Historique
Article de Périodique
Effects of legal access versus illegal market cannabis on use and mental health: A randomized controlled trial (2025)
Auteur(s) :
BALTES-FLUECKIGER, L. ;
STEINAUER, R. ;
MEYER, M. ;
GUESSOUM, A. ;
HERRMANN, O. ;
MOSANDL, C. F. ;
KRONSCHNABEL, J. ;
PICHLER, E. M. ;
VOGEL, M. ;
WALTER, M.
Année
2025
Page(s) :
1982-1992
Langue(s) :
Anglais
Domaine :
Drogues illicites / Illicit drugs
Discipline :
EPI (Epidémiologie / Epidemiology)
Thésaurus géographique
SUISSE
Thésaurus mots-clés
ETUDE RANDOMISEE
;
CANNABIS
;
MARCHE DE LA DROGUE
;
SANTE MENTALE
;
LEGALISATION
;
COMPARAISON
;
PRODUIT ILLICITE
;
ADULTE
;
USAGE RECREATIF
;
MESUSAGE
Note générale :
Sznitman S.R., Auer R., Broers B. (2025) Commentary on Baltes-Flueckiger et al.: Rethinking expectations and evidence in cannabis policy. Addiction, Vol. 120, n° 10, p. 1993-1994. https://doi.org/10.1111/add.70161
Résumé :
AIMS: We measured the effects of public health-oriented cannabis access compared with the illegal market on cannabis use and related mental health outcomes in adult cannabis users.
DESIGN: This was a two-arm, parallel group, open-label, randomized controlled trial. Follow-up outcome measurement took place after 6 months. SETTING: The study was conducted in Basel-Stadt, Switzerland.
PARTICIPANTS: A total of 378 adult (aged >=18 years) cannabis users were enrolled and randomized between August 2022 and March 2023, although only 374 users who completed baseline measures could be included.
INTERVENTION AND COMPARATOR: Participants were randomly assigned to the intervention group with public health-oriented recreational cannabis access in pharmacies (regulated cannabis products, safer use information, voluntary counseling, no advertisement; 189/188) or the illegal market control group (continued illicit cannabis sourcing; 189/186).
MEASUREMENTS: The primary outcome was self-reported severity of cannabis misuse after 6 months, as measured by the Cannabis Use Disorders Identification Test - Revised (range 0-32). Secondary outcomes involved depressive, anxiety, and psychotic symptoms, cannabis consumption amount, alcohol, and drug use.
FINDINGS: Ten participants were not followed (2.7%). Primary analysis included those with complete data (182 vs. 182). There was some evidence of a difference in cannabis misuse between the legal cannabis intervention group (mean [M] = 10.1) and the illegal market control group (M = 10.9; β = -0.69, 95% confidence interval [CI] = -1.4 to 0.0, P = 0.052). These results were supported by an intention-to-treat multiple imputation analysis (n = 374). Additional sub-group analysis by whether the participant used other drugs or not suggested that any reduction in cannabis misuse was confined to those in the legal cannabis intervention group who used other drugs (P(Interaction) < 0.001). We found no statistically significant changes in any of the secondary outcomes.
CONCLUSIONS: Public health-oriented recreational cannabis access may decrease cannabis use and cannabis-related harms, especially among those using other drugs. [Author's abstract]
DESIGN: This was a two-arm, parallel group, open-label, randomized controlled trial. Follow-up outcome measurement took place after 6 months. SETTING: The study was conducted in Basel-Stadt, Switzerland.
PARTICIPANTS: A total of 378 adult (aged >=18 years) cannabis users were enrolled and randomized between August 2022 and March 2023, although only 374 users who completed baseline measures could be included.
INTERVENTION AND COMPARATOR: Participants were randomly assigned to the intervention group with public health-oriented recreational cannabis access in pharmacies (regulated cannabis products, safer use information, voluntary counseling, no advertisement; 189/188) or the illegal market control group (continued illicit cannabis sourcing; 189/186).
MEASUREMENTS: The primary outcome was self-reported severity of cannabis misuse after 6 months, as measured by the Cannabis Use Disorders Identification Test - Revised (range 0-32). Secondary outcomes involved depressive, anxiety, and psychotic symptoms, cannabis consumption amount, alcohol, and drug use.
FINDINGS: Ten participants were not followed (2.7%). Primary analysis included those with complete data (182 vs. 182). There was some evidence of a difference in cannabis misuse between the legal cannabis intervention group (mean [M] = 10.1) and the illegal market control group (M = 10.9; β = -0.69, 95% confidence interval [CI] = -1.4 to 0.0, P = 0.052). These results were supported by an intention-to-treat multiple imputation analysis (n = 374). Additional sub-group analysis by whether the participant used other drugs or not suggested that any reduction in cannabis misuse was confined to those in the legal cannabis intervention group who used other drugs (P(Interaction) < 0.001). We found no statistically significant changes in any of the secondary outcomes.
CONCLUSIONS: Public health-oriented recreational cannabis access may decrease cannabis use and cannabis-related harms, especially among those using other drugs. [Author's abstract]
Affiliation :
Psychiatric and Psychotherapeutic Clinic, Psychiatric Services Aargau, Windisch, Switzerland
Health Department, Basel, Switzerland
Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
Faculty of Medicine, University of Basel, Basel, Switzerland
Health Department, Basel, Switzerland
Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
Faculty of Medicine, University of Basel, Basel, Switzerland
Cote :
Abonnement électronique