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Introduction: Although there is momentum towards legalising adult recreational cannabis use worldwide, the extent of youth cannabis‐related harm associated with legalisation is still uncertain. The current study aimed to assess whether the initial implementation of Canada's cannabis legalisation (via the Cannabis Act) on 17 October 2018 might be associated with youth harm, as assessed by emergency department visits for cannabis‐related disorders/poisoning. Methods: We used Ontario and Alberta, Canada emergency department data from 1 April 2015 to 31 December 2019. We identified all cannabis‐related disorders/poisoning (ICD‐10 CA: F12.X, T40.7) emergency department visits of youth (n = 13,615), defined as patients younger than the minimum legal cannabis sales age (18 years, Alberta; 19 years, Ontario). Seasonal Autoregressive Integrated Moving Average (SARIMA) models were employed to assess the impact of legalisation on weekly counts of cannabis‐related harms. Results: The final SARIMA intervention (step) parameter indicated a post‐legalisation increase of 14.7 (95% confidence interval [CI] 5.0; 24.3, p < 0.01) weekly youth cannabis‐related disorder/poisoning presentations to Ontario/Alberta emergency department settings, equivalent to an increase of 20.0% (95% CI 6.2%; 33.9%). There was no evidence of associations between cannabis legalisation and comparison series of youth alcohol, opioid or appendicitis emergency department episodes. Discussion/Conclusion: Our findings require replication and extension but are consistent with the possibility that the implementation of the Cannabis Act was associated with an increase in youth cannabis‐related presentations to Ontario/Alberta emergency departments. [ABSTRACT FROM AUTHOR]

Background: Worldwide momentum toward legalization of recreational cannabis use has raised a common concern that such policies might increase cannabis-impaired driving and consequent traffic-related harms, especially among youth. The current study evaluated this issue in Canada.Methods: Utilizing provincial emergency department (ED) records (April 1, 2015-December 31, 2019) from Alberta and Ontario, Canada, we employed Seasonal Autoregressive Integrated Moving Average (SARIMA) models to assess associations between Canada's cannabis legalization (via the Cannabis Act implemented on October 17, 2018) and weekly provincial counts of ICD-10-CA-defined traffic-injury ED presentations. For each province (Alberta/Ontario), SARIMA models were developed on two driver groups: all drivers, and youth drivers (aged 14-17 years in Alberta; 16-18 years, Ontario).Results: There was no evidence of significant changes associated with cannabis legalization on post-legalization weekly counts of drivers' traffic-injury ED visits in: (1) Alberta, all drivers (n = 52,752 traffic-injury presentations), an increase of 9.17 visits (95 % CI -18.85; 37.20; p = 0.52); (2) Alberta, youth drivers (n = 3265 presentations), a decrease of 0.66 visits (95 % CI -2.26; 0.94; p = 0.42); (3) Ontario, all drivers (n = 186,921 presentations), an increase of 28.93 visits (95 % CI -26.32; 84.19; p = 0.30); and (4) Ontario, youth drivers (n = 4565), an increase of 0.09 visits (95 % CI -6.25; 6.42; p = 0.98).Conclusions: Implementation of the Cannabis Act was not associated with evidence of significant post-legalization changes in traffic-injury ED visits in Ontario or Alberta among all drivers or youth drivers, in particular. [ABSTRACT FROM AUTHOR]

Objective: Cannabis legalization in many jurisdictions worldwide has raised concerns that such legislation might increase the burden of transient and persistent psychotic illnesses in society. Our study aimed to address this issue., Methods: Drawing upon emergency department (ED) presentations aggregated across Alberta and Ontario, Canada records (April 1, 2015-December 31, 2019), we employed Seasonal Autoregressive Integrated Moving Average (SARIMA) models to assess associations between Canada's cannabis legalization (via the Cannabis Act implemented on October 17, 2018) and weekly ED presentation counts of the following ICD-10-CA-defined target series of cannabis-induced psychosis (F12.5; n  = 5832) and schizophrenia and related conditions ("schizophrenia"; F20-F29; n  = 211,661), as well as two comparison series of amphetamine-induced psychosis (F15.5; n  = 10,829) and alcohol-induced psychosis (F10.5; n  = 1,884)., Results: ED presentations for cannabis-induced psychosis doubled between April 2015 and December 2019. However, across all four SARIMA models, there was no evidence of significant step-function effects associated with cannabis legalization on post-legalization weekly ED counts of: (1) cannabis-induced psychosis [0.34 (95% CI -4.1; 4.8; P  = 0.88)]; (2) schizophrenia [24.34 (95% CI -18.3; 67.0; P  = 0.26)]; (3) alcohol-induced psychosis [0.61 (95% CI -0.6; 1.8; P  = 0.31); or (4) amphetamine-induced psychosis [1.93 (95% CI -2.8; 6.7; P  = 0.43)]., Conclusion: Implementation of Canada's cannabis legalization framework was not associated with evidence of significant changes in cannabis-induced psychosis or schizophrenia ED presentations. Given the potentially idiosyncratic rollout of Canada's cannabis legalization, further research will be required to establish whether study results generalize to other settings.