Researchers propose 28 indicators to track whether cannabis legalization helps or hurts public health in Canada

A comprehensive framework of 28 public health indicators across five themes was developed to evaluate Canada's cannabis regulation, with early data from other jurisdictions showing mixed results but some potential benefits.

Lake, Stephanie et al.·Drug and alcohol review·2019·Moderate EvidenceReview
RTHC-02122ReviewModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Twenty-eight indicators were identified under five themes: public safety, cannabis use trends, other substance use trends, cardiovascular/respiratory health, and mental health/cognition. Early data from US jurisdictions showed little consensus on harms but emerging evidence for benefits like reduced opioid use.

Key Numbers

28 indicators identified across 5 broad themes. Preliminary data from legalized US jurisdictions referenced for each indicator where available.

How They Did This

Systematic search of five scientific databases to compile cannabis-related public health and safety indicators, supplemented with preliminary evidence from US states and Canadian provinces that had already legalized.

Why This Research Matters

Canada's legalization is a natural experiment. Without agreed-upon metrics to track outcomes, it would be impossible to know whether the policy is working or where adjustments are needed.

The Bigger Picture

Most public discourse about cannabis legalization focuses on potential harms. This framework explicitly includes indicators for potential benefits, pushing back against one-sided evaluation of drug policy.

What This Study Doesn't Tell Us

Framework is proposed rather than validated. Preliminary evidence from other jurisdictions may not translate to Canada. Many indicators lack reliable baseline data.

Questions This Raises

  • ?Which of the 28 indicators show the most meaningful changes after legalization?
  • ?Are the proposed metrics sensitive enough to detect real-world policy effects?

Trust & Context

Key Stat:
28 indicators across 5 themes
Evidence Grade:
Moderate: systematic development of evaluation framework with preliminary supporting evidence.
Study Age:
Published in 2019.
Original Title:
Guidelines for public health and safety metrics to evaluate the potential harms and benefits of cannabis regulation in Canada.
Published In:
Drug and alcohol review, 38(6), 606-621 (2019)
Database ID:
RTHC-02122

Evidence Hierarchy

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

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

What are the five themes used to evaluate legalization?

Public safety, cannabis use trends, other substance use trends, cardiovascular and respiratory health, and mental health and cognition.

Does early evidence show legalization is harmful?

Early data from US jurisdictions showed little consensus on harms, with some evidence pointing to potential benefits like reduced opioid use and overdose.

Read More on RethinkTHC

Cite This Study

RTHC-02122·https://rethinkthc.com/research/RTHC-02122

APA

Lake, Stephanie; Kerr, Thomas; Werb, Dan; Haines-Saah, Rebecca; Fischer, Benedikt; Thomas, Gerald; Walsh, Zach; Ware, Mark A; Wood, Evan; Milloy, M-J. (2019). Guidelines for public health and safety metrics to evaluate the potential harms and benefits of cannabis regulation in Canada.. Drug and alcohol review, 38(6), 606-621. https://doi.org/10.1111/dar.12971

MLA

Lake, Stephanie, et al. "Guidelines for public health and safety metrics to evaluate the potential harms and benefits of cannabis regulation in Canada.." Drug and alcohol review, 2019. https://doi.org/10.1111/dar.12971

RethinkTHC

RethinkTHC Research Database. "Guidelines for public health and safety metrics to evaluate ..." RTHC-02122. Retrieved from https://rethinkthc.com/research/lake-2019-guidelines-for-public-health

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.