Tag: legalization

Reading of the Week: Cannabis, with Papers from CMAJ and JAMA; Also, Carroll on Legalization

February 12, 2026 /

From the Editor

With more and more countries legalizing cannabis, we must wonder about the health implications. This week’s Reading offers three selections.

How does legalization (and increased use) affect mental health? Is there more psychosis? In the first selection, just published in CMAJ, Dr. Daniel T. Myran (of the University of Toronto) and his co-authors analyzed data from 12 million people born in Ontario, Canada, to attempt to answer those questions. They looked at diagnoses of psychosis-related disorders and years of birth, finding those born in the early 2000s were about twice as likely to have been diagnosed with a psychotic disorder by age 20. “The incidence of psychotic disorders has increased in more recent birth cohorts.” We consider the paper and its implications.

In a recent US survey, 20% of respondents reported using CBD in the last year – which is often assumed to be safer than THC. In the second selection from JAMA Internal Medicine, Jeffry Florian (of the US Food and Drug Administration) and his co-authors analyzed liver enzymes of healthy participants randomized to CBD or placebo. “In this randomized double-blinded placebo-controlled trial, 5.6% of healthy adults administered CBD 5 mg/kg/d for up to 28 days experienced liver enzyme level elevations greater than 3 times the upper limit of normal.”

Finally, in the third selection, Dr. Aaron E. Carroll (of Indiana University) writes about cannabis legalization. While arguing that there are successes with this policy change, he also worries about long-term consequences. He writes that reforms are needed, from better regulation to more education. “The real lesson here isn’t even about cannabis. It’s about our capacity to learn and adapt.”

DG

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Reading of the Week: Suicide-related Reporting – the New BJP Paper; Also, Cannabis Use & Psychosis, and Mental Health & Working from Home

October 16, 2025 /

From the Editor

The stakes are high: news coverage of suicide can affect suicide rates. So how responsibly do journalists report? How has this changed with time?

In a new paper for The British Journal of Psychiatry, Dr. Mark Sinyor (of the University of Toronto) and his co-authors attempt to answer these questions. Focusing on US network news, they analyzed suicide-related news segments over an 11-year period, including for putatively harmful characteristics. “Coverage of suicide stories by major US cable news networks was often inconsistent with responsible reporting guidelines.” We consider the paper and its implications.

In the second selection from JAMA Psychiatry, Dr. Andrew S. Hyatt (of Harvard University) and his co-authors look at cannabis use after legalization and those individuals with psychosis. In this brief report, they drew from a US database with almost 2 000 participants. “In this study, individuals with psychosis reported a large increase in current cannabis use following legalization and commercialization of cannabis in their state, and by larger amounts than previously reported estimates of the general population.”

Is working from home better for mental health? In the third selection, from Mental Health & Prevention, Jean-Philippe Chaput (of the University of Ottawa) and his co-authors drew on national data to analyze work location and several self-rated measures, including mental health. The dataset is impressive with almost 25 000 participants. “We observed that work location was not related to self-rated mental health, life satisfaction, or life and work stress.”

DG

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Reading of the Week: Motor Vehicle Crashes and Mental Disorders – the New CJP Paper; Also, Psychedelics & the States, and Hogan on NYC & Coercion

May 18, 2023 /

From the Editor 

He’s not well but insists that he can still drive his car. Should you report him to the Ministry of Transportation?

As clinicians, we often struggle with such issues, which touch on clinical judgment, as well as legal requirements. In Ontario, half a decade ago, the governme­­nt changed the law, requiring mandatory reporting for several conditions, including “acute” psychosis. Yet other provinces continue to leave major decisions to the discretion of providers. What does the literature say about motor vehicle crashes and mental disorders? In the first selection, Dr. Mark J. Rapoport (of the University of Toronto) and his co-authors do a systematic review for The Canadian Journal of Psychiatry, drawing on 24 studies. “The available evidence is mixed, not of high quality, and does not support a blanket restriction on drivers with psychiatric disorder.” We consider the paper and its implications.

In the second selection, Dr. Joshua S. Siegel (of Washington University in St. Louis) and his co-authors look at US state legislation for psychedelic drugs in a new JAMA Psychiatry Special Communication. They note a sharp uptick in legislative activity and draw comparisons to cannabis. “After decades of legal restriction, US states have been swiftly moving toward increased access to psychedelics.”

And in the third selection, Michael F. Hogan (of Case Western Reserve University) writes about coercion and mental health care in JAMA Psychiatry. He considers the proposals of New York City Mayor Eric Adams which would expand efforts to hospitalize those with several, persistent mental illness. “Mayor Adams’ proposal for a more vigorous police response leading to inpatient care is well intended but incomplete. It would be preferable for New York to implement comprehensive crisis programs, including intensive care options that reduced the burden on police.”

DG

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Reading of the Week: Cannabis in America (and Canada) – the New JAMA Psychiatry Paper with Commentary

November 21, 2019 /

From the Editor

It’s legal. Are people using more? And has cannabis use disorder become more common?

This week, we look at a new paper considering cannabis legalization and use. The authors draw on American data where legalization is increasingly found across different states though not as extensively as in Canada; to date, 11 US states have legalized recreational cannabis, with 33 (and D.C.) having legalized medical marijuana.

In a new JAMA Psychiatry paper, Magdalena Cerdá and her co-authors use the National Survey on Drug Use, a major survey involving more than half a million participants, considering marijuana use, frequent use, and cannabis use disorder. What effect does legalization have? They find that cannabis use disorder is more common in adolescents after legalization and for adults who are 26 years of age and older, use, frequent use, and substance use are all up.

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We consider the paper. We also discuss the commentary that accompanies it. Finally, with an eye closer to home, we ask: are the findings relevant here in Canada?

DG

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Reading of the Week: Marijuana Policy After Legalization; Also, Remembering Charles Krauthammer

June 28, 2018 /

From the Editor

Last week, the Senate voted 52 to 29 in favour of Bill C-45, clearing the last hurdle for marijuana legalization. The federal government is aiming for implementation in the fall.

So, what now?

In the first selection, the University of Toronto’s Tony P. George et al. discuss a “framework” for cannabis policy post-legalization. This Canadian Journal of Psychiatry perspective paper is prescriptive, aiming to reduce the negative effects of the legal change. They make six recommendations, including a national strategy for education.


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Also, in this week’s Reading, we consider the life and psychiatric contributions of Charles Krauthammer, who died last week at age 68. Dr. Krauthammer is best known for his political commentary, but he had a career in psychiatry before becoming a prominent essayist, and penned a classic paper on “secondary mania.”

Please note that there will be no Reading next week.

DG

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Reading of the Week: Marijuana Use and Misuse

October 29, 2015 /

In the United States, laws and attitudes toward the use of marijuana are changing. Twenty-three states now have medical marijuana laws, and marijuana use is higher in states with such laws than in other states. Four of these states have also legalized marijuana for recreational use. More Americans now favor legalization of marijuana use than in previous years. Further, fewer Americans view marijuana use as risky, although studies have shown that use or early use of marijuana is associated with increased risk for many outcomes, including cognitive decline, psychosocial impairments, vehicle crashes, emergency department visits, psychiatric symptoms, poor quality of life, use of other drugs, a cannabis-withdrawal syndrome, and addiction risk. Further, marijuana use disorders (abuse or dependence) are associated with substantial comorbidity and disability and are consequently of substantial public health concern.

So begins a new paper looking at an old question: how does drug legalization affect use and misuse?

This week’s Reading: “Prevalence of Marijuana Use Disorders in the United States Between 2001-2002 and 2012-2013” by Deborah S. Hasin et al., just published online (and ahead of print) by JAMA Psychiatry.

You can find the paper here:

http://archpsyc.jamanetwork.com/article.aspx?articleid=2464591

Columbia University’s Hasin and her co-authors have picked a timely topic. Here’s a quick summary: as laws and public attitude have shifted, looking at U.S. survey data, they conclude that marijuana use has sharply increased. Continue reading