Health Research Needs and Priorities Related to Cannabis Legalization and Regulation Workshop
September 18, 2017
Montréal, QC
Canada will legalize and regulate the use of cannabis for non-medical purposes, with legislation expected to be enacted by July 2018. There are still research gaps related to health and safety of using cannabis as well as questions related to the behavioural, social and economic implications of legalization – which could play out differently across Canadian jurisdictions. The Canadian Institutes for Health Research (CIHR) Institute of Population and Public Health (IPPH), Institute of Neuroscience, Mental Health, and Addictions (INMHA), Institute of Health Services and Policy Research (IHSPR), Institute of Circulatory and Respiratory Health (ICRH), Institute of Gender and Health (IGH) and Institute of Human Development, Child, and Youth Health (IHDCYH), have been exploring health research gaps and needed supports to ensure a comprehensive and coordinated approach to future research. We have heard that action must take place on multiple fronts. Researchers require support to use and build on existing research, to define appropriate measures, to identify and conduct studies in communities across Canada and to be better connected through networking activities. CIHR will be developing potential mechanisms to address these objectives and convened a workshop of key researchers and knowledge users to help inform this work.
Workshop objectives
- Prioritize identified areas and goals for cannabis research that are relevant across jurisdictions in Canada, in the core domains of health and public safety.
- Establish core research questions and topics in most pressing need of study.
- Suggest mechanisms to enable coordinated, comprehensive, and actionable health research that is relevant for future decisions related to cannabis legalization in Canada, including evidence that will inform the prevention of problematic use and harm reduction strategies.
- Identify key health research assets, their interest/capacity, and requirements for leveraging and enhancing their research activities, as well as linking them to key areas of greatest research need.
- Suggest potential funding mechanisms/tools for CIHR to consider to best achieve the identified goals.
- Identify opportunities to leverage and maximize current and future funding investments with relevant partners and stakeholders.
Executive Summary
Cannabis has a long history of being an illicit substance in Canada and in most other countries, which has limited access and the ability for researchers to widely study cannabis. In August 2016, the Canadian government revised the Controlled Drugs and Substances Act to allow medical use of cannabis, thereby acknowledging a small yet growing body of research that recognizes the potential benefits cannabis can have on some medical conditions. In April 2017, the federal government introduced legislation to legalize and regulate recreational cannabis in Canada by July 2018. If passed, the proposed federal Cannabis Act would create rules for producing, possessing and selling cannabis across Canada. With the pending legalization, regulators, health practitioners, employers, public safety workers and others are looking for evidence to help inform their policies and practices.
On September 18, 2017, the Canadian Institutes of Health Research held a workshop to help narrow the scope of required health research related to cannabis use and prioritize areas and research questions in need of immediate investigation that are relevant across jurisdictions in Canada, in the core domains of health and public safety. By convening 45 key researchers and knowledge users and facilitating an environment for knowledge exchange, plenary discussions and breakout group discussions, progress towards defining a Canadian research agenda was made. The following areas of research were identified as important, but more work is required to prioritize which research areas should be prioritized:
- Research standards and pan-canadian data sharing and linkage: Supporting surveillance and epidemiological work involving baseline information and understanding patterns, attitudes, motivations and reasons for use across populations; and supporting data and measurement infrastructure – standards, accessible tools/platforms, the science of surveillance
- Brain development: Understanding the long-term impacts of cannabis use (pre and post-natal outcomes, brain development and other biological issues) and supporting animal and human studies documenting the mechanisms of cannabis’s effects and risk and protective factors
- Potency, product safety and harm reduction: Researching the differential health impacts of available products on the market
- Impairment: Exploring the spectrum of cannabis impairment and its effects on cognitive functioning, driving and workplace safety, including thresholds for harm
- Risk communication: what are the best means for communicating product standards and harm reduction information
- Prevention: what are effective interventions to prevent problematic use
- Treatment: what are effective treatment interventions across the continuum of problematic use
- Regulatory models: Documenting and researching the acute and long-term health impacts of different regulatory models
- Co-morbidities, dual diagnoses, and polysubstance use: Understanding the link between psychosis, other illnesses, and cannabis use and the effects of co-use with various other substances and potential impacts
While not explicitly mentioned, the relationship between mental health and cannabis use was an undercurrent in various conversations. Impacts of cannabis use on key populations such as youth, lesbian, gay, bi-sexual, transgender, questioning, intersex, or two-spirited (LGBTQI2-S) and Indigenous communities were also mentioned frequently throughout discussions, as was how researchers can better ensure effective translation of research evidence into policy.
The meeting concluded with CIHR committing to consider and integrate recommendations from the workshop with advice and information from government partners and other stakeholders in order to determine where future CIHR investments will be best placed. CIHR will continue to consult with the research community for additional feedback. Next steps will also involve prioritizing the priorities, coordinating resources and mobilizing existing knowledge.
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