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

Cannabis emergency department epidemiology hospitalization mental health mental health services outpatient psychiatric services psychotic disorders

Journal

The International journal of social psychiatry
ISSN: 1741-2854
Titre abrégé: Int J Soc Psychiatry
Pays: England
ID NLM: 0374726

Informations de publication

Date de publication:
27 Oct 2023
Historique:
medline: 27 10 2023
pubmed: 27 10 2023
entrez: 27 10 2023
Statut: aheadofprint

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND UNASSIGNED
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 UNASSIGNED
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 UNASSIGNED
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 UNASSIGNED
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.

Identifiants

DOI: 10.1177/00207640231206053 PMID: 37886802
pubmed: 37886802
doi: 10.1177/00207640231206053
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

207640231206053

Déclaration de conflit d'intérêts

DisclosuresLena Palaniyappan reports personal fees for serving as chief editor from the Canadian Medical Association Journals, speaker/consultant fees from Janssen Canada and Otsuka Canada (2019), SPMM Course Limited, UK, Canadian Psychiatric Association; book royalties from Oxford University Press; investigator-initiated educational grants from Janssen Canada, Sunovion and Otsuka Canada outside the submitted work.

Auteurs

Jared C Wootten (JC)

Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.

Rebecca Rodrigues (R)

Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.

Jason Gilliland (J)

Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Department of Pediatrics, Western University, London, ON, Canada.
Department of Geography and Environment, Western University, London, ON, Canada.
Lawson Health Research Institute, London Health Sciences Centre, ON, Canada.

Brooke Carter (B)

ICES Western, London, ON, Canada.

Salimah Z Shariff (SZ)

Lawson Health Research Institute, London Health Sciences Centre, ON, Canada.
ICES Western, London, ON, Canada.
Department of Nursing, Western University, London, ON, Canada.

Shiran Zhong (S)

Department of Geography and Environment, Western University, London, ON, Canada.

Suzanne Archie (S)

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.

Jordan Edwards (J)

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.

Tara Elton-Marshall (T)

Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
School of Epidemiology and Public Health, University of Ottawa, ON, Canada.
Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Dalla Lana School of Public Health, University of Toronto, ON, Canada.

Daniel Thomas Myran (DT)

Department of Family Medicine, University of Ottawa, ON, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada.
ICES uOttawa, Ottawa Hospital Research Institute, ON, Canada.

Lena Palaniyappan (L)

Department of Psychiatry, Western University, London, ON, Canada.
Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, PQ, Canada.

Christopher M Perlman (CM)

School of Public Health Sciences, University of Waterloo, ON, Canada.

Jamie A Seabrook (JA)

Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Department of Pediatrics, Western University, London, ON, Canada.
Lawson Health Research Institute, London Health Sciences Centre, ON, Canada.
School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada.
ORCID: 0000-0003-4297-6450

Robin M Murray (RM)

Institute of Psychiatry, Psychology, and Neuroscience, King's College London, UK.

Kelly K Anderson (KK)

Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
Lawson Health Research Institute, London Health Sciences Centre, ON, Canada.
ICES Western, London, ON, Canada.
Department of Psychiatry, Western University, London, ON, Canada.
ORCID: 0000-0001-9843-404X

Classifications MeSH