HMN 2025: How Having a cannabis dispensary in the neighborhood is linked to increased harm rates

A population-based natural experiment study examined the association between exposure to cannabis retail stores and cannabis-related harms. The study found that exposure to retail stores was associated with increased rates of harm, particularly in neighborhoods with greater densities of stores.

The findings suggest that restrictions on the overall number of cannabis retail stores, on store concentrations, or on being located in certain areas could offer public health benefits. The study is published in Annals of Internal Medicine.

Researchers from North York General Hospital and colleagues studied data from 6,140,595 residents of Ontario, Canada aged 15 to 105 years old residing in 10,574 neighborhoods between April 2017 and December 2022 to determine if exposure to a cannabis store after legalization in October 2018 affected neighborhood-level rates of cannabis-related emergency department (ED) visits.

They leveraged provincial data on cannabis store locations to define neighborhoods as exposed (within 1000m of a cannabis retail store) or unexposed (more than 1000m from a cannabis retail store). The primary health outcome was the neighborhood level rate of cannabis-attributable ED visits per 100,000 persons aged 15 years or older.

The researchers found that exposed neighborhoods were more likely to be in large urban centers and the lowest income quintile compared to unexposed neighborhoods.

Overall, exposed neighborhoods did not experience an increase in monthly rates of cannabis-attributable ED visits after they were exposed to a cannabis store, whereas unexposed neighborhoods experienced a reduction in monthly rates of cannabis-attributable ED visits. Relative to unexposed neighborhoods, the absolute rate of cannabis attributable ED visits increased by 12% (CI, 6% to 19%) in exposed neighborhoods.

There was also evidence that having more cannabis stores within 1000 m correlated to larger increases in rates of cannabis-attributable ED visits.

The findings suggest that legalization of cannabis accompanied by retail commercialization may have different public health risks as opposed to legalization alone.

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