Canada's Cannabis Surveillance Is Broken: Outdated Tools Miss the Harms Legalization Was Supposed to Track

Narrative review and commentary examining Canada's current cannabis surveillance infrastructure, including national surveys, diagnostic frameworks, administrative health records, and case-finding tools. Assessed alignment with current diagnostic standards (DSM-5) and capacity to detect cannabis use disorder and related harms.

Other countries and jurisdictions are using Canada as a model for cannabis legalization. If Canada's own surveillance systems can't determine whether legalization has increased or decreased harms, the evidence base for global cannabis policy is undermined. This isn't an argument against legalization — it's an argument that any public health intervention this large requires adequate measurement tools, and Canada's are currently not up to the job.

This is the surveillance and policy counterpart to the clinical and biological studies in the database. Studies like RTHC-00115 (potency trends) and RTHC-00103 (cardiovascular meta-analysis) generate data about cannabis harms, but if national surveillance systems can't detect those harms in the population, the research findings never translate into effective public health responses. For other countries considering legalization, this is a cautionary tale about building measurement infrastructure before making policy changes.

This is a commentary/perspective piece rather than original research. Focused specifically on Canada — other jurisdictions may have better or worse surveillance. The author's argument that surveillance is inadequate is well-supported by examples, but others might argue that existing data captures enough for policy-making. The piece doesn't quantify how much CUD is being missed, only argues that current tools are insufficient to capture it accurately.