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Annual cannabis survey reveals many positive trends — and some concerning ones

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By Alexandra Keeler

On Christmas Eve, during his final year of high school, Justin Schneider’s friend handed him his first bowl of weed.

Schneider says he remembers it being an especially stressful evening and thinking, ‘Oh my God, they were lying to us about this.’

“Here I was this ‘good kid,’ staying away from alcohol and drugs, but this stuff is the best thing I’ve ever had,” he said. “But that reaction was brought on because it was the first time I’d ever taken any type of medication for anxiety.”

At first, Schneider used cannabis to cope with generalized anxiety, depression and insomnia. By his late twenties, he had become a heavy user.

In 2018, after more than 20 years of daily cannabis use, he was finally able to overcome his cannabis dependency with the help of a psychiatrist and addictions counselor.

Canadians’ relationship with cannabis has shifted dramatically since it was first legalized for non-medical use in 2018, a new survey shows.

The 2024 Canadian Cannabis Survey, released by Health Canada Dec. 6, reveals cannabis use has become increasingly normalized, driven by broader legal access and growing social acceptance. It also suggests legalization has achieved many of policymakers’ key goals.

But Schneider and others warn cannabis is not without its risks, and say better public education is required to address some of cannabis’ lesser known risks.

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‘Some sketchy guy’

Health Canada’s annual survey, which collected responses from more than 1,600 Canadians aged 16 and older, reveals a thriving legal cannabis market in Canada.

The number of users purchasing cannabis through legal channels has nearly doubled since legalization, rising from 37 per cent in 2019 to 72 per cent today.

“I imagine if I was just starting out [with cannabis] now, I wouldn’t ever have to interact with some sketchy guy, and that would have been easier growing up,” said Jesse Cohen, a 34-year-old daily cannabis user from Montreal.

Cohen uses cannabis to unwind after work or while performing menial tasks at home. Today, he picks up his supply from a sleek, well-lit government-regulated dispensary. He feels this interaction is safer than buying it on the black market.

Cohen says he has also seen the quality and variety of products on the market improve — accompanied by an increase in price.

In the survey, just over one-quarter of all respondents said they used cannabis for non-medical purposes in the past year, up from 22 per cent in 2018. Among youth, that number was 41 per cent.

The number of youth using cannabis has remained stable since 2018, a finding that challenges some critics’ claims that legalization would lead to higher rates of youth consumption.

“For youth, I do think that the whole legalization de-stigmatized and took the risk out of it — it wasn’t a taboo subject or a taboo activity anymore — so there wasn’t the same draw,” said Ian Culbert, executive director of the Canadian Public Health Association, a non-profit that promotes public health.

“Let’s face it, youth experiment, and if it’s something your grandmother is doing, you don’t necessarily want to be doing it too.”

Another positive trend, Culbert says, is that cannabis users now seem to be better informed about the risks of driving while high.

Only 18 per cent of people who had used cannabis in the past year reported getting behind the wheel after cannabis use, down from 27 per cent in 2018.

Culbert interviewed cannabis users when cannabis was legalized. At that time, many said they thought their driving abilities improved when under the influence of cannabis.

“Of course, that’s just not the truth … They felt that their video game experience was so much better when they were consuming, therefore why wouldn’t driving a car be better?” Culbert said.

“I think [because of] education efforts, and the fact that police across the country have put in programs to identify and prosecute people who are driving impaired, that message has gotten through, and people are now equating it to drinking alcohol and driving.”

Public health campaigns also seem to have raised awareness of cannabis’ risks to physical health. Successive Health Canada cannabis surveys have shown a growing understanding of cannabis’ effects on lung health and youth brain development.

Schneider believes public health campaigns now need to focus more on the mental health risks associated with heavy cannabis use.

“I think there’s a responsibility to say that, for a small proportion of people, it can be very psychologically addictive and very, very risky to mental health.”

According to Health Canada, regular cannabis users can experience psychological and mild physical dependence, with withdrawal symptoms that include irritability, anxiety, upset stomach and disturbed sleep.

“You don’t actually have anxiety,” said Schneider about his own withdrawal symptoms. “But your brain creates it anyway, driving you to use cannabis to relieve it.”

Research also shows frequent use of high-THC cannabis is linked to an increased risk of psychosis, a mental condition marked by a disconnection from reality. Individuals with mental disorders or a family history of schizophrenia are at particular risk.

In the survey, only 70 per cent of respondents said they had enough reliable information to make informed decisions about cannabis use. And the number of respondents saying they have not seen any education campaigns or public health messages about cannabis has increased, from 24 per cent in 2019 to 50 per cent today.

Culbert says the revenue that the government generates from cannabis creates a disincentive for it to issue strong health warnings.

“There’s no coherence in our regulatory and legal frameworks with respect to health harms and the level of regulation,” he said.

“Governments are addicted to their sin taxes,” he said.


This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

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Addictions

Calls for Public Inquiry Into BC Health Ministry Opioid Dealing Corruption

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Sam Cooper

The leaked audit shows from 2022 to 2024, a staggering 22,418,000 doses of opioids were prescribed by doctors and pharmacists to approximately 5,000 clients in B.C., including fentanyl patches.

A confidential investigation by British Columbia’s Ministry of Health, Financial Operations and Audit Branch has uncovered explosive allegations of fraud, abuse, and organized crime infiltration within PharmaCare’s prescribed opioid alternatives program. Internal audit findings, obtained by The Bureau, suggest that millions of taxpayer dollars are being diverted into illicit drug trafficking networks rather than serving harm reduction efforts.

The leaked documents include photographs from vehicle searches that show collections of fentanyl patches and Dilaudid (hydromorphone) apparently packaged for resale after being stolen from the taxpayer-funded “safer supply” program. This program expanded dramatically following a federal law change implemented by Prime Minister Justin Trudeau’s government in 2020, which broadened circumstances in which pharmacy staff could dispense opioids, according to the document’s evidence.

“Prior to March 17, 2020, only pharmacists in BC were permitted to deliver [addiction therapy treatment] drugs,” the audit says.

B.C.’s safer supply program was launched in March 2020 as a response to the opioid overdose crisis, declared in 2016. It allows people with opioid-use disorder to receive prescribed drugs to be used on-site or taken away for later use.

The Special Investigations Unit and PharmaCare Audit Intelligence team identified a disturbing link between doctors, pharmacists, assisted living residences, and organized crime, where prescription opioids meant to replace illicit drugs are instead being diverted, sold, and trafficked at scale.

“A significant portion of the opioids being freely prescribed by doctors and pharmacists are not being consumed by their intended recipients,” the document states.

It suggests that financial incentives have created a business model for organized crime, asserting that “prescribed alternatives (safe supply opioids) are trafficked provincially, nationally, and internationally,” and that “proceeds of fraud” are being used to pay incentives to doctors, pharmacists, and intermediaries.

BC Conservative critic Elenore Sturko, a former RCMP officer, began raising concerns about the program two years ago after hearing anecdotes about prescribed opioids being trafficked. She asserts that the program is a failure in public policy and insists that Provincial Health Officer Dr. Bonnie Henry be dismissed for having “denied and downplayed” problems as they emerged. Sturko also argues that B.C. must change its drug policy in light of U.S. President Donald Trump’s stance linking the trafficking of fentanyl and other opioids to potential trade sanctions against Canada.

The document shows that PharmaCare’s dispensing fee loophole has incentivized pharmacies to maximize billings per patient, with some locations charging up to $11,000 per patient per year—compared to just $120 in normal cases.

Perhaps most alarming is the deep infiltration of B.C.’s safer supply program by criminal networks. The Ministry of Health report lists “Gang Members/Organized Crime” as key players in the prescription drug pipeline, which includes “Doctors, pharmacies, and assisted living residences.”

This revelation confirms long-standing fears that B.C.’s “safe supply” policy—originally designed to prevent deaths from contaminated street drugs—is instead sometimes supplying criminal organizations with pharmaceutical-grade opioids.

The leaked audit shows from 2022 to 2024, a staggering 22,418,000 doses of opioids were prescribed by doctors and pharmacists to approximately 5,000 clients in B.C., including fentanyl patches.

Beyond organized crime’s direct involvement, pharmacies themselves have exploited regulatory gaps to generate massive profits from PharmaCare’s policies:

  • Pharmacies offer kickbacks to doctors, housing staff, and medical professionals to steer patients toward specific locations.
  • Financial incentives fuel fraud, with multiple investigations identifying 60+ pharmacies offering incentives to clients.
  • Non-health professionals, including housing staff, are witnessing OAT (opioid agonist treatment) dosing, violating patient safety protocols.

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Addictions

Provinces are underspending on addiction and mental health care, new report says

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The Greta and Robert H. N. Ho Psychiatry and Education Centre, the HOpe Centre, a health care facility for mental illness and addiction in North Vancouver, B.C. (Dreamstime)

By Alexandra Keeler

The provinces are receiving billions in federal funds to address mental health and substance use. Why are so many spending so little?

The provinces are failing to allocate sufficient funding to addiction and mental health care services, a new report says.

The report, released Dec. 19 by the Canadian Alliance on Mental Illness and Mental Health, criticizes the provinces for a “long history of … demanding maximum cash for health care from the federal government with minimum accountability.”

The alliance is a coalition of 18 prominent health organizations dedicated to improving Canada’s mental health care. Its members include the Canadian Medical Association, the Canadian Psychiatric Association and the Canadian Mental Health Association.

On average, the provinces have allocated just 16 per cent of $25 billion in federal health-care funding toward mental health and addiction services, the report says.

“Given the crisis of timely access to care for those with mental health and substance use health problems, why are so many provinces and territories investing so little new federal dollars to improve and expand access to mental health and substance use health care services?” the report asks.

However, some provinces dispute the report’s criticisms.

“The funding received from the federal government is only a small part of Alberta’s total $1.7 billion allocation towards mental health, addiction and recovery-related services,” an Alberta Ministry of Mental Health and Addiction spokesperson told Canadian Affairs in an emailed statement.

“[This] is a nation leading level of investment response.”

‘Take the money and run?’

In 2023, Ottawa and the provinces committed to spend $25 billion over 10 years investing in four priority areas. These areas are mental health and substance use, family health services, health workers and backlogs, and a modernized health system.

The alliance’s report, which looks at provincial investments in years 2023 through 2026, says mental health and substance use are being given short shrift.

B.C., Manitoba and P.E.I. have allocated zero per cent of the federal funds to mental health and substance use, the report says. Three other provinces allocated 10 per cent or less.

By contrast, Alberta allocated 25 per cent, Ontario, 24 per cent, and Nova Scotia, 19 per cent, the report says.

The underspending by some provinces occurs against a backdrop of mental health care already receiving inadequate investment.

“[P]ublicly available data tells us that Canada’s mental health investments account for roughly 5% of their health budgets, which is significantly below the recommended 12% by the Royal Society of Canada,” the report says.

However, several provinces told Canadian Affairs they took issue with the report’s findings.

“Neither the Department of Health and Wellness nor Health PEI received requests to provide information to inform the [alliance’s] report,” Morgan Martin, a spokesperson for P.E.I.’s Department of Health and Wellness, told Canadian Affairs.

Martin pointed to P.E.I.’s investments in opioid replacement therapy, a mobile mental health crisis unit and school health services as some examples of the province’s commitment to providing mental health and addiction care.

But Matthew MacFarlane, Green Party MLA for P.E.I.’s Borden-Kinkora riding, says these investments have been inadequate.

“P.E.I. has seen little to no investments into acute mental health or substance use services,” he said. He criticized a lack of new detox beds, unmet promises of a new mental health hospital and long wait times.

The alliance’s report says New Brunswick has allocated just 3.2 per cent of federal funds to mental health and addiction services.

However, a New Brunswick Department of Health spokesperson Tara Chislett said the province’s allocation of $15.4 million annually from the federal funds does not reflect the additional $200 million of provincial funding that New Brunswick has committed to mental health and substance use.

In response to requests for comment, a spokesperson for the alliance said the federal funding is important, but “does not nearly move the yardsticks fast enough in terms of expanding the capacity of provincial health systems to meet the growing demand for mental health and substance use health care services.”

 

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‘Blaming and shaming’

The discrepancies between the report’s findings and the provinces’ claims highlight a need for standardized metrics around mental health and addiction spending.

The report calls on federal and provincial governments to develop national performance indicators for mental health and substance use services.

“At the end-of-the day you cannot manage what you do not measure,” the report reads.

It advises governments to communicate their performance to Canadians via a national dashboard.

“Dashboards are being used with increasing frequency in the health system and other sectors to summarize complex information and would be one way to effectively tell a story … to the public,” the report says.

It also urges Ottawa to introduce legislation — what it dubs the Mental Health and Substance Use Health Care For All Parity Act — to ensure equal treatment for mental and physical health within Canada’s health-care system.

This call for mental and physical health parity echoes the perspective of other health-care professionals. In a recent Canadian Affairs opinion editorial, a panel of mental health physicians argued Canada’s failure to prioritize mental health care affects millions of Canadians, leading to lower medication reimbursement rates and longer wait times.

The alliance says its call for more aggressive and transparent spending on mental health and addictions care is not intended to criticize or cast blame.

“This is not about blaming and shaming, but rather, this is about accelerating the sharing of lessons learned and the impact of innovative programs,” the report says.


This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

Our content is always free.

Subscribe to get BTN’s latest news and analysis, or donate to our journalism fund.

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