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Cannabis Use in Canada The Need for a ‘Public Health’ Approach
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Cannabis is the most commonly used illicit drug in Canada, used by 1 in 7 adults and 1 in 4 students. Other forms of drug use (e.g., alcohol or injection drug use) are increasingly approached within a public health policy framework that focuses on reducing harms rather than use per se. Cannabis, by contrast, remains formally controlled by a criminal justice approach that focuses on enforcing abstinence. Its use is associated with a variety of possible acute or chronic health problems that include cognitive and respiratory impairment, psychotic episodes, dependence and injury risk.
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The incidence of these outcomes, however, is predicted by early onset and a high frequency and length of use that only apply to a minority of users. In a public health framework, cannabis use – especially in young populations – should be systematically monitored and high-risk patterns of use screened for in appropriate settings, e.g., schools and GP offices. Evidence-based primary and secondary prevention, treatment and enforcement need to be targeted at these high-risk patterns of use. Given the large cannabis user population, especially among young people, and the failure of the criminalization approach to discourage use, a public health framework for cannabis use is urgently needed in Canada.
March/April 2009
Canadian Journal of Public Health