Cantor Nathan, Silverman Max, Gaudreault Adrienne, Hutton Brian, Brown Catherine, Elton-Marshall Tara, Imtiaz Sameer, Sikora Lindsey, Tanuseputro Peter, Myran Daniel T
Department of Medicine, McMaster University, 90 Main St W Hamilton, ON, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, ON, Canada.
Lancet Reg Health Am. 2024 Mar 7;32:100708. doi: 10.1016/j.lana.2024.100708. eCollection 2024 Apr.
An increasing number of regions have or are considering legalising the sale of cannabis for adult use. Experience from tobacco and alcohol regulation has found that greater access to physical retail stores is positively associated with increased substance use and harm. Whether this association exists for cannabis is unclear. We completed a systematic review examining the association between cannabis retail store access and adverse health outcomes. We identified articles up until July 20, 2023 by searching four databases. We included studies examining the association between measures of cannabis store access and adverse outcomes: frequent or problematic cannabis use, healthcare encounters due to cannabis use (e.g., cannabis-induced psychosis), and healthcare encounters potentially related to cannabis (e.g., self-harm episodes). Results were compared by study design type, retail access measure, and by subgroups including: children, adolescents, young adults, adults, and pregnant individuals. This review was registered with PROSPERO (CRD42021281788). The search generated 5750 citations of which we included 32 studies containing 44 unique primary analyses (unique retail measure and outcome pairs). Studies come from 4 countries (United States, Canada, Netherlands and Uruguay). Among the included analyses, there were consistent positive associations between greater cannabis retail access and 1) increased healthcare service use or poison control calls directly due to cannabis (10/12 analyses; 83%) (2) increased cannabis use and cannabis-related hospitalization during pregnancy (4/4; 100%) and 3) frequent cannabis use in adults and young adults (7/11; 64%). There was no consistent positive association between greater cannabis retail and increased frequent cannabis use in adolescents (1/4; 25%), healthcare service use potentially related to cannabis (2/6; 33%) or increased adverse neonatal birth outcomes (2/7; 26.8%). There is a positive association between greater cannabis store access and increases in cannabis harm. In countries with legal cannabis, retail restrictions may reduce use and harm.
Canadian Centre on Substance Use and Addiction (CCSA).
越来越多的地区已经或将考虑将成人使用大麻的销售合法化。烟草和酒精监管的经验表明，实体零售店的更多获取途径与物质使用和危害的增加呈正相关。大麻是否存在这种关联尚不清楚。我们完成了一项系统综述，研究大麻零售店获取途径与不良健康结果之间的关联。我们通过搜索四个数据库确定了截至2023年7月20日的文章。我们纳入了研究大麻商店获取途径措施与不良结果之间关联的研究：频繁或有问题的大麻使用、因大麻使用导致的医疗就诊（如大麻诱发的精神病）以及可能与大麻相关的医疗就诊（如自残事件）。结果按研究设计类型、零售获取措施以及包括儿童、青少年、年轻人、成年人和孕妇在内的亚组进行比较。本综述已在PROSPERO（CRD42021281788）注册。搜索产生了5750条引用，其中我们纳入了32项研究，包含44项独特的主要分析（独特的零售措施和结果对）。研究来自4个国家（美国、加拿大、荷兰和乌拉圭）。在纳入的分析中，大麻零售获取途径增加与以下方面之间存在一致的正相关：1）直接因大麻导致的医疗服务使用增加或中毒控制呼叫增加（10/12项分析；83%）；2）孕期大麻使用和与大麻相关的住院增加（4/4；100%）；3）成年人和年轻人频繁使用大麻（7/11；64%）。大麻零售增加与青少年频繁使用大麻增加（1/4；25%）、可能与大麻相关的医疗服务使用增加（2/6；33%）或不良新生儿出生结局增加（2/7；26.8%）之间没有一致的正相关。大麻商店获取途径增加与大麻危害增加之间存在正相关。在大麻合法的国家，零售限制可能会减少使用和危害。
加拿大物质使用和成瘾中心（CCSA）。
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