The Relationship Between Rates of Cannabis Use and Covid-19 Infection Rates During the Pandemic: An Analysis of Canada's National Cannabis Survey.

Background: The well-documented relationship between mental health and substance use is corroborated by recent research on the impacts of the Covid-19 pandemic on cannabis use behavior. Social isolation, anxiety, depression, stress, and boredom are all linked to the greater prevalence of cannabis and other substance use. Objectives: To better understand the relationship between infection rates in Canada and cannabis use behavior, this research examines the prevalence and frequency of cannabis use across health regions in all 10 provinces at the height of the pandemic. Methods: Our analyses linked data from the National Cannabis Survey with Covid-19 case rates and cannabis availability through legal retail outlets at the end of 2020, 2 years after cannabis legalization came into effect. Hierarchical generalized linear models were employed, controlling for age, gender, SES, mental health, the number of cannabis stores per square kilometer, and prevalence of cannabis use in each health region prior to the pandemic. Results: Even after controlling for other predictors, our models show that those residing where infection rates are higher are more likely to use cannabis and use it more often. Conclusions: The findings of this study support investing in better-targeted harm reduction measures in areas hit hardest by the pandemic to address contributing societal conditions. The implications are noteworthy for drug policy observers in North America and other global jurisdictions pursuing evidence-based public health approaches to regulating cannabis and other substance use.

An analysis of cannabis home cultivation and associated risks in Canada, before and after legalization.

Background: In 2018, Canada legalized the use and sale of non-medical cannabis, with most provinces also permitting home cultivation. To advance the knowledge of home cultivation patterns in Canada within the context of legalization, this study examines (1) the demographics and use patterns of cannabis home growers before and after legalization and (2) the relationship between home cultivation and cannabis-related risks, including workplace use and driving after cannabis use(DACU). Data and methods: The study is based on seven waves of the National Cannabis Survey, dating from 2018 to 2019. Descriptive statistics were used to analyze home cultivation across several individual and sociodemographic characteristics pre- and post-legalization. Logistic regression was used to examine whether home cultivation is correlated to selected cannabis-related risks. Results: The rate and demographics of home cultivation remained relatively unchanged post-legalization. Those most likely to cultivate cannabis post-legalization were male; 35 years and older; not single; married, common law, divorced, separated or widowed; lived in the Atlantic provinces; consumed cannabis medically or medically and non-medically on a daily or almost daily basis; had more than a high school diploma; and reported "smoking" as their primary consumption method. Home cultivation was correlated to workplace use but not to DACU. Interpretation: The research provides early insights into home cultivation within a legalized framework. It also shows a relationship between home cultivation and certain cannabis-related risks (e.g., workplace use), suggesting a need for future research to determine whether tailored education and policy interventions are needed to target cannabis home growers.

Fentanyl Contamination as a Risk Priority: the Impact of the Fentanyl Epidemic on Club Drug-Using Behaviours.

BACKGROUND: Over the last decade, rates of fentanyl-related overdoses have increased substantially across North America, a phenomenon which has widely been described as the "fentanyl epidemic." While research has explored the cultural impact of the fentanyl epidemic on opioid and/or injection drug use, less is known about its impact on other types of drug use. Drawing on two years of ethnographic research with people who use club drugs in Toronto's Electronic Dance Music (EDM) scene, this study looks at how people who use club drugs make sense of and respond to the fentanyl epidemic. METHODS: Data for the study was collected via participant observation and semi-structured interviews (n = 26). FINDINGS: The key finding was that fentanyl contamination had become a "risk priority" for the participants. They thereby adjusted their drug-using behaviors to account for this risk. However, by prioritizing fentanyl contamination above everything else, they often overlooked and/or disregarded other forms of harm reduction that they had once practiced (like getting testing kits to test for other adulterants). CONCLUSION: The findings suggest that the fentanyl epidemic has impacted not only practices of illegal opioid use, but also practices of club drug use. They suggest that the fentanyl epidemic has in some ways facilitated the adoption of risk management, while in other ways undermined it. The findings are interpreted with reference to Rhodes' "risk environment" framework and with particular attention to the need for harm reduction interventions that take into consideration how risk perceptions and behaviors are situation- and context-dependent.

Examining the impact of legalization on the prevalence of driving after using cannabis: A comparison of rural and non-rural parts of Canada.

OBJECTIVE: The purpose of this study was to examine the likelihood of driving after using cannabis, and of being a passenger with someone who is driving after using cannabis, in rural areas and non-rural areas before and after legalization. METHODS: A multi-wave analysis of Canada's National Cannabis Survey was conducted using logistic regression with interactions to predict the prevalence of driving after using cannabis, and of being a passenger with someone who is driving after using cannabis, in relation to place of residence (rural or non-rural) and in the weeks and months before and after legalization. Three time points were compared: pre-legalization, two months following legalization and 1 year after legalization. RESULTS: At the national level, there are no significant differences between the predicted estimates of driving after using cannabis for those who live in rural and non-rural areas. However, when examining the impact of legalization, we found a significant increase in driving after using cannabis among rural residents directly following legalization. Furthermore, it was observed that this increase in driving after using cannabis returns to pre-legalization rates one year after legalization. By contrast, in the weeks and months following legalization, driving after using cannabis decreased among those living in non-rural areas, and slowly increased soon thereafter. No significant differences were observed, in either time period or group, in the prevalence of being a passenger with someone who is driving after using cannabis. CONCLUSIONS: The finding of significantly higher risk of driving after use of cannabis soon after legalization in rural areas suggests a need for more attention to address immediate concerns for public safety. The increased potential for traffic injuries and deaths in other jurisdictions contemplating legalization supports the call for more and better targeted prevention efforts in rural communities that have far too often been overlooked and under-served.

Home cultivation across Canadian provinces after cannabis legalization.

Aims: Little research exists on home cultivation in Canada after non-medical cannabis legalization in 2018. The aims of the study were to: (1) estimate the percentage of home cultivation before and after legalization; (2) estimate the quantity and expenditure of cannabis plants; and (3) examine the association between provincial policies and home cultivation after legalization. Methods: Repeat cross-sectional survey data come from Canadian respondents in the International Cannabis Policy Study in 2018, 2019, and 2020. Respondents aged 16-65 were recruited through online commercial panels. Home cultivation rates were estimated among all respondents in 2019 and 2020 (n = 26,304) and among a sub-sample of past 12-month cannabis consumers in 2018-2020 (n = 12,493). Weighted multivariable logistic regression models examined the association between home cultivation and provincial policies among all respondents, 2019-2020. Results: Cannabis consumers in 2019 (7.9%; AOR = 1.47, 95% CI: 1.07,2.01) and 2020 (8.8%; AOR = 1.62, 95 %CI: 1.18,2.23) had higher odds of reporting home cultivation in the past 12 months than pre-legalization (5.8%). Post-legalization, past 12-month home cultivation was lower in Quebec and Manitoba, the two provinces that prohibited home cultivation (3.2%), than in provinces where home cultivation was permitted (6.8%; AOR = 0.48, 95 %CI: 0.39, 0.59). The median number of plants grown across all provinces was between 3.1 and 3.5 in all years. Conclusions: Almost one in ten Canadian cannabis consumers reported home cultivation of cannabis in 2020, with modest increases following legalization and most growing within the non-medical limit of four plants. Home cultivation was less common in provinces where home cultivation was prohibited.