Grant: Team Grant: Cannabis Research in Priority Areas - Mental Health

On October 17, 2018, the Cannabis Act came into force, making Canada the fourth country in the world to legalize the recreational use and possession of cannabis nationwide. The impetus towards legalization has focused primarily on cost savings and public safety, without sufficient consideration of the impact on vulnerable persons such as youth and those with serious forms of mental illness (SMI). The primary purpose of this study is to investigate the potential harms and health-related impacts of cannabis legalization on a representative sample of psychiatrically complex and vulnerable individuals: users of forensic mental health services in Ontario. Consistent with the literature documenting risk enhancing effects of substance use in persons with SMI, we expect to see a higher rate of poor health outcomes and mental health deterioration, as well as other clinically adverse events (hospital readmission, longer durations of hospital stay, criminal offending), among patients if increased levels of cannabis use are observed as time elapses from the point of legalization. In addition to investigating effects on patients, we will assess changes in forensic clinician and decision-maker attitudes over time, with the hypothesis that attitudes will become more permissive with respect to cannabis use among forensic patients as time elapses from the point of legalization. Although cannabis is the most commonly used illicit drug in the general population, its use among those with mental health problems is associated with a host of adverse clinical, health and public safety outcomes. With the recent legalization of cannabis in this country, now is a critical point in time to address the impact of cannabis use and its legalization on the forensic system and the patients under its care.