A recently published study from the Public Health Agency of Canada documents trends in cannabis-attributable hospitalizations and emergency department visits in Canada from 2007 to 2020.

The study, based on existing literature over a 14-year time period, shows steady annual increases in both categories, highlighting the impact cannabis use has on Canada’s public health system and the need for continued, ongoing monitoring of such trends.

This study was based on the ongoing Canadian Substance Use Costs and Harms (CSUCH) project, which estimates costs and harms dating back to 2007 across a range of substances and outcomes.

While extrapolating the data for all of Canada, it does not include reports from Quebec due to data access limitations. Emergency Department visit data with complete diagnostic information was available only for Ontario (2006/07–2020/21), Alberta (2010/11–2020/21), and Yukon (2014/15–2020/21), with data for other provinces being imputed.

As the report only goes until 2020, the direct impacts of legalization are not fully understood, but the report notes the impacts of various factors such as changes in Canada’s medical cannabis access laws over the 14-year time period, the proposal made during the 2015 federal election period to legalize cannabis, the impact of COVID-19, as well as the early impacts of introduction of federal cannabis legalization in October 2018. 

Rates of cannabis use appear to have increased in 2020 in part due to the COVID-19 pandemic and related policies, which the study also notes may have influenced these trends, further complicating the ability to understand the impact cannabis legalization has had on these long-term trends. 

In 2020, cannabis was responsible for an estimated 5,318 hospitalizations. The overall crude rate of cannabis-attributable inpatient hospitalizations increased by 120% between 2007 and 2020. The majority of this increase occurred prior to legalization (2007–2016). 

Following cannabis legalization, hospitalizations increased from a rate of 12.8 per 100,000 in 2019 to 14 per 100,000 in 2020 (9%). 

The largest percentage increase in crude rates of cannabis-attributable hospitalizations over the study period occurred among people under the age of 15. Females in this age group saw a 247% increase, while males saw a 226% increase. 

The crude rate of cannabis-attributable ED visits for acute intoxication (per 100,000) for people in Canada under the age of 15 was 2.8 to 2.9 in 2020. For those aged 15-34, it decreased from 26.1 to 24.9.

For individuals aged 35-64, the rate increased from 6.4 to 8.1, and for those over 65, there was a slight increase from 3.0 to 3.5.

The total cure rate for all cannabis-attributable hospitalizations in Canada based on available data was 30.8 in 2018 and 35.8 in 2020.

Rates of emergency department visits due to cannabis use peaked in 2019 among all age groups and then decreased in 2020.

For the purpose of comparison, Hospitalizations Entirely Caused by Alcohol (per 100,000) in 2023-2024 was 271. In 2020, over 62% of the total costs of substance use in Canada were due to alcohol and tobacco. In 2020, healthcare costs attributable to substance use in Canada were $13.4 billion (27.3% of the total cost of SU) or $386 per person in Canada. Alcohol ($6.3 billion) and tobacco ($5.4 billion) contributed about 87% of those costs.

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