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In 2018, Canada became the second country in the world to legalize the use and supply of cannabis for non-medical purposes. The official primary objectives of the government are protecting public health, restricting access by youth, and reducing illicit drug market activity. The mandate of protecting health and safety shifts the focus from justifying punitive responses to addressing increasing rates of use and related risk behaviours such as driving after cannabis use (DACU). To shed more light on DACU through comparison of data immediately before and after legalization in the Canadian experience, we conducted a multi-wave analysis of the National Cannabis Survey. With particular attention to the influence of gender on perceptions and behaviour of youth and young adults, our findings (reassuringly) suggest there have been no measurable increases in self-reported rates of DACU. Whereas gender is a reliably significant predictor, with DACU being far more common among males, we also found that females in this age group are just as likely to report having been as a passenger of a driver who recently used cannabis. The findings are interpreted with reference to research on education and prevention, and gendered variation in peer-based harm reduction initiatives for youth and young adults. [ABSTRACT FROM AUTHOR]

This article challenges the assumptions underlying the shared federal, provincial, and territorial goals of reducing criminal involvement in the drug trade and preventing substance use by youth. These official government objectives, it is argued, reflect a harmful tendency that continues the tradition of neglecting decades of sociological research on the efficiency of informal sources of control. Rather than continue to prioritize prevention, consistent evidence‐based policy development for cannabis requires articulation of more informed and realistic goals of harm reduction. New educational initiatives need to build on informal controls that more effectively regulate responsible substance use behaviour. [ABSTRACT FROM AUTHOR]

Cannabis (marijuana) has undergone a normalizing process as indicated by high use rates, social tolerance, and broader cultural acceptance of its use in many countries. Users also maintain access through extended friendship networks that facilitate the cultural diffusion of the practice. The social nature of supply is herein theorized in terms of Goffman's understanding of activities that function to preserve a sense of normalcy as a collective achievement enabling predictable constructions of reality. Based on in-depth interviews with undergraduate students, we explore how social networks of supply--characterized by casual access, reciprocity, and sharing--contribute to shared meanings about using marijuana as an unremarkable or "normal" thing to do. [ABSTRACT FROM AUTHOR]

Background/Objectives: The drug normalization framework investigates the social integration of substance use. This article contributes a quantitative assessment of cannabis normalization as differentiated by social location predictors. Methods: Logistic and zero-inflated negative binomial regression models assess three areas of cannabis normalization: accessibility, acceptability, and recent use. Peer network cannabis use prevalence, gender, nativity, campus locale and living arrangement are explored as focal predictors of variation in normalization among 1,713 cannabis using and nonusing undergraduate students in Canada. Results: Women report lower odds of positive cannabis acceptability attitudes. Whilewomen report lower rates of recent cannabis use, gender is not a significant predictor for lifetime prevalence. Being a recent immigrant significantly predicts lower recent use, lower odds of favorable attitudes to cannabis, and reduced accessibility in comparison to students born in Canada. Longer-term immigrants do not show significant differences from students born in Canada on accessibility and acceptability, suggesting a substance use acculturation effect. Lower peer cannabis use prevalence exhibits a protective effect against use. In comparison to students who report that "some" of their peer network uses cannabis, those with "all" users in their network exhibit lower acceptability attitudes. This suggests a threshold relationship between peer use prevalence and acceptability. Conclusions/Importance: This article provides a data point for assessing future shifts in cannabis normalization prior to impending changes in Canadian drug policy thatwill legalize recreational cannabis use. Results showthat normalization components of recent use, acceptability, and accessibility are differentiated by gender, nativity, and peer network cannabis use prevalence. [ABSTRACT FROM AUTHOR]

Aims: To critically investigate the extent of normalisation of the use of cannabis by undergraduate students. To examine the extent of peer accommodation, this paper focuses on attitudes of students who abstain. It sheds light on social meanings of the practice by exploring non-users’ reasons for abstaining in addition to their attitudes, perceptions and experiences of use among their peers.Methods: Respondents were recruited to participate in interviews through an online survey of undergraduate students in social science classes at three Canadian universities.Findings: Peer accommodation of the use of cannabis requires that users exercise due caution and discretion and be respectful of the choices of non-users not to use. Non-users’ attitudes, however, still reflect longstanding cultural assumptions about drug use as a deviant behaviour. Attitudes towards the use of cannabis reflect norms and expectations about gender among other culturally constructed social statuses and roles.Conclusions: Future research should continue to investigate nuances of the differentiated normalisation process. A better understanding of the cultural transformation of cannabis, and other drugs in common use by youth, requires more exploration of the emerging social context and attitudes of users and non-users of the drug. [ABSTRACT FROM PUBLISHER]

Objective: Comorbidity between anxiety and cannabis use is common yet the nature of the association between these conditions is not clear. Four theories were assessed, and a fifth hypothesis tested to determine if the misattribution of stress symptomology plays a role in the association between state-anxiety and cannabis. Methods:Three-hundred-sixteen participants ranging in age from 18 to 71 years completed a short online questionnaire asking about their history of cannabis use and symptoms of stress and anxiety. Results: Past and current cannabis users reported higher incidence of lifetime anxiety than participants who had never used cannabis; however, these groups did not differ in state anxiety, stress, or age of onset of anxiety. State-anxiety and stress were not associated with frequency of cannabis use, but reported use to self-medicate for anxiety was positively associated with all three. Path analyses indicated two different associations between anxiety and cannabis use, pre-existing and high state-anxiety was associated with (i) higher average levels of intoxication and, in turn, acute anxiety responses to cannabis use; (ii) frequency of cannabis use via the mediating effects of stress and self-medication. Conclusion: None of the theories was fully supported by the findings. However, as cannabis users reporting self-medication for anxiety were found to be self-medicating stress symptomology, there was some support for the stress-misattribution hypothesis. With reported self-medication for anxiety being the strongest predictor of frequency of use, it is suggested that researchers, clinicians, and cannabis users pay greater attention to the overlap between stress and anxiety symptomology and the possible misinterpretation of these related but distinct conditions. [ABSTRACT FROM AUTHOR]

Deterrence research has evolved considerably since the 1970s when a favourite offence for study was the emerging phenomenon of widespread cannabis use among mainstream populations. The deterrent model of crime prevention has expanded far beyond the study of objective and subjective indicators of certainty and severity to encompass social support, moral evaluations, peer involvement and, most recently, risk sensitivity and situational factors. Most earlier research found no evidence of deterrence of cannabis use, a finding attributed to its low actual and perceived risk of arrest and changes in public attitudes. This interview study with adult experienced cannabis users drawn from a representative survey base in Toronto, Canada, where possession is still treated as a criminal offence, provides a more nuanced interpretation of deterrence. The authors found that users had generally inaccurate knowledge about the current law and penalties and believed they would avoid arrest in the future. However, they were not oblivious to the possibility of police intervention, and took precautions such as carrying small amounts and avoiding public use. Thus, users were not unaffected by the law, but rather these discreet practices illustrate the operation of restrictive deterrence, shaping their choices of when, where and how to commit the crime of cannabis use. Further research on deterrence should examine situated choices by risk-sensitive offenders, and should also include cross-national patterns of arrest and user risk perceptions. While cannabis continues to be prohibited by international treaties, the reality of widespread use presents opportunities for innovative deterrence studies into this normalised yet illegal crime. The variation in policies, penalty structures and enforcement across European nations, compared to those in other Western jurisdictions, can foster relevant research for a transatlantic discussion about global drug policy transformation. [ABSTRACT FROM AUTHOR]

Once associated with 'deviant' subcultures, the use of cannabis is now common across Canadian society. This has led some to argue that cannabis use is becoming normalized in Canada with important implications for drug policy, law enforcement and public health. This article takes up these issues, reporting the results of a qualitative study involving 165, socially integrated, adult cannabis users in four Canadian cities (Vancouver, Montreal, Toronto and Halifax). The aims of this study were twofold; first, we sought to contribute to recent efforts to extend the analysis of normalization and its associated features from adolescent and young adult populations to older adults, with a particular focus on cannabis. Second, we wished to respond to recent calls for greater analysis of both the social and structural determinants of normalization, as well as its contingent, 'micro-level' features. Our examination of these diverse dimensions revealed significant changes in the meaning and status of cannabis use in Canada. Although some social and personal stigmas remain, our research suggests they are largely confined to the immoderate, 'irresponsible' use of cannabis, while more 'controlled' use among adults appears all but de-stigmatized. This process has involved changes in the ways risks associated with cannabis use are characterized and managed; shifts in the ways adult cannabis users seek to moderate their use; as well as broader social and cultural shifts in the meanings associated with cannabis in Canada. We conclude with a discussion of the potential impacts of these developments for drug policy debates in Canada and elsewhere. [ABSTRACT FROM AUTHOR]

Cannabis (marijuana) has undergone a normalizing process as indicated by high use rates, social tolerance, and broader cultural acceptance of its use in many countries. Yet, consistent with its status as a banned drug, users still face the threat of legal sanctions and experiences of stigma that challenge the assumptions of the normalization thesis. In this paper we shed light on extra-legal forms of stigma based on in-depth interviews with marijuana users (N = 92) randomly recruited in the city of Toronto. Notwithstanding indications of a normalizing process in respondents’ understanding and experience of use, mainstream conventional perspectives about cannabis as risky, even marginal or deviant, were prominent as well. The findings are interpreted with reference to Goffman’s (1963) theoretical distinction between normalization and the more apt description of normification reflected in the attitudes of marijuana users. Consistent with the latter term, these data indicate that stigma is internalized by users which results in the active reinforcement and performance of established cultural requirements emphasizing self-control. [ABSTRACT FROM PUBLISHER]

Despite the growing literatures on cannabis dependence, and urgent declarations as to treatment need, there is a scarcity of data on cannabis problems as a primary reason for treatment. This article compares characteristics of cannabis treatment seekers with those of a nontreatment sample of users. Findings are reported from two independent studies that included items from the DSM-IV criteria for diagnosing substance dependence and abuse. Other survey items covered different drug reactions, both positive and negative, commonly attributed to cannabis consumption. Adverse reactions, as expected, were more often reported by users in treatment, and positive effects by those in the nontreatment group. Expected differences on DSM measures of impairment were least pronounced for symptoms of compulsion as compared to other problems of dependence or indicators of abuse. Put otherwise, adverse effects are more germane or distinctive to the treatment seeker's profile than dependence in and of itself. The findings are interpreted as evidence in favor of expanding harm reduction oriented treatment options to target cannabis misuse, or psychosocial and health problems, as opposed to “chronic” use of cannabis per se. [ABSTRACT FROM AUTHOR]

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Despite the cross-culturally persistent high prevalence of cannabis use in general adult populations, in-depth analyses of extended use careers are uncommon in the scientific literature. This paper reports on in-depth interviews conducted with 104 users living in Toronto. Canada. A pretested questionnaire developed for use in a larger, cross-national study guided data collection on use levels and frequency from the first year to most recent month of use. The data support a controlled drug use model, with aggregate intake eventually decreasing and becoming stable or more moderate over time. Four main career patterns are identified and compared on measures of dependence and levels of consumption in the year prior to the study. In comparison with those whose long-term use has varied, stable users report fewer cannabis-related problems, despite using more heavily and frequently. While dependency problems are highly subjective, transitions in use patterns more generally reflect personal contingencies of lifestyle. [ABSTRACT FROM AUTHOR]

Based on structured interviews with 104 experienced users in Toronto, Canada, this article examines the perceived costs and benefits of cannabis consumption. A pretested questionnaire that was developed by Cohen and Sas ( 1998 ) in the Netherlands, and later translated for use in the U.S. and Germany as part of a three-city cross-national comparative study [(Reinarman et al . ( 2000 ). Is availability destiny? Drug use prevalence and discontinuance in Amsterdam, San Francisco and Bremen. Paper presented at the 11th International Conference on the Reduction of Drug-Related Harm, St. Helier, Jersey, Channel Islands, April 9-13, 2000; Cohen and Kaal ( 2001 ). The Irrelevance of Drug Policy: Patterns and Careers of Experienced Cannabis Use in the Populations of Amsterdam, San Francisco and Bremen. Centre for Drug Research, University of Amsterdam)] guided data collection on a range of drug effects, including measures of dependence inspired by DSM-IV criteria. The findings support a rational choice view of cannabis use insofar as reported advantages outweigh negative use outcomes. Top reasons for use pertain to relaxation and enhancement of recreational activities followed by coping with stress and anxiety. The frequency of respiratory and throat problems attributed to using cannabis underscores the perceived risk of pulmonary damage due to long-term heavy use. Whereas concerns about use levels nonetheless overshadowed other dependency indicators, including concern for personal health, however, no association was found between amounts nor frequency of use and the number of DSM-IV items reported by respondents. Users acknowledged and accepted the potential for dependence, adapting use levels accordingly when seen as problematic. [ABSTRACT FROM AUTHOR]

Abstract: An affinity between the evidence and arguments for drug normalization and the policy and programme directions favoured by harm reduction is often assumed but seldom critically examined. This commentary looks at parallels and contradictions emerging with respect to different cultures, social settings, types of problems and responses where the match is less than perfect. Mounting evidence of normalization has also led to backlash in some countries and the mobilization of forces reaffirming prohibition. We call for further research on normalization that focuses on substance use, risks, harms, and social context across a broader spectrum of the population, and in a variety of cultures. By emphasizing the most serious harms experienced by persons in the smallest segments of drug using populations, harm reduction often has neglected broader research and policy suggestions that might be implemented to benefit controlled, recreational drug users. Future policy development with respect to normalization will require more research and more serious discussion of its implications for informing the transition toward a global public health approach to substance use. [Copyright &y& Elsevier]

Background: It is now commonly accepted that there exists a form of drug supply, that involves the non-commercial supply of drugs to friends and acquaintances for little or no profit, which is qualitatively different from profit motivated 'drug dealing proper'. 'Social supply', as it has become known, has a strong conceptual footprint in the United Kingdom, shaped by empirical research, policy discussion and its accommodation in legal frameworks. Though scholarship has emerged in a number of contexts outside the UK, the extent to which social supply has developed as an internationally recognised concept in criminal justice contexts is still unclear.Methods: Drawing on an established international social supply research network across eleven nations, this paper provides the first assessment of social supply as an internationally relevant concept. Data derives from individual and team research stemming from Australia, Belgium, Canada, Czech Republic, Finland, Germany, Hong Kong, the Netherlands, England and Wales, and the United States, supported by expert reflection on research evidence and analysis of sentencing and media reporting in each context. In situ social supply experts addressed a common set of questions regarding the nature of social supply for their particular context including: an overview of social supply research activity, reflection on the extent that differentiation is accommodated in drug supply sentencing frameworks; evaluating the extent to which social supply is recognised in legal discourse and in sentencing practices and more broadly by e.g. criminal justice professionals in the public sphere. A thematic analysis of these scripts was undertaken and emergent themes were developed. Whilst having an absence of local research, New Zealand is also included in the analysis as there exists a genuine discursive presence of social supply in the drug control and sentencing policy contexts in that country.Results: Findings suggest that while social supply has been found to exist as a real and distinct behaviour, its acceptance and application in criminal justice systems ranges from explicit through to implicit. In the absence of dedicated guiding frameworks, strong use is made of discretion and mitigating circumstances in attempts to acknowledge supply differentiation. In some jurisdictions, there is no accommodation of social supply, and while aggravating factors can be applied to differentiate more serious offences, social suppliers remain subject to arbitrary deterrent sentencing apparatus.Conclusion: Due to the shifting sands of politics, mood, or geographical disparity, reliance on judicial discretion and the use of mitigating circumstances to implement commensurate sentences for social suppliers is no longer sufficient. Further research is required to strengthen the conceptual presence of social supply in policy and practice as a behaviour that extends beyond cannabis and is relevant to users of all drugs. Research informed guidelines and/or specific sentencing provisions for social suppliers would provide fewer possibilities for inconsistency and promote more proportionate outcomes for this fast-growing group. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to review the results and limitations of studies of injury risks associated with cannabis and cocaine use. Three types of fatal and non-fatal injuries are considered: injuries due to collisions, intentional injuries and injuries in general. Four types of studies were reviewed: (I) laboratory studies, (II) descriptive and analytic epidemiological studies on the prevalence of cannabis or cocaine use through drug testing of those injured, (III) studies of non-clinical samples, and (IV) studies of clinical samples of drug users. The research that utilized drug tests showed similar proportions testing positive for cannabis in fatal and non-fatal injury groups, and for collisions, violence and injuries in general. By contrast, large differences in the average proportions testing positive for cocaine were found among these same injury groups. For example, 28.7% of people with intentional injuries (primarily homicides) tested positive for cocaine, while 4.5% of injured drivers tested positive. Studies of non-clinical samples have shown that both cannabis and cocaine use are related to intentional injuries and injuries in general. Results indicate higher risk for all types of injuries among cannabis and cocaine clients in treatment. Strengths and limitations of the different types of studies are discussed. More rigorous studies are needed which should focus on ruling out alternative explanations for relationships between drug use and injuries. [Copyright &y& Elsevier]