declines in misuse, likely reflecting behavioural adjustment or ageing-out trends.

Yet, it is essential to caution against assuming these findings indicate reduced harm. For non-users and occasional users before legalisation, misuse risks appeared to increase. This highlights an important point, especially from a public health perspective—not everyone who starts using cannabis will develop misuse issues, but those who do are often caught off guard. Prevention, focusing on education and early intervention, remains the best defence against substance dependence.

Changing Preferences in Cannabis Products

One notable shift in Canada following cannabis legalisation involved changes in product preferences. Data showed a movement away from traditional combusted products, like dried flowers and concentrates, towards non-combusted options, including edibles, liquids, and vape pens. For example:

• Dried flower use dropped significantly, from 81.3% pre-legalisation to 64.6% five years later.
• The use of vape pens increased from 18.4% to 33.0% over the same period.

While reduced reliance on smoking products might seem like progress, the increasing popularity of high-THC vape pens and cannabis drinkables raises serious concerns. These products often contain concentrated THC levels, which introduce greater risks of adverse health effects, both mental and physical. A lack of long-term studies on many of these products makes their safety questionable, emphasising the need to avoid legalisation in other nations. Prevention remains a safer route than managing unforeseen consequences.

The Role of Moderators

The study also revealed how demographic factors, such as age and sex, influenced trends in cannabis use and misuse. Younger individuals, often at greater risk for misuse, showed declines in misuse rates over time. However, their cannabis use frequency increased modestly. Similarly, males exhibited more noticeable reductions in cannabis misuse compared to females.

External factors, like the COVID-19 pandemic, also played a role. Misuse declined sharply with lockdowns and restrictions in 2020, only to rise slightly in the years following. These patterns show how external events and societal trends can significantly influence substance use behaviours.

Why Prevention is Better Than Recovery

While recovery from substance misuse is possible, prevention remains the most effective strategy. The findings from this Canadian study highlight the need for proactive measures to avoid promoting cannabis use as a harmless recreational activity.

The lessons from Canada highlight the potential pitfalls of legalising cannabis. Even with minimal overall increases in misuse, the normalisation of its use and the rise in highly potent products carry risks that demand vigilance. Prevention is not just about avoiding harm but about ensuring healthier futures for communities and individuals alike.

Do Not Legalise Cannabis

From the data explored, it is clear that legalising cannabis comes with unforeseen challenges. While some may focus on short-term positives, the long-term consequences for public health cannot be ignored. The findings exemplify why other jurisdictions should think twice before following Canada’s path. Education, awareness, and advocacy are powerful tools, but they must be applied before legalisation, not after.

The path forward is clear. Prevention must remain a top priority. Legalisation may ease access, but it also normalises behaviour that can have lasting repercussions on people’s health and wellbeing. Learn more here.