I am delighted to serve as Guest Editor for this Special Issue of the Canadian Journal of Addiction focusing on the timely topic of “Current Perspectives on Cannabis in Mental Health.” There arguably has never been a more exciting time for scientific research and clinical practice related to cannabis in Canada. This is clearly reflected in the rapid expansion of research programs and academic centres related to cannabis as well as targeted funding announcements from Canadian health research agencies. Capitalizing on the growing excitement around cannabis, this Special Issue brings together a diverse collection of articles and expert commentaries on the current state of cannabis and mental health. The articles selected for this issue primarily examine research questions that align with the journal's focus on addiction medicine. Consideration of therapeutic benefits of cannabis is generally outside the scope of the Special Issue, although several of the articles do discuss issues related to medicinal use. This editorial summarizes the background and rationale for the Special Issue and provides an overview of the included articles.
The regulatory landscape of cannabis in Canada has evolved dramatically in recent years, culminating with federal legalization of recreational cannabis in October 2018. This shift in legal status was the result of a long process that was influenced by many groups, including policy makers, public health and law enforcement officials, medical professionals, academic scientists, and community groups. With the potential for wider access to cannabis products following legalization, there is an increased demand for empirical research to inform policy, prevention, treatment, and public education efforts to mitigate potential harms. Fortunately, the scientific community has responded to this need by charting new research directions on the risks and benefits associated with recreational and therapeutic use of cannabis. Mental health professionals, physicians, and addictions researchers are particularly invested in expanding the study of cannabis given the increasing role this substance plays in their scholarly and clinical work. This includes understanding the factors that contribute to cannabis use and misuse along with investigating potential consequences in specific subpopulations such as youth and persons with mental illnesses.
With these guiding priorities in mind, we endeavoured to assemble a collection of articles that address pressing topics in cannabis science and clinical practice. This Special Issue is comprised of 9 articles that include original research studies in human participants and translational animal models, critical appraisals of the Canadian government's approach to cannabis legalization, and commentaries on the history and emerging priorities for cannabis research in Canada. First, the commentary by Brewster (pp. 6–9) traces the historical roots of cannabis research in Canada, from the Le Dain Commission through legalization with an emphasis on how the legal status of cannabis impacted the type and amount of research being conducted. Next, the 2 articles by Romano et al (pp. 10–21) and Hellemans et al (pp. 22–29) examine sociodemographic, mental health, and psychological factors that contribute to cannabis use among Canadian high school and university students, respectively. The next 2 articles focus on cannabis use in clinical populations, including individuals seeking outpatient treatment for anxiety and related disorders (Ouellette et al, pp. 30–37) and problematic cannabis use among people with type 1 diabetes (Camsari et al, pp. 38–41). The study by Teeters et al (pp. 42–50) employs a behavioural economic methodology to investigate predictors of driving after cannabis use among university students, an especially risky behaviour that contributes to high rates of traffic accidents, injuries, and fatalities. DeVillaer (pp. 51–59) then provides a critical analysis of the Canadian approach to legalization, arguing that the public health approach proposed by the Canadian government has not been sufficiently adopted despite its many potential benefits. Finally, the study by Nelong et al (pp. 60–66) investigated the impact of exposure to vapourized cannabis on neural activity in a preclinical animal model. This study was included as an excellent example of how innovative laboratory animal research can uncover novel insights about cannabis effects that are often difficult to experimentally manipulate in humans. The Special Issue concludes by looking toward the future, with MacKillop (pp. 67–71) proposing a comprehensive framework of priority areas for cannabis research in Canada.
In summary, the onset of cannabis legalization generated a new frontier for scientific research and clinical practice in Canada. The articles in this Special Issue reflect novel and high-quality research on the intersection between cannabis and mental health. Broader dissemination of knowledge gained from research in these domains is critically important to increase the evidence base for clinicians, researchers, policy makers, community members, and other stakeholders to effectively respond to changes that occur in this exciting post-legalization era. The Canadian Journal of Addiction is excited to contribute to the growing scholarly discourse on cannabis and mental health with the publishing of this Special Issue.
MA is supported in part by the Peter Boris Centre for Addictions Research at McMaster University and St. Joseph's Healthcare Hamilton. The authors recognizes and acknowledges that this work was completed on the traditional territories of the Mississauga and Haudenosaunee nations, and within the lands protected by the Dish With One Spoon wampum agreement.
Editor in Chief's Note on CJA's Special Issue
The CJA Editorial team members are each assuming the role of Guest Editor for Special Issues reflecting their areas of interest. Dr Michael Amlung has collated this Special Issue: Current Perspectives on Cannabis in Mental Health as part of our reflection on cannabis legalization in Canada.
Michael Amlung, PhD, is an Assistant Professor at McMaster University in the Department of Psychiatry and Behavioral Neurosciences, a core faculty member in the Peter Boris Centre for Addictions Research, and Director of the Cognitive Neuroscience of Addictions Laboratory (CNALab). Dr Amlung's interests now encompass cannabis as part of the Michael G. DeGroote Centre for Medicinal Cannabis Research.
Hoping you will enjoy the Issue. We thank Dr Amlung for his efforts.
Nady el-Guebaly, C.M., MD, FRCPC
Editor in Chief, CJA-JCA