Fig 1.
Timeline of medical and recreational cannabis access regimes in Canada.
Note: MMAR: Marihuana Medical Access Regulations. MMPR: Marihuana for Medical Purposes Regulations. ACMPR: Access to Cannabis for Medical Purposes Regulations.
Fig 2.
Number of physicians prescribing patient medical cannabis use (panel a), number of authorized patients, in thousands (panel b) and number of patients per physician (panel c), by month, 2003–5 to 2014–3 (MMAR) and 2014–4 to 2021–12 (MMPR/ACMPR). Note: Monthly data from the Marihuana Medical Access Regulations (MMAR) regime in blue. Data from the Marihuana for Medical Purposes Regulations (MMPR) and Access to Cannabis for Medical Purposes Regulations (ACMPR) regimes in red. The vertical line indicates the date of legalization of use of non-medical cannabis (October 2018). Data source: Health Canada administrative data provided to the authors.
Fig 3.
Volume of cannabis sales from Licensed Producers to registered patients, by cannabis presentation and month.
Panel (a) Volume in kilograms; dry and oil-based presentations; 2014–04 to 2019–09. Panel (b) Volume in packaged units; dry, extracts, and edible presentations; 2019–10 to 2022–03. Panel (a) data source: Health Canada administrative data provided to the authors. Note: after September 2018, cannabis oil sales volumes were measured in litres, not kilograms. Panel (b) data source: Health Canada administrative data obtained from Government of Canada Open Government website [20].
Fig 4.
Fraction of cannabis products sold by Licensed Producers, by THC and CBD concentrations, month (2016–06 to 2022–12) and presentation: Oil vs dry cannabis.
Data Source: monthly review of on-line Licensed Producers product catalogs.
Fig 5.
Mean real price of cannabis sold by Licensed Producers, by THC and CBD concentration, month (2016–06 to 2022–12) and presentation: dry (a) and oil (b). Data Source: monthly review of on-line product catalogs of Licensed Producers. Note: nominal prices deflated using all-item CPI with 2016–07 = 100. Prices do not include sales and excise taxes.
Table 1.
Number of patients, number of patients with cannabis production licenses, and number of cannabis plants authorized under the MMAR, December 2013, by province.
Fig 6.
Number of cannabis shipments from Licensed Producers per 1,000 population, by month, 2013–08 to 2022–03, and patient province of residence.
Note: The first red vertical line indicates the date of introduction of the Access to Cannabis for Medical Purposes Regulations (August 2016), which allowed those authorized to use medical cannabis to cultivate cannabis for personal use; the second red vertical line indicates the date of legalization of use of non-medical cannabis (October 2018). Data source: Health Canada administrative data provided to the authors.
Table 2.
Provincial College of Physicians restrictions on prescribing of medical cannabis, by province, April 2016.
Fig 7.
Average monthly cannabis shipments from Licensed Producers per 100,000 population, March to May 2016, and composite cannabis prescribing restriction score, by province.
Note: BC = British Columbia, AB = Alberta, SK = Saskatchewan, MB = Manitoba, ON = Ontario, QC = Quebec, NB = New Brunswick, NS = Nova Scotia, PE = Prince Edward Island, NF = Newfoundland and Labrador. Shipments Data Source: Health Canada administrative data provided to the authors.
Fig 8.
Ratio of patients enrolled in medical cannabis access program to the estimated population aged 20 years and older that uses cannabis daily or weekly, by province, July 2015.
Data Source: Enrollment in medical access program (MAP): Health Canada administrative data provided to the authors. Estimated population aged 20 years and older that uses cannabis daily or weekly: 2015 Statistics Canada Canadian Tobacco, Alcohol and Drugs Survey. BC = British Columbia, AB = Alberta, SK = Saskatchewan, MB = Manitoba, ON = Ontario, QC = Quebec, NB = New Brunswick, NS = Nova Scotia, PE = Prince Edward Island, NL = Newfoundland and Labrador.
Fig 9.
Estimated fraction of community dwelling population aged 20 years and older that consumes cannabis daily or almost daily, by province, survey, and year, 1989–2021.
Note: the blue line is a median spline curve fitted to the provincial estimates (the blue dots). The red vertical lines indicate the introduction of the following policies: 1) the 2001 Marihuana Medical Access Regulations (MMAR) regime which provided medical cannabis access to severely ill patients; 2) the 2014 Marihuana for Medical Purposes Regulations (MMPR) regime which delegated medical cannabis authorization to physicians and expanded the indications for cannabis use; and 3) the 2018 legalization of recreational cannabis. Data source: 1989 National Alcohol and Drugs Survey; 1994 Canada’s Alcohol and Other Drugs Survey; 2002 Canadian Community Health Survey; 2004 Canada Addiction Survey (CAS); 2005–2013 Canadian Tobacco Use Monitoring Survey; 2008–2012 Canadian Alcohol and Drug Use Monitoring Surveys (CADUMS); 2013, 2015, 2017 Canadian Tobacco, Alcohol and Drugs Survey; 2019–2021 Canadian Tobacco and Nicotine Survey; and the 2018, 2019 and 2020 National Cannabis Survey (NCS). All surveys were conducted by Statistics Canada except for the 2004 CAS, the 2008–2012 CADUMS, and the 2018–2020 NCS which were commissioned by Health Canada and conducted by private sector survey firms.
Fig 10.
Estimated fraction of national community dwelling population aged 20 years and older that consumes cannabis daily or almost daily, by month, and estimated fraction of population age 20 years and older enrolled in medical cannabis access program, by month 2005m1 – 2021m12.
Note: the blue line is a median spline curve fitted to the national estimates of fraction of population 20+ that uses cannabis daily (the blue dots). The red line is a median spline curve fitted to the national participation rates in the medical access program (the red dots). The green vertical lines indicate the introduction of the following policies: 1) the 2014 Marihuana for Medical Purposes Regulations (MMPR) regime which delegated medical cannabis authorization to physicians and expanded the indications for cannabis use; and 2) the October 2018 legalization of recreational cannabis.