KEY POINTS

• In October 2018, recreational use of cannabis was legalized in Canada with the primary objectives of improving cannabis-related public health and safety, reducing youth access to cannabis, and reducing cannabis-related crime and illegal markets.

• Five years after policy implementation, available evidence suggests that outcomes related to health — such as the prevalence of cannabis use, cannabis-related emergency department visits and admissions to hospital and cannabis-impaired driving — have mostly increased or remained steady.

• Data on some important health indicators are unavailable.

• Substantial reductions in criminal arrests and charges related to cannabis use — and related stigma and other personal burdens — among both adults and youth should be noted as related positive social justice and possibly indirect public health outcomes.

• Continued measurement of key health and social outcomes, as well as robust ways to integrate diverse data when evaluating policy outcomes, are needed to inform evidence-based adjustments to regulatory parameters that will more effectively serve the declared public health objectives of cannabis legalization in Canada.