Cannabis Use in Canada

The Canadian Cannabis Survey 2019 was released in December to look at cannabis use in Canada.  It is a great review of current use.  They divided the survey into 4 themes, with some key points for each.  Here is a quick summary.

Theme 1 -Knowledge, attitudes and behaviours

This theme looked at what people knew and thought about cannabis.

• Alcohol as was the most socially acceptable substance (55% of respondents).  Smoked cannabis was next (44%) followed by edibles (43%), vaping cannabis (42%), e-cigarettes containing nicotine (41%), and tobacco (35%)
• People are worried about cannabis stigma – Only 21% said they were willing to disclose cannabis use and 23% said that they would not be willing to say if they use cannabis
• Smoking is greater risk than alcohol or cannabis – The majority of people felt that occasional use of alcohol or cannabis had no risk or slight risk, whereas smoking tobacco or using an e-cigarette with nicotine once in a while was seen as having moderate or great risk by the majority of people
• Cannabis misuse risk – 90% of people thought that using cannabis could be habit forming

Theme 2: Cannabis Use and Products Used

• Recreational cannabis use is growing – Twenty-five percent (25%) of people reported having used cannabis in the past 12 months, an increase from 22% in the previous cycle
• Greatest use in younger adults –Past 12-month use of cannabis among people aged 16 to 19 years and those aged 20 to 24 was 44% and 51%, respectively, compared to 21% for people aged 25 years and older, all increases from 2018 (36%, 44%, and 19%, respectively)
• Lower education = higher cannabis use – Those who reported having less than high school or a high school diploma as their highest level of education had the highest proportion reporting cannabis use in the past 12 months (31% each), almost twice that of those with a post-graduate degree/diploma (17%)
• The average age of starting cannabis – 19.2 years
• Frequency of use – Over half of these respondents reported using cannabis three days per month or less (55%), and 18% reported daily cannabis use
• Smoking is still the most common method of administration – Smoking (84%) was the most common method of cannabis consumption reported.  Other methods of consumption were: eating it in food (46%), an increase from 42% in 2018; vaporizing using a vape pen or e-cigarette (27%), and vaporizing using a vaporizer (15%)
• Dried flower is still the most common format used – The six most common products used were dried flower/leaf (77%); edible food products (44%); vape pens/cartridges (26%); hashish/kief (23%); cannabis oil for oral use (23%); and concentrates/extracts (17%)
• High THC low CBD is preferred for recreational use – Thirty-seven percent (37%) indicated higher THC and lower CBD, 16% selected equal levels of THC and CBD, 13% indicated higher CBD and lower THC, and 2% selected other.  Thirty-two percent (32%) indicated they did not know the relative levels of THC and CBD
• People are increasingly purchasing cannabis for legal retailers – The top sources to obtain cannabis were from a legal storefront (24%), from a friend (22%), from a legal online source (13%), shared among friends (10%), from an illegal storefront (7%), grown by or for them (6%), and from a dealer (6%)
• Most people don’t get professional advise surrounding cannabis – Only 3% reported ever having received professional help for non-medical cannabis use

Theme 3: Driving and Cannabis

• Some risky driving behaviour – 26% reported that they had ever driven within two hours of smoking or vaporizing cannabis, and of those who had driven after smoking or vaporizing cannabis, 43% did so within the past 30 days, 31% within the past 12 months, and 25% more than 12 months ago
• Most believe that cannabis affects driving – More than eight in ten (85%) people reported that they think that cannabis use affects driving; this is an increase from 81% in 2018

Theme 4: Cannabis for Medical Purpose

• Increasing medical use – Fourteen percent (14%) of all respondents aged 16 years and older indicated that they used cannabis for medical purposes, an increase from 13% in 2018
• Most people don’t get professional help for medical cannabis use – The majority (73%) who reported cannabis use for medical purposes did not have a document from a healthcare professional
• Cannabis reduces other medications – The majority of people (61%) who used cannabis for medical purposes reported that cannabis use helped decrease their use of other medications
• Daily use is commonly required – The most common frequency reported was daily (35%), followed by less than one day per month (15%), two or three days per month (15%), one or two days per week (11%), three or four days per week (11%), five or six days per week (7%), and one day per month (6%)
• Medical cannabis oil use is increasing – The three main products used were dried flower/leaf (60%, a decrease from 71% in 2018), cannabis oil for oral use (46%, not comparable to previous cycle) and edibles (28%, a decrease from 34% in 2018)
• Higher CBD use is more common with medical users – Forty-one percent (41%) indicated higher CBD and lower THC, 18% selected higher THC and lower CBD, 14% indicated equal levels of THC and CBD, 14% indicated they used a mix of different products, and 4% selected other
• 1.5 grams of dried flower or 1.5 mL of cannabis oil per day – The average amount used on a typical use day was 1.5 grams whereas those who used edible cannabis products consumed approximately 1.1 servings; cartridges/vape pens, 0.1 cartridges; hashish, 0.4 grams; and beverages, 400 millilitres, all unchanged from 2018. Among those who used cannabis oil for oral use, the average amount used was 1.5 millilitres
• Many medical users not obtaining it from LP – In 2019, the top five sources to obtain cannabis for medical purposes were from a legal storefront (27%), a Health Canada licensed producer (23%, unchanged from 2018), a friend (21%, a decrease from 30% in 2018), a legal website other than a Health Canada licensed producer (20%), and an illegal storefront (12%)
• Spending an average of $100 per month – People who used cannabis for medical purposes in the past 12 months and who completed the medical section of the survey spent approximately $108 on cannabis for medical purposes in a typical month

Medical Cannabis Use in Canada

In December Health Canada published data on cannabis for medical purposes. The key statistics from this report:

• Active client registrations are continuing to increase – There was 369,614 medical client registrations with federally licensed sellers at the end of September 2019.  This is an increase from 345,520 in October 2018
• Average cannabis authorization is consistent – The average amount of cannabis authorized for daily use was 2.0 grams/day

How Does this Translate to Practice?

• Lots of great data from Health Canada on Cannabis use
• The number of registered medical users is continuing to increase even with easy recreational cannabis access
• Most medical users are not obtaining cannabis by obtaining an authorization from a healthcare professional
• Many people don’t ask or get any support by a healthcare professional for cannabis use.  This is an issue as many are worried about the stigma of cannabis use
• Healthcare professionals should regularly screen patients for cannabis use and offer support and education