Canadian Medical Cannabis Use after Legalization

In a major policy decision, Canada legalized recreational cannabis in October 2018. However, provinces implemented legalization differently. In particular, Ontario opened cannabis storefronts much later than other provinces, and retail data indicate that this affected consumer behaviour. I use this exogenous variation in access to legalized cannabis, combined with large-N patient data from a chain of medical cannabis clinics operating in several provinces, to help understand the observed decline in purchased medical cannabis and significant growth in individually produced medical cannabis. After legalization, the purchase of medical cannabis fell less in Ontario than in higher-access provinces. However, I find no evidence that legalization changed trends in the composition of medical cannabis purchasers by gender, age, or medical condition. This suggestive evidence is consistent with minimal misuse of the medical cannabis system and hence does not support more restrictive policies regarding medical cannabis purchases. However, the substantial increase in the personal growing of medical cannabis for use may become a future policy focus.