Canada’s Recreational Cannabis Legalization and Medical Cannabis Patient Activity, 2017–2022

What is it about?

This study analyzed monthly Health Canada data from 2017-2022 regarding how many patients were registered to use medical cannabis, how often they purchased, and how much they bought. The analysis found that the passage of the Cannabis Act in June 2018 was immediately followed by slowing patients registration rates, but there was no significant change in either purchasing frequency or purchase sizes. After legal sales started in October 2018, there was no apparent change in registration rates or purchase sizes, but patients purchased medical cannabis less often. When sales of edibles and vapes began in December 2019, patient registration rates declined again. However, purchase frequencies stopped falling and purchase sizes increases. These results imply that after recreational cannabis legalization, many patients left Canada's medical cannabis system, but the patients who remained became more active. Other countries legalizing recreational cannabis might therefore see similarly large changes in their existing medical cannabis systems.

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Why is it important?

Before recreational legalization in Oct 2018, patients worried that physicians would stop authorizing cannabis, or that producers would abandon the medical market. Afterward, observers noted that patient registrations were declining, and so they wondered if the medical market had become obsolete. However, less attention was paid to the details of those declines and their implications: was it all bad news? Many patients stayed in the system: did their use change? What did all this imply about the legitimacy of medical cannabis before legalization, or the need for it afterward? Other countries that are legalizing recreational cannabis will also need to consider how their medical cannabis systems might be affected.