Realistically furthering the goals of public health by cannabis legalization with strict regulation: Response to Kalant

Cannabis use is associated with lower rates of initiation of injection drug use among street‐involved youth: A longitudinal analysis

“…Although a wealth of studies have investigated the gateway hypothesis, the impact of so-called gateway drugs on the initiation of high-risk drug use behaviours, such as injecting, has not been fully evaluated. Given the high risk of injection-related harm among recently initiated young injectors, as well as intense scrutiny of the possible impacts of cannabis on youth health in general, we sought to examine the impact of frequent cannabis use on rates of injection initiation among a prospective cohort of at-risk youth and young adults in Vancouver, Canada, between September 2005 and May 2015 9, 13–15, 27 . To build on the existing research in this area, we also conducted sub-analyses to examine the distinct effects of cannabis use on both stimulant and opioid injecting.…”

Cannabis Legalization in Canada: Reflections on Public Health and the Governance of Legal Psychoactive Substances

“…In the specific case of cannabis, proponents of a public health approach contend that: the illegal status of cannabis causes harm to its users by exposing them to criminalization, which furthermore tends to be arbitrarily and inequitably applied ( 11 ); and for the average adult user, cannabis is relatively benign, with the health harms 1 concentrated among a subset of users who use it frequently and/or began using it early in life [see ( 12 )]; and therefore society is better served by legalizing cannabis, strictly regulating it, and managing the risks through the health system ( 13 , 14 ). …”

“…the illegal status of cannabis causes harm to its users by exposing them to criminalization, which furthermore tends to be arbitrarily and inequitably applied ( 11 ); and…”

Legalisation of non-medical cannabis in Canada: will supply regulations effectively serve public health?

“…Rather, they are being built in the long-existing context of both flourishing black markets and extensive supply structures for medical cannabis, including hundreds of illegal dispensaries across Canada, which have evolved to expand their cannabis distribution far beyond supply for therapeutic purposes. 4 Furthermore, jurisdictional challenges exist: although cannabis legalisation in Canada is principally enabled by federal legislation, many of its key practical details, especially regarding retail distribution, will be defined by provincial regulations, possibly creating lateral and vertical inconsistencies or tensions. Some of these tensions are already emerging or present.…”