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Cannabis is one of the most widely used recreational substances globally. The term “cannabis” refers to a variety of products derived from the Cannabis sativa plant, commonly sought after for its psychoactive and therapeutic properties (Calabria et al., 2010, p. 1). While cannabis has the potential to contribute to public health improvements, some argue that its increased use in recent years can be attributed to legalization in multiple countries, including Canada (Imtiaz et al., 2023, p. 2). Nurses, as key healthcare providers, have a duty to educate individuals and promote informed decision-making about cannabis use. This requires an understanding of trends and the implementation of preventive strategies tailored to community needs. Addressing cannabis use, especially among adolescents, is crucial as it poses significant public health challenges. Policy interventions and public health measures can play a pivotal role in reducing the negative impacts associated with adolescent cannabis consumption (The National Academies Press, 2017, p. 217).
Cannabis consumption has been linked to several adverse effects, regardless of the age of the individual. However, the increasing prevalence of cannabis use among Canadian adolescents is a particularly pressing concern. Reports indicate that Canadian adolescents exhibit some of the highest rates of cannabis consumption among youth in developed countries (UNICEF Office of Research, 2013, as cited in Canadian Centre on Substance Abuse, 2015, p. 6). One contributing factor is the increased accessibility brought about by legalization, which has also led to a reduced perception of risk among young people. Adolescents are increasingly misled to believe that the benefits of cannabis outweigh its risks (Burnett, 2016, p. 423-424). Between 2018 and 2019, approximately 18.1% of Canadian adolescents reported cannabis use, compared to a global rate of 5.6% among adolescents (Drug Free Kids, 2023; Abdel-Salam, 2019, p. 495).
Individuals under the age of 25 are particularly vulnerable to the adverse effects of cannabis due to the ongoing development of the brain. Cannabis use during this critical developmental period has been associated with neurocognitive impairments, academic underperformance, and mental health issues (Blevins et al., 2018, p. 1). Therefore, the implementation of targeted public health policies and evidence-based guidelines is essential for mitigating these risks and ensuring better health outcomes for young people. Uniform policies across Canadian provinces are necessary to address the widespread issue of adolescent cannabis use. Notably, cannabis is the substance most frequently linked to hospitalizations among Canadian adolescents (Drug Free Kids, 2023). Increasing awareness about the risks of cannabis use during adolescence is essential to reducing its harmful effects (Kaur et al., 2022, p. 2). This policy paper advocates for reforming public health strategies to address the long-term consequences of cannabis use in youth while promoting sustainable solutions for future generations.
While the short-term effects of cannabis, such as its euphoric properties, are widely recognized, the long-term consequences of use—particularly in adolescents—are often neglected (Burnett, 2016, p. 424). Canada’s Cannabis Act, which regulates the production, possession, distribution, and sale of cannabis, was designed with objectives such as preventing youth access, promoting public health, and reducing criminal activity (Canadian Centre on Substance Use and Addiction, 2023). Despite the positive intentions behind this policy, there are significant concerns regarding its impact on youth. Specifically, critics point to three major issues: the rise in cannabis use among adolescents, the irreversible harm to the developing brain caused by use before age 25, and the correlation between cannabis use and severe mental health conditions in youth (Haines-Saah & Fischer, 2021, p. 192).
One notable gap in the current policy is the minimum legal age for cannabis use. At the time of legalization, most provinces set this age at 19, while Alberta and Quebec set it at 18. In 2020, Quebec raised the minimum legal age to 21 to protect adolescents from the neurodevelopmental risks associated with cannabis use (Nguyen & Mital, 2022, p. 2). This change aligns with recommendations from the Canadian Medical Association, which advocates for higher legal age limits to minimize health risks (Rubin-Kahana et al., 2022, p. 3; Nguyen & Mital, 2022, p. 6). Research supports that brain development continues into the mid-20s, with significant vulnerability to damage from cannabis and other psychoactive substances during this period (Nguyen et al., 2020, p. 1). This evidence underscores the need for policies that raise the minimum legal age for cannabis use to 25.
Quebec’s decision to raise the legal age for cannabis use to 21 represents a proactive approach to reducing cannabis use among adolescents. This policy aligns with neuroscientific evidence that highlights the ongoing development of the brain during adolescence and early adulthood. Exposure to cannabis during these years can result in lasting cognitive, psychological, and social consequences (Nguyen et al., 2020, p. 2). By adopting similar measures, other provinces could potentially achieve comparable reductions in adolescent cannabis use.
The alternative model proposed in this paper takes this one step further by raising the minimum legal age for cannabis use to 25. This approach addresses gaps in the Cannabis Act and incorporates strategies to discourage adolescents from using cannabis. Raising the legal age to 25 aligns with scientific evidence, ensuring that policies prioritize public health outcomes. This model also emphasizes the importance of prevention and harm reduction through targeted education and public health initiatives.
Revising the minimum legal age for cannabis use in Canada requires a data-driven approach to ensure the effectiveness of policy changes. The Differences-in-Differences (DiD) model provides a framework for evaluating the impact of policy reforms on adolescent cannabis use. This model examines the relationship between policy changes and outcomes such as perceived availability of cannabis and usage patterns (Benedetti et al., 2021, p. 3).
The Chief Medical Officers of Health of Canada and the Urban Public Health Network emphasize the importance of policies that limit both the demand for and availability of cannabis to prevent morbidity and mortality associated with its use (2016, p. 13). The proposed policy, which raises the minimum legal age to 25, aligns with these recommendations. By limiting access to cannabis during critical developmental years, this policy could significantly reduce the cognitive and mental health risks associated with adolescent cannabis use.
An experimental design could validate the proposed policy by comparing outcomes in individuals aged 25 and older with those aged 24 and younger. This analysis would demonstrate whether older individuals experience fewer long-term adverse effects from cannabis use. However, implementing this policy would not be without challenges. For example, raising the legal age could lead to increased illegal sales, creating additional regulatory and enforcement challenges (Nguyen & Mital, 2022, p. 6). To address these issues, policymakers must continuously evaluate the effectiveness of the policy and make adjustments as needed.
The evidence clearly demonstrates that cannabis use during adolescence is associated with long-term risks, including increased likelihood of psychosis, depression, and anxiety (Hosseini & Oremus, 2018, p. 305). Given the importance of brain development during the years leading up to age 25, policies that limit access to cannabis during this period are essential. While raising the minimum legal age for cannabis use to 25 may present certain challenges, such as the potential for increased illegal sales, the benefits—improved educational, occupational, and health outcomes—far outweigh the disadvantages. Implementing this policy provides an opportunity for Canadian provinces, including Ontario, to enhance the health and well-being of their youth population.
Addressing the rising rates of adolescent cannabis use requires comprehensive prevention strategies. Raising the minimum legal age to 25 is a critical step in reducing the harmful effects of cannabis on young people. Public awareness campaigns must emphasize the long-term risks of cannabis use, focusing on its impact on brain development, mental health, and cognitive functioning. Nurses and healthcare providers can play a vital role in disseminating this information, fostering informed decision-making among adolescents and their families.
In addition to healthcare professionals, educators must also be equipped to inform students about the risks associated with cannabis use. Schools provide an ideal setting for delivering evidence-based education on this topic. Policymakers should prioritize research to support these efforts, ensuring that prevention strategies are both credible and effective. Collaboration between researchers, healthcare providers, educators, and policymakers is essential for developing guidelines that protect adolescents and reduce cannabis-related harm. By adopting evidence-based approaches, Canada can create a healthier future for its youth while addressing the public health challenges posed by cannabis use (Beirness & Porath, 2022, p. 5).
Abdel-Salam, O. M. E. (2019). The harm of cannabis in adolescents. Biomedical and
Pharmacology Journal, 12(2), 495-498. https://doi.org/10.13005/bpj/1667
Beirness, D. J., & Porath, A. J. (2022). Clearing the smoke on cannabis: Cannabis use and
driving. Canadian Centre on Substance Use and Addiction.
https://www.ccsa.ca/sites/default/files/2022-12/CCSA-Cannabis-Use-Driving-Report-
2022-en.pdf
Benedetti, E., Resce, G., Brunori, P., & Molinaro, S. (2021). Cannabis policy changes and
adolescent cannabis use: Evidence from Europe. International Journal of Environmental
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Blevins, C. E., Marsh, E., Banes, K. E., Stephens, R. S., Walker, D. D., & Roffman, R. A. (2018).
The implications of cannabis policy changes in Washington on adolescent perception of
risk, norms, attitudes, and substance use. Substance Abuse: Research and Treatment, 12.
https://doi.org/10.1177/1178221818815491
Burnett, A. L. (2016). The adverse effects of cannabis use in adolescents. Journal of Pain
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risk of death? Systematic review of epidemiological evidence on adverse effects of
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https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Effects-of-Cannabis-Use-during-
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https://www.ccsa.ca/policy-and-regulations-cannabis
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Drug Free Kids. (2023). Cannabis. https://www.drugfreekidscanada.org/drugspotlights/
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%2021%25%20of%20girls.&text=An%20estimated%20one%20in%205,%25
Haines-Saah, R. J., & Fischer, B. (2021). Youth cannabis use and legalization in Canada –
Reconsidering the fears, myths and facts three years in. Journal of the Canadian
Academy of Child and Adolescent Psychiatry, 30(3), 191-196.
Hosseini, S., & Oremus, M. (2018). The effect of age of initiation of cannabis use on psychosis,
depression, and anxiety among youth under 25 years. Canadian Journal of Psychiatry,
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Imtiaz, S., Nigatu, Y. T., Ali, F., Douglas, L., Hamilton, H. A., Rehm, J., Rueda, S., Schwartz, R.
M., Wells, S., & Elton-Marshall, T. (2023). Cannabis legalization and cannabis use, daily
cannabis use and cannabis-related problems among adults in Ontario, Canada (2001–
2019). Drug and Alcohol Dependence, 244,1-8 Ireland: Elsevier B.V.
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Kaur, N., Bastien, G., Gagnon, L., Graham, J., Mongeau-Pérusse, V., Bakouni, H., Morissette, F.,
Theriault, C., Fischer, B., & Jutras-Aswad, D. (2022). Variations of cannabis-related
adverse mental health and addiction outcomes across adolescence and adulthood: A
scoping review. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.973988
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Sciences. https://www.ncbi.nlm.nih.gov/books/NBK425742/
Nguyen, H. V., Bornstein, S., Gamble, J., Mathews, M., Bishop, L., & Mital, S. (2020). Too
young for cannabis? Choice of minimum legal age for legalized non-medical cannabis in
Canada. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08639-z
Ngyuen, H. V., & Mital, S. (2022). Changes in youth cannabis use after an increase in Cannabis
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Rubin-Kahana, D. S., Crépault, J. F., Matheson, J., & Le Foll, B. (2022). The impact of cannabis
legalization for recreational purposes on youth: A narrative review of the Canadian
experience. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.984485
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