Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Department of Pediatrics, Western University, London, ON, Canada.
Int J Soc Psychiatry. 2024 Mar;70(2):308-318. doi: 10.1177/00207640231206053. Epub 2023 Oct 27.
Cannabis is associated with the onset and persistence of psychotic disorders. Evidence suggests that accessibility of substances is associated with an increased risk of use-related harms. We sought to examine the effect of residing in proximity to non-medical cannabis retailers on the prevalence of health service use for psychosis.
We conducted a cross-sectional study using linked health administrative data, and used geospatial analyses to determine whether people in Ontario, Canada (aged 14-60 years) resided within walking (1.6 km) or driving (5.0 km) distance of non-medical cannabis retailers (open as of February-2020). We identified outpatient visits, emergency department (ED) visits, and hospitalizations for psychotic disorders between 01-April-2019 and 17-March-2020. We used zero-inflated Poisson regression models and gamma generalized linear models to estimate the association between cannabis retailer proximity and indicators of health service use.
Non-medical cannabis retailers were differentially located in areas with high levels of marginalization and pre-existing health service use for psychosis. People residing within walking or driving distance of a cannabis retailer had a higher rate of psychosis-related outpatient visits, ED visits, and hospitalizations, compared to people living outside these areas. This effect was stronger among those with no prior service use for psychosis.
Proximity to a non-medical cannabis retailer was associated with higher health service use for psychosis, even after adjustment for prior health service use. These findings suggest that opening of non-medical cannabis retailers could worsen the burden of psychosis on mental health services in areas with high-risk populations.
大麻与精神病的发病和持续有关。有证据表明，物质的可及性与使用相关危害的风险增加有关。我们试图研究接近非医用大麻零售商与精神疾病相关的卫生服务使用的患病率之间的关系。
我们使用了链接的健康管理数据进行了一项横断面研究，并使用地理空间分析来确定加拿大安大略省（年龄在 14 至 60 岁之间）的人是否居住在非医用大麻零售商（截至 2020 年 2 月开业）步行（1.6 公里）或驾车（5.0 公里）距离内。我们确定了 2019 年 4 月 1 日至 2020 年 3 月 17 日期间精神病门诊就诊、急诊就诊和住院治疗。我们使用零膨胀泊松回归模型和伽马广义线性模型来估计大麻零售商接近程度与卫生服务使用指标之间的关系。
非医用大麻零售商在处于边缘化程度较高的地区和已存在的精神病卫生服务使用地区的分布存在差异。与居住在这些地区以外的人相比，居住在步行或驾车距离大麻零售商较近的人，其精神病相关的门诊就诊、急诊就诊和住院治疗的发生率更高。这种影响在那些没有精神病服务使用史的人中更为明显。
即使在调整了先前的卫生服务使用情况后，接近非医用大麻零售商与更高的精神病卫生服务使用之间仍存在关联。这些发现表明，在高危人群地区开设非医用大麻零售商可能会使精神疾病对精神卫生服务的负担恶化。
