Cannabis Use in Canada: The Need for a 'Public Health' Approach (Commentary) (Report‪)‬

Cannabis is one of the three psychoactive substances most commonly used in Canada (the other two being alcohol and tobacco). In 2004, after substantial increases in use rates for about a decade, one in seven adults reported recreational use of cannabis in the past year. (1) Among Ontario secondary school students, one in four reported past-year cannabis use--double the proportion of tobacco users. (2) Compared to other industrialized nations, Canada features some of the highest cannabis use rates among adults and adolescents. The specific reasons for these increasing use rates are not clear but they suggest the limited effectiveness of the current deterrence-based policies. Key areas of popular psychoactive substance use have become embraced by a public health framework in recent years. This approach is primarily concerned with reducing substance use related harms by acting on determinants and risks, rather than focusing on use per se, and by implementing targeted interventions to reduce the public health burden of use. (3) A leading example of such a policy framework is alcohol use, where problems like binge-drinking, alcohol dependence and drunk driving have been recognized as key harms that are targeted by prevention, treatment and enforcement. (4) Even the field of injection drug use has been influenced by public health-oriented policy with the adoption of interventions like needle exchange programs, supervised consumption sites and opioid prescription for maintenance to reduce the overall health burden of this form of drug use. (5)