Cannabis, Behaviours, COVID-19 and a Template For International Comparisons : Canadian Journal of Addiction

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Cannabis, Behaviours, COVID-19 and a Template For International Comparisons

Nady, el-Guebaly CM, MD, FRCPC

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The Canadian Journal of Addiction 13(3):p 4-5, September 2022. | DOI: 10.1097/CXA.0000000000000153
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Since its legalization in 2018, cannabis-related issues continue to be a focus for Canadian scholars. Two literature reviews are included in this issue: Bahji et al1 analyze an increase of cannabis consumption in Canadian households in both prelegalization and postlegalization times, based on 29 Statistics Canada surveys; Bahji and Gorelick,2 in a secondary analysis of lifetime and past year prevalence of cannabis withdrawal syndrome differentiate factors elicited with one or both prevalence metrics.

A second topic of broad interest is the impact of coronavirus disease 2019 (COVID-19) on various behaviours. Purias et al3 report the results of an online questionnaire of shoppers during the pandemic with online shoppers demonstrating greater scores on 2 measures of problem shopping as well as associated sex difference with gaming involvement. In the second COVID-related article, Shaw et al4 analyze the impact of social lockdown on gambling activities. The third article, by Hawke et al,5 deals with the associated substance use in youth.

These 3 papers are part of our COVID Chronicles series, so far 17 Editorials, Commentaries, or Research Articles have been published in the CJA over the last 2 years.6–17

At the time of writing this Editorial, a seventh COVID wave is announced, spurred mainly by the Omicron BA.5 variant. Further stress on our health system is looming once more including closures of emergency services in peripheral areas due to staff shortages from infections or burnouts after 2 years of relentless working conditions. This body of work calls for a comparison of the relative impact of the pandemic and related public health measures in our country versus others.

Recently, The Canadian Medical Association Journal has published a noteworthy template for international comparisons.18 Ten comparator countries were chosen on the basis of similarities in economic and political models, per capita income levels and population size. Several data repositories were mined. The comparisons included the G7 countries plus Belgium, the Netherlands, Sweden, and Switzerland. The metrics used in the analysis included infections, related and excess deaths, percentage of population vaccinated, societal restrictions, and economic impact. Canada had among the most sustained and stringent policies based on the Oxford Stringency Index, that is, restrictions on internal movement, public events and gatherings, workplace closures, and international controls.19

In conclusion, I draw attention to this article as we debate our current and future policies including the many impacts in our field, be it opioid and/or methamphetamine use, overdoses, social isolation, limited access to treatment, use of telehealth, and recovery efforts, to name a few. We look forward for this COVID template to be a good platform to be emulated and amended for our international comparisons.


1. Bahji A, Kaur S, Devoe D, et al. Trends in Canadian cannabis consumption over time: a two-step meta-analysis of Canadian household survey data. Can J Addict 2022;13(3):6–13.
2. Bahji A, Gorelick D. Factors associated with past-year and lifetime prevalence of cannabis withdrawal. Can J Addict 2022;13(3):14–25.
3. Puiras E, Cummings S, Oliver C, et al. Add to cart: problematic shopping and behavioral addictions. Can J Addict 2022;13(3):26–35.
4. Shaw C, Hodgins D, Williams R, et al. Gambling in Canada during the pandemic: six months after the national COVID lockdown. Can J Addict 2022;13(3):36–45.
5. Hawke L, Sheikhana N, Oates S, et al. Impact potpourri: a multimethod study on youth substance use during COVID-19. Can J Addict 2022;13(3):46–55.
6. el-Guebaly N. COVID-19 and social distancing. Can J Addict 2020;11(2):4–6.
7. Crockford D. The COVID-19 pandemic and its impact on addiction treatment. Can J Addict 2020;11(2):7–8.
8. Cherkasova M. Addiction in the times of pandemic. Can J Addict 2020;11(2):9–12.
9. el-Guebaly N. COVID-19 and the seeds of unrest. Can J Addict 2020;11(3):4–5.
10. el-Guebaly N. 2020—a year of reckoning. Can J Addict 2021;12(1):4–5.
11. Hong RH, Fairbairn N. Provision of lower barrier, patient-centred care and safer supply of substances in the time of dual crises. Can J Addict 2021;12(1):16–17.
12. el-Guebaly N. Viruses, variants, and vaccines: overcoming despair. Can J Addict 2021;12(2):4–5.
13. Bahji A, Danilewitz M, Crockford D. Supporting persons who use drugs during the COVID-19 pandemic: a rapid review of international guidelines. Can J Addict 2021;12(2):6–18.
14. Chopra N, Pereira C, Prata A, et al. Building substance use disorder management capacity during COVID-19: Outcomes from a tele-mentoring program for community-based healthcare professionals. Can J Addict 2021;12(2):19–23.
15. el-Guebaly N. Diverse hopes for 2022. Can J Addict 2022;13(2):4.
16. Imtiaz S, Hamilton H, Jankowicz D, et al. Cannabis use, increased cannabis use and cannabis use frequency in the context of COVID pandemic in Canada. Can J Addict 2022;13(2):23–27.
17. Li A, Philpott J, Danilewitz M. Opioid prescriptions in primary care for opioid naïve patients during the COVID-19 pandemic. Can J Addict 2022;13(2):28–29.
18. Razak F, Shin S, Naylor CD, et al. Canada’s response to the initial 2 years of the COVID-19 pandemic: a comparison with peer countries. CMAJ 2022;194:E870–E877. doi:10.1503/cmaj.220316
19. Hale T, Angrist N, Goldszmidt R, et al. “A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker).” Nature Human Behaviour; 2021. Available at: Accessed June 30, 2022.
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