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This study examined trends in past-year cannabis consumption by sociodemographic and geographic characteristics from 2004 to 2017, using several national surveys. Of the 289 823 respondents 15 years of age or older (51% female), the overall prevalence of cannabis use increased from 12.2% (95% confidence interval [CI] 11.0%–13.5%) to 18.7% (95% CI 16.2%–21.5%) among men and from 6.6% (95% CI 5.9%–7.4%) to 11.1% (95% CI 9.4%–13.0%) among women. The crude rate of change was greater between 2011 and 2017 than that between 2004 and 2011 in both men and women. After adjustment for age, education, tobacco smoking and province, the 2011–2017 trend was stronger in men but not in women. Cannabis use was associated with tobacco smoking. Heterogeneity was found in cannabis use trends by age, education and province. Cannabis use decreased among respondents aged 15–19 years and increased in other age groups. Full article
In 2004, Ontario delisted routine eye examinations for people aged 20–64 years, potentially encouraging patients seeking eye care to visit government-insured primary care providers (PCPs) rather than optometrists whose services had been deinsured. This comparative analysis found a significant increase in utilization of PCP services for nonrefractive ocular diagnoses after 2004 among people affected by the delisting: 17.8% (95% confidence interval [CI] 17.0% to 18.7%) for people aged 20–39 years and 11.6% (95% CI 10.6% to 12.5%) for people aged 40–64 years. Among people aged 65 years and older (an age group not affected by the delisting), utilization of PCP services for nonrefractive ocular diagnoses was stable throughout the study period. Additionally, changes in utilization of PCP services for nonocular diagnoses were nonsignificant among people aged 0–19, 40–64, and 65 years and older. Full article
Intentional and unintentional gun injury is a frequent cause of death that generates substantial immediate attention. Drawing from Ontario administrative databases, this cohort study looked at whether additional health losses arise in patients who survive with long-term disability. Between 2002 and 2019, 8313 patients were injured from firearms in Ontario, of which 36.3% were injured from intentional incidents and 63.7% were injured from unintentional incidents. After a mean 7.75 years of follow-up, patients surviving intentional injuries were twice as likely to have long-term disability than those with unintentional injury. This difference was not explained by demographic characteristics, extended to survivors treated and released from the emergency department, and was observed regardless of whether the incident was self-inflicted or from interpersonal assault. Additional predictors of long-term disability included a lower socioeconomic status, an urban home location, arrival by ambulance transport, a history of mental illness and a diagnosis of a substance use disorder. Full article
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