Crude estimates of cannabis-attributable mortality and morbidity in Canada-implications for public health focused intervention priorities

J Public Health (Oxf). 2016 Mar;38(1):183-8. doi: 10.1093/pubmed/fdv005. Epub 2015 Jan 28.

Abstract

Background: Cannabis is the most commonly used drug in Canada; while its use is currently controlled by criminal prohibition, debates about potential control reforms are intensifying. There is substantive evidence about cannabis-related risks to health in various key outcome domains; however, little is known about the actual extent of these harms specifically in Canada.

Methods: Based on epidemiological data (e.g. prevalence of relevant cannabis use rates and relevant risk behaviors; risk ratios; and annual numbers of morbidity/mortality cases in relevant domains), and applying the methodology of comparative risk assessment, we estimated attributable fractions for cannabis-related morbidity and mortality, specifically for: (i) motor-vehicle accidents (MVAs); (ii) use disorders; (iii) mental health (psychosis) and (iv) lung cancer.

Results: MVAs and lung cancer are the only domains where cannabis-attributable mortality is estimated to occur. While cannabis use results in morbidity in all domains, MVAs and use disorders by far outweigh the other domains in the number of cases; the popularly debated mental health consequences (e.g., psychosis) translate into relatively small case numbers.

Conclusions: The present crude estimates should guide and help prioritize public health-oriented interventions for the cannabis-related health burden in the population in Canada; formal burden of disease calculations should be conducted.

Keywords: Canada; attributable fractions; cannabis use; health risks; morbidity; mortality; public health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Traffic / statistics & numerical data
  • Canada / epidemiology
  • Female
  • Health Priorities
  • Humans
  • Lung Neoplasms / chemically induced
  • Lung Neoplasms / epidemiology
  • Male
  • Marijuana Abuse / complications
  • Marijuana Abuse / epidemiology*
  • Marijuana Abuse / mortality
  • Marijuana Abuse / prevention & control
  • Mental Disorders / epidemiology
  • Public Health Practice*
  • Risk Factors