The effect of non-medical cannabis retailer proximity on use of mental health services for psychotic disorders in Ontario, Canada

Jared C Wootten, Rebecca Rodrigues, Jason Gilliland, Brooke Carter, Salimah Z Shariff, Shiran Zhong, Suzanne Archie, Jordan Edwards, Tara Elton-Marshall, Daniel Thomas Myran, Lena Palaniyappan, Christopher M Perlman, Jamie A Seabrook, Robin M Murray and Kelly K Anderson

International Journal of Social Psychiatry, 2024, vol. 70, issue 2, 308-318

Abstract: Background: Cannabis is associated with the onset and persistence of psychotic disorders. Evidence suggests that accessibility of substances is associated with an increased risk of use-related harms. We sought to examine the effect of residing in proximity to non-medical cannabis retailers on the prevalence of health service use for psychosis. Methods: We conducted a cross-sectional study using linked health administrative data, and used geospatial analyses to determine whether people in Ontario, Canada (aged 14–60 years) resided within walking (1.6 km) or driving (5.0 km) distance of non-medical cannabis retailers (open as of February-2020). We identified outpatient visits, emergency department (ED) visits, and hospitalizations for psychotic disorders between 01-April-2019 and 17-March-2020. We used zero-inflated Poisson regression models and gamma generalized linear models to estimate the association between cannabis retailer proximity and indicators of health service use. Results: Non-medical cannabis retailers were differentially located in areas with high levels of marginalization and pre-existing health service use for psychosis. People residing within walking or driving distance of a cannabis retailer had a higher rate of psychosis-related outpatient visits, ED visits, and hospitalizations, compared to people living outside these areas. This effect was stronger among those with no prior service use for psychosis. Conclusions: Proximity to a non-medical cannabis retailer was associated with higher health service use for psychosis, even after adjustment for prior health service use. These findings suggest that opening of non-medical cannabis retailers could worsen the burden of psychosis on mental health services in areas with high-risk populations.

Keywords: Cannabis; psychotic disorders; mental health; epidemiology; mental health services; emergency department; hospitalization; outpatient psychiatric services (search for similar items in EconPapers)
Date: 2024
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Persistent link: https://EconPapers.repec.org/RePEc:sae:socpsy:v:70:y:2024:i:2:p:308-318

DOI: 10.1177/00207640231206053

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