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J Public Health (Oxf). 2016 Mar;38(1):183-8. doi: 10.1093/pubmed/fdv005. Epub 2015 Jan 28.

Crude estimates of cannabis-attributable mortality and morbidity in Canada-implications for public health focused intervention priorities.

Author information

1
Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada M5S 2S1 Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada V6B 5K3 Department of Psychiatry, University of Toronto, Toronto, Canada M5T 1R8.
2
Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada M5S 2S1 Institute of Medical Science, University of Toronto, Toronto, Canada M5S 1A8.
3
Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada M5S 2S1 Dalla Lana School of Public Health, University of Toronto, Toronto, Canada M5T 3M7.
4
Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada M5S 2S1 Department of Psychiatry, University of Toronto, Toronto, Canada M5T 1R8 Institute of Medical Science, University of Toronto, Toronto, Canada M5S 1A8 Dalla Lana School of Public Health, University of Toronto, Toronto, Canada M5T 3M7 WHO/PAHO Collaborating Centre for Mental Health and Addiction, Toronto, Canada M5S 2S1 Klinische Psychologie und Psychotherapie, Technische Universität Dresden, Dresden 01069, Germany.

Abstract

BACKGROUND:

Cannabis is the most commonly used drug in Canada; while its use is currently controlled by criminal prohibition, debates about potential control reforms are intensifying. There is substantive evidence about cannabis-related risks to health in various key outcome domains; however, little is known about the actual extent of these harms specifically in Canada.

METHODS:

Based on epidemiological data (e.g. prevalence of relevant cannabis use rates and relevant risk behaviors; risk ratios; and annual numbers of morbidity/mortality cases in relevant domains), and applying the methodology of comparative risk assessment, we estimated attributable fractions for cannabis-related morbidity and mortality, specifically for: (i) motor-vehicle accidents (MVAs); (ii) use disorders; (iii) mental health (psychosis) and (iv) lung cancer.

RESULTS:

MVAs and lung cancer are the only domains where cannabis-attributable mortality is estimated to occur. While cannabis use results in morbidity in all domains, MVAs and use disorders by far outweigh the other domains in the number of cases; the popularly debated mental health consequences (e.g., psychosis) translate into relatively small case numbers.

CONCLUSIONS:

The present crude estimates should guide and help prioritize public health-oriented interventions for the cannabis-related health burden in the population in Canada; formal burden of disease calculations should be conducted.

KEYWORDS:

Canada; attributable fractions; cannabis use; health risks; morbidity; mortality; public health

PMID:
25630540
PMCID:
PMC4750519
[Available on 2017-03-01]
DOI:
10.1093/pubmed/fdv005
[Indexed for MEDLINE]
Free PMC Article

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