Cannabis use declined after COVID-19, while legalization brought no…
Trends before and after legalization and COVID-19 on cannabis use among gay, bisexual, and other men who have sex with men in Montreal, Toronto, and Vancouver, Canada: A prospective cohort study.
Canadian journal of public health = Revue canadienne de sante publique•• Highly Relevant
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AI Summary
This prospective observational cohort study examined cannabis-use patterns before and after Canadian legalization and the COVID-19 pandemic among sexually active gay, bisexual, and other men who have sex with men in Montreal, Toronto, and Vancouver. Participants completed surveys from 2017 through 2022; the analysis included 1,595 people. Researchers tracked any cannabis use in the previous six months, use frequency, and high-risk use measured with the ASSIST screening tool.
The proportion reporting any recent cannabis use showed no significant change after legalization and declined after the start of the pandemic. Use frequency did not show significant trends, and high-risk use was not associated with the post-legalization or post-pandemic observation periods. Instead, high-risk use was associated with higher alcohol-screening scores and moderate-to-severe anxiety or depression, as well as a depression diagnosis. Because this was an observational study, these associations do not establish cause and effect. This abstract-based summary cannot determine why use changed or whether the findings apply beyond the study population.
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Key Findings
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Among 1,595 participants across three Canadian cities, reported cannabis use in the prior six months showed no significant change after legalization.
High
80%
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Reported past-six-month cannabis use declined after June 2020, during the COVID-19 period; the abstract does not establish that the pandemic caused the decline.
High
80%
3
There were no significant trends in frequency of use, and high-risk use was not associated with study visits in either the post-legalization or post-pandemic period.
High
80%
4
High-risk use was associated with elevated alcohol-screening scores, moderate-to-severe anxiety or depression, and a depression diagnosis; these observational associations do not show causation.
High
80%
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Original Abstract
OBJECTIVES: We examined how cannabis use was affected by the legalization of cannabis in Canada in October 2018 and the COVID-19 pandemic among urban gay, bisexual, and other men who have sex with men (GBM).
METHODS: Sexually active GBM aged ≥ 16 years in Vancouver, Montreal, and Toronto, Canada, were recruited from February 2017 to August 2019. Participants completed surveys every 6-12 months until August 2022. We examined past 6-month (P6M) trends of any cannabis use, frequency of use, and high-risk use measured by the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) with observation periods stratified into February 2017-October 2018; November 2018-March 2020; and June 2020-August 2022. We modelled associations between high-risk use (ASSIST scores ≥ 27) using multivariable generalized linear mixed models.
RESULTS: We analysed data from 950 GBM in Montreal, 258 in Toronto, and 387 in Vancouver. No significant changes in P6M any cannabis use were noted from November 2018 to March 2020 but declines were noted after June 2020 (OR = 0.81; 95% CI 0.66-1.00). There were no significant trends in frequency of consumption in any time period. High-risk cannabis use was not associated with visits from November 2018-March 2020 (AOR = 1.23; 95% CI 0.7-2.13) or after COVID-19 (AOR = 0.66; 95% CI 0.36-1.20) but was associated with AUDIT-C scores ≥ 4 (AOR = 1.69; 95% CI 1.00-2.87); moderate/severe anxiety scores (AOR = 2.94; 95% CI 1.60-5.39), moderate/severe depression scores (AOR = 2.55; 95% CI 1.26-5.17), and diagnoses of depression (AOR = 2.42; 95% CI 1.29-4.57).
CONCLUSION: Our study found no changes in the proportion of GBM reporting any cannabis use after legalization and declines after COVID-19. High-risk cannabis use was not associated with study visits after legalization or after COVID-19.
RéSUMé: OBJECTIFS: Nous avons cherché à savoir en quoi la légalisation du cannabis au Canada en octobre 2018 et la pandémie de COVID-19 ont pu influencer la consommation de cannabis chez les hommes gais, bisexuels et autres hommes ayant des relations sexuelles avec des hommes (GBH) en milieu urbain. MéTHODES: Des hommes GBH sexuellement actifs âgés de ≥ 16 ans vivant à Vancouver, Montréal et Toronto, au Canada, ont été recrutés entre février 2017 et août 2019. Les participants ont rempli des questionnaires tous les 6 à 12 mois jusqu’en août 2022. Nous avons examiné les tendances des six mois antérieurs (6MA) pour la consommation de cannabis (le cas échéant), la fréquence de consommation et la consommation à risque élevé, mesurées selon le test de dépistage ASSIST (Alcohol, Smoking and Substance Involvement Screening Test), avec des périodes d’observation stratifiées comme suit : février 2017–octobre 2018; novembre 2018–mars 2020 et juin 2020–août 2022. Nous avons modélisé les associations entre la consommation à risque élevé (scores ASSIST ≥ 27) à l’aide de modèles linéaires généralisés mixtes multivariés. RéSULTATS: Nous avons analysé les données de 950 hommes GBH à Montréal, 258 à Toronto et 387 à Vancouver. Aucun écart significatif n’a été observé dans la consommation de cannabis des 6MA entre novembre 2018 et mars 2020, mais des baisses de consommation ont été observées après juin 2020 (RC = 0,81; IC de 95 % 0,66-1,00). Aucune période d’observation n’a présenté de tendances significatives pour la fréquence de consommation. La consommation de cannabis à risque élevé n’était pas associée aux visites effectuées dans le cadre de l’étude entre novembre 2018 et mars 2020 (RCa = 1,23; IC de 95 % 0,7-2,13), ni après la COVID-19 (RCa = 0,66; IC de 95 % 0,36-1,20), mais elle était associée aux scores AUDIT-C ≥ 4 (RCa = 1,69; IC de 95 % 1,00-2,87), à l’anxiété modérée à sévère (RCa = 2,94; IC de 95 % 1,60-5,39), à la dépression modérée à sévère (RCa = 2,55; IC de 95 % 1,26-5,17) et aux diagnostics de dépression (RCa= 2,42; IC de 95 % 1,29-4,57). CONCLUSION: Notre étude n’a constaté aucun changement dans la proportion d’hommes GBH ayant déclaré une consommation de cannabis après la légalisation, et des baisses après la COVID-19. La consommation de cannabis à risque élevé n’était pas associée aux visites dans le cadre de l’étude après la légalisation, ni après la COVID-19.
