Canadians' use of cannabis for therapeutic purposes since legalization of recreational cannabis: a cross-sectional analysis by medical authorization status.

BACKGROUND: There has been a precipitous decline in authorizations for medical cannabis since non-medical cannabis was legalized in Canada in 2018. This study examines the demographic and health- and medical cannabis-related factors associated with authorization as well as the differences in medical cannabis use, side effects, and sources of medical cannabis and information by authorization status. METHODS: Individuals who were taking cannabis for therapeutic purposes completed an online survey in early 2022. Multivariable logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI) of demographic and health- and medical cannabis-related variables associated with holding medical cannabis authorization. The differences in medical cannabis use, side effects, and sources of information by authorization status were determined via t-tests and chi-squared analysis. RESULTS: A total of 5433 individuals who were currently taking cannabis for therapeutic purposes completed the study, of which 2941 (54.1%) currently held medical authorization. Individuals with authorization were more likely to be older (OR ≥ 70 years vs. < 30 years, 4.85 (95% CI, 3.49-6.76)), identify as a man (OR man vs. woman, 1.53 (1.34-1.74)), have a higher income (OR > $100,000/year vs. < $50,000 year, 1.55 (1.30-1.84)), and less likely to live in a small town (OR small town/rural vs. large city, 0.69 (0.59-0.81)). They were significantly more likely to report not experiencing any side effects (29.9% vs. 23.4%; p < 0.001), knowing the amount of cannabis they were taking (32.1% vs. 17.7%; p < 0.001), obtaining cannabis from regulated sources (74.1% vs. 47.5%; p < 0.001), and seeking information about medical cannabis from healthcare professionals (67.8% vs. 48.2%; p < 0.01) than individuals without authorization. CONCLUSIONS: These findings offer insight into the possible issues regarding equitable access to medical cannabis and how authorization may support and influence individuals in a jurisdiction where recreational cannabis is legalized, highlighting the value of a formal medical cannabis authorization process.

Living for the moment: men situating risk-taking after the death of a friend.

The primary cause of death for men under the age of 30 is unintentional injury and, despite health-promotion efforts and programme interventions, male injury and death rates have not decreased in recent years. Drawing on 22 interviews from a study of men, risk and grief, we describe how a risk-related tragedy shaped the participants' understandings of and practices of risk-taking. The findings indicate that most participants did not alter their perceptions and engagement in risky practices, which reflected their alignment to masculine ideals within specific communities of practice where risk-taking was normalised and valorised. Continued reliance on risky practices following the death of a friend was predominantly expressed as 'living for the moment,' where caution and safety were framed as conservative practices that undermined and diluted the robustness ideally embodied by this subgroup of young men. Two main themes: living life, accepting death and upping the ante illustrate how risk-taking can persist following a death. A smaller group of participants articulated a different viewpoint; reining in risk practices, to describe their risk management approaches after the death of a male friend. This novel study confirms the ongoing challenge of reducing men's risk-taking practices, even after the death of a friend.