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The Devil Is in the Details! On Regulating Cannabis Use in Canada Based on Public Health Criteria Comment on "Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts".

ABSTRACT: This commentary to the editorial of Hajizadeh argues that the economic, social and health consequences of legalizing cannabis in Canada will depend in large part on the exact stipulations (mainly from the federal government) and on the implementation, regulation and practice of the legalization act (on provincial and municipal levels). A strict regulatory framework is necessary to minimize the health burden attributable to cannabis use. This includes prominently control of production and sale of the legal cannabis including control of price and content with ban of marketing and advertisement. Regulation of medical marijuana should be part of such a framework as well.

SUBMITTER: Rehm J

PROVIDER: S-EPMC5337256 | biostudies-other | 2016 Aug

REPOSITORIES: biostudies-other

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The Challenges of Projecting the Public Health Impacts of Marijuana Legalization in Canada Comment on "Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts".

Project description:A recent editorial in this journal provides a summary of key economic, social, and public health considerations of the forthcoming legislation to legalize, regulate, and restrict access to marijuana in Canada. As our government plans to implement an evidence-based public health framework for marijuana legalization, we reflect and expand on recent discussions of the public health implications of marijuana legalization, and offer additional points of consideration. We select two commonly cited public concerns of marijuana legalization - adolescent usage and impaired driving - and discuss how the underdeveloped and equivocal body of scientific literature surrounding these issues limits the ability to predict the effects of legalization. Finally, we discuss the potential for some potential public health benefits of marijuana legalization - specifically the potential for marijuana to be used as a substitute to opioids and other risky substance use - that have to date not received adequate attention.

| S-EPMC5417150 | biostudies-other

How Useful Are Early Economic Models? Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modelling".

Project description:Early economic modelling has long been recommended to aid research and development (R&D) decisions in medical innovation, although they are less frequently published and critically appraised. A review of 30 innovations by Grutters et al provides an opportunity to evaluate how early models are used in practice. The evidence of early models can be used to inform two types of decision: to continue development ("stop or go") or to alter future R&D activities. I argue that early models have limited use in stop or go decisions, as less resource and data undermine the reliability of the models' indicative estimates of cost-effectiveness. Whilst they are far more useful for informing future R&D directions, the best techniques available from statistical decision science, such as value of information analysis, are not regularly used. It is highly recommended that early models adopt these methods to best deal with uncertainty, quantify the potential value of further research, identify areas of study with the greatest potential benefit and generate recommendations on study design and sample size.

| S-EPMC7306112 | biostudies-literature

Assessing the climate suitability and potential economic impacts of Oak wilt in Canada.

Project description:We assess risks posed by oak wilt-a disease caused by the fungal pathogen Bretziella fagacearum. Though not currently found in Canada, our distribution models indicate that suitable climate conditions currently occur in southern Ontario for B. fagacearum and two of its main insect dispersal vectors, Colopterus truncatus and Carpophilus sayi. Climate habitat for these species is projected to expand northward under climate change, with much of the oak range in eastern Canada becoming climatically suitable within the next two decades. Potential costs for the removal and replacement of oak street trees ranged from CDN$266 to $420 million, with variation related to uncertainty in costs, rate of tree replacement, and city-level estimates of oak street tree density. The value of standing oak timber in eastern Canada was estimated at CDN$126 million using provincial stumpage fees and as a CDN$24 million annual contribution to national Gross Domestic Product (GDP) when calculated using a combination of economic and forestry product statistics. These values can help inform the scale of eradication and/or management efforts in the event of future oak wilt introductions.

| S-EPMC7656453 | biostudies-literature

Early Health Economic Modelling - Optimizing Development for Medical Device Developers? Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling".

Project description:This commentary considers the positive and negative consequences of early economic modelling and explores potential future directions. Early economic modelling offers device manufacturers an opportunity to assess the potential value of an innovation at an early stage of development. Early modelling can direct resources into potentially viable technologies and reduce investment in technologies with limited prospect of value. However, it is unclear whether early modelling is sufficiently specific to identify innovations with low value. It may be that early modelling is more useful for directing data gathering to reduce decision uncertainty. Early modelling is of primary benefit to the manufacturer and may have both positive and negative consequences for reimbursement processes that should be considered.

| S-EPMC7557429 | biostudies-literature

Transforming Disciplinary Traditions Comment on "Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling".

Project description:Grutters et al show that economic assessments can inform the development of new health technologies at an early stage. This is an important contribution to health services and policy research, which implies a "shift away" from the more traditional forms of academic health economic modeling. Because transforming established disciplinary traditions is both valuable and demanding, we invite scholars to further the discussion on how the value of health innovations should be appraised in view of today's societal challenges.

| S-EPMC7444432 | biostudies-literature

Aeroallergens in Canada: Distribution, Public Health Impacts, and Opportunities for Prevention.

Project description:Aeroallergens occur naturally in the environment and are widely dispersed across Canada, yet their public health implications are not well-understood. This review intends to provide a scientific and public health-oriented perspective on aeroallergens in Canada: their distribution, health impacts, and new developments including the effects of climate change and the potential role of aeroallergens in the development of allergies and asthma. The review also describes anthropogenic effects on plant distribution and diversity, and how aeroallergens interact with other environmental elements, such as air pollution and weather events. Increased understanding of the relationships between aeroallergens and health will enhance our ability to provide accurate information, improve preventive measures and provide timely treatments for affected populations.

| S-EPMC6121311 | biostudies-literature

Drug vaping applied to cannabis: Is "Cannavaping" a therapeutic alternative to marijuana?

Project description:Therapeutic cannabis administration is increasingly used in Western countries due to its positive role in several pathologies. Dronabinol or tetrahydrocannabinol (THC) pills, ethanolic cannabis tinctures, oromucosal sprays or table vaporizing devices are available but other cannabinoids forms can be used. Inspired by the illegal practice of dabbing of butane hashish oil (BHO), cannabinoids from cannabis were extracted with butane gas, and the resulting concentrate (BHO) was atomized with specific vaporizing devices. The efficiency of "cannavaping," defined as the "vaping" of liquid refills for e-cigarettes enriched with cannabinoids, including BHO, was studied as an alternative route of administration for therapeutic cannabinoids. The results showed that illegal cannavaping would be subjected to marginal development due to the poor solubility of BHO in commercial liquid refills (especially those with high glycerin content). This prevents the manufacture of liquid refills with high BHO concentrations adopted by most recreational users of cannabis to feel the psychoactive effects more rapidly and extensively. Conversely, "therapeutic cannavaping" could be an efficient route for cannabinoids administration because less concentrated cannabinoids-enriched liquid refills are required. However, the electronic device marketed for therapeutic cannavaping should be carefully designed to minimize potential overheating and contaminant generation.

| S-EPMC4881394 | biostudies-other

Unintentional Pediatric Cannabis Exposures After Legalization of Recreational Cannabis in Canada.

Project description: Not available

| S-EPMC8742190 | biostudies-literature

Valuing Health Impacts In Climate Policy: Ethical Issues And Economic Challenges.

Project description:Deciding which climate policies to enact, and where and when to enact them, requires weighing their costs against the expected benefits. A key challenge in climate policy is how to value health impacts, which are likely to be large and varied, considering that they will accrue over long time horizons (centuries), will occur throughout the world, and will be distributed unevenly within countries depending in part on socioeconomic status. These features raise a number of important economic and ethical issues including how to value human life in different countries at different levels of development, how to value future people, and how much priority to give the poor and disadvantaged. In this article we review each of these issues, describe different approaches for addressing them in quantitative climate policy analysis, and show how their treatment can dramatically change what should be done about climate change. Finally, we use the social cost of carbon, which reflects the cost of adding carbon emissions to the atmosphere, as an example of how analysis of climate impacts is sensitive to ethical assumptions. We consider $20 a reasonable lower bound for the social cost of carbon, but we show that a much higher value is warranted given a strong concern for equity within and across generations.

| S-EPMC7891186 | biostudies-literature

Health and economic impacts of eight different dietary salt reduction interventions.

Project description:BackgroundGiven the high importance of dietary sodium (salt) as a global disease risk factor, our objective was to compare the impact of eight sodium reduction interventions, including feasible and more theoretical ones, to assist prioritisation.MethodsEpidemiological modelling and cost-utility analysis were performed using a Markov macro-simulation model. The setting was New Zealand (NZ) (2.3 million citizens, aged 35+ years) which has detailed individual-level administrative cost data.ResultsOf the most feasible interventions, the largest health gains were from (in descending order): (i) mandatory 25% reduction in sodium levels in all processed foods; (ii) the package of interventions performed in the United Kingdom (UK); (iii) mandatory 25% reduction in sodium levels in bread, processed meats and sauces; (iv) media campaign (as per a previous UK one); (v) voluntary food labelling as currently used in NZ; (vi) dietary counselling as currently used in NZ. Even larger health gains came from the more theoretical options of a "sinking lid" on the amount of food salt released to the national market to achieve an average adult intake of 2300 mg sodium/day (211,000 QALYs gained, 95% uncertainty interval: 170,000-255,000), and from a salt tax. All the interventions produced net cost savings (except counseling--albeit still cost-effective). Cost savings were especially large with the sinking lid (NZ$ 1.1 billion, US$ 0.7 billion). Also the salt tax would raise revenue (up to NZ$ 452 million/year). Health gain per person was greater for Māori (indigenous population) men and women compared to non-Māori.ConclusionsThis study substantially expands on the range of previously modelled salt reduction interventions and suggests that some of these might achieve major health gains and major cost savings (particularly the regulatory interventions). They could also reduce ethnic inequalities in health.

| S-EPMC4409110 | biostudies-literature

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