Cannabis use among Canadian cancer patients increased 26% after recreational legalization, but access problems also grew | Research

The takeaway

Comparing surveys before and after Canada's 2018 recreational cannabis legalization, current cannabis use among cancer patients increased by 26% (23% to 29%), but more post-legalization users reported problems accessing preferred products.

Oncologists, cannabis policy makers, and cancer patients navigating legal cannabis systems.

Use up 26%, but access problems doubled after legalization

What the researchers found

Cannabis use prevalence increased 26% after legalization (23.1% to 29.1%, p=0.01). Recreational motive disclosure increased from 32% to 40%. However, access problems doubled (8% to 18%, p<0.01), mainly due to unavailability of preferred products (especially edibles) through legal channels.

Why it matters

The paradox that legalization both increased use and worsened access highlights the gap between patient needs and regulatory implementation, particularly around product types like edibles that were not initially available through legal channels.

The numbers in context

Use increased: 23.1% to 29.1% (p=0.01). Recreational motive: 32% to 40%. Access problems: 8% to 18% (p<0.01). Most did not use the legal medical access system. Median age 66, 53% female.

How the study worked

Two identical anonymous cross-sectional surveys of cancer patients in British Columbia, administered 2 months before and 3 months after recreational legalization. Same eligibility criteria for both cohorts.

What this study cannot tell us

Low overall response rate (27%). Pre-post comparison without individual tracking. Short timeframe after legalization (3 months). British Columbia may not represent all Canadian provinces.

How to read the evidence

Moderate: pre-post comparison with identical survey methodology, though limited by low response rate and short post-legalization timeframe.

When this study was published

Published in 2020 in BMC Health Services Research.

The bigger picture

If legal cannabis systems do not meet patient needs in terms of product availability, cost, and convenience, patients will continue using illegal sources, undermining the harm-reduction goals of legalization.

Questions still open

Have access problems improved as more legal products became available? Does increased use after legalization translate to better or worse symptom management? Would a medical-specific cannabis pathway better serve cancer patients?

Common questions

Did legalization help cancer patients access cannabis?

It was mixed. More patients used cannabis after legalization, and some felt more comfortable disclosing recreational use. However, access problems actually increased because the legal market did not initially offer preferred products like edibles.

Why did most patients not use the legal medical system?

The study found that most cannabis-using cancer patients bypassed the medical access system in both cohorts. Reasons included complexity of the system, cost, and the availability of preferred products through other channels.

Read the original research

The impact of legalization of access to recreational Cannabis on Canadian medical users with Cancer.

BMC health services research, 20(1), 977

View on PubMed ↗Publisher’s paper ↗

Citation

Hawley, Philippa; Gobbo, Monica; Afghari, Narsis. (2020). The impact of legalization of access to recreational Cannabis on Canadian medical users with Cancer.. BMC health services research, 20(1), 977. https://doi.org/10.1186/s12913-020-05756-8