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

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.

Hawley, Philippa et al.·BMC health services research·2020·Moderate EvidenceCross-Sectional
RTHC-02605Cross SectionalModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study 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.

Key Numbers

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 They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?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?

Trust & Context

Key Stat:
Use up 26%, but access problems doubled after legalization
Evidence Grade:
Moderate: pre-post comparison with identical survey methodology, though limited by low response rate and short post-legalization timeframe.
Study Age:
Published in 2020 in BMC Health Services Research.
Original Title:
The impact of legalization of access to recreational Cannabis on Canadian medical users with Cancer.
Published In:
BMC health services research, 20(1), 977 (2020)
Database ID:
RTHC-02605

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked 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 More on RethinkTHC

Cite This Study

RTHC-02605·https://rethinkthc.com/research/RTHC-02605

APA

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

MLA

Hawley, Philippa, et al. "The impact of legalization of access to recreational Cannabis on Canadian medical users with Cancer.." BMC health services research, 2020. https://doi.org/10.1186/s12913-020-05756-8

RethinkTHC

RethinkTHC Research Database. "The impact of legalization of access to recreational Cannabi..." RTHC-02605. Retrieved from https://rethinkthc.com/research/hawley-2020-the-impact-of-legalization

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.