SAIMSARA Journal

Machine Generated Science • ISSN 3054-3991

Cannabis Legalization and Public Health Outcomes: Scoping Review with ☸️SAIMSARA.

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Longevity & Public Health

Issue 2, Volume 1, 2026

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DOI: 10.62487/saimsara19c0132a

Editorial note
• Last update: 2026-05-16 10:58:17
What is this paper about
Cannabis legalization is not a single public-health story: the strongest signal emerges after commercialization, where higher use, ED visits, hyperemesis, pediatric exposures, psychosis-related harms, and vulnerable-population risks become more visible. The full SAIMSARA evidence map is worth reading because it separates legalization, retail expansion, potency, packaging, taxation, risk perception, and clinical-risk groups across 175 references and 533 original studies.
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Evidence preview · Did you know?
Realistic pediatric emergency department scene with a cannabis-edible exposure safety theme.

Edibles changed the pediatric risk

Did you know? Moderate/severe pediatric cannabis exposures rose with 83.5% involving edibles.

Legal products can create child-specific harm pathways through attractive, ingestible, and harder-to-dose forms.

Realistic emergency psychiatry scene showing cannabis-related acute mental health risk.

The psychosis signal is not simple

Did you know? Ontario data suggested the schizophrenia population-attributable risk fraction linked to CUD rose from 3.7% to 10.3% after legalization.

The strongest signal appears around commercialization and vulnerable groups, not only legalization as a binary policy switch.

Realistic public-health policy scene with regulated cannabis retail, warnings, and governance oversight.

Legal supply can still expand exposure

Did you know? Canada reported a 75% increase in total cannabis market size, while legal channels captured 78% of spending five years after legalization.

Regulation can shrink illicit supply and still enlarge the public-health exposure landscape, making policy design central.

Swipe sideways on mobile · full evidence map opens after unlock

Abstract: To synthesize original research on cannabis legalization and health, emphasizing recurrent health signals, affected populations, clinical implications, and future research priorities across policy, health care, behavioral, and public health domains. The review uses 175 references and builds its evidence map from 533 original studies with 680,895,925 total participants/sample observations (topic-deduplicated ΣN). Across diverse North American jurisdictions, cannabis legalization—particularly when followed by commercialization and retail expansion—was consistently associated with higher cannabis use and more cannabis-attributable acute care, including emergency department visits for intoxication, hyperemesis, and cannabis-induced psychosis. Signals were strongest among clinically vulnerable groups such as people with psychosis, pregnant individuals, children, and older adults, while general-population effects on outcomes like overall psychosis utilization or prenatal use prevalence were less uniform. Policy design appeared consequential, with minimum legal age laws linked to a 34% reduction in youth cannabis-related hospitalizations and potency-based taxation showing differential effects on high-THC demand. These patterns support strengthened post-commercialization surveillance, pediatric exposure prevention, and clinician training, though heterogeneity across settings limits causal interpretation. Future research should prioritize prospective, design-rigorous studies that disentangle specific regulatory components—retail density, potency, packaging, and taxation—from broader legalization effects on health.

Keywords: Cannabis legalization; Recreational cannabis; Medical cannabis; Public health; Psychosis; Cannabis use disorder; Mental health; Emergency department visits; Traffic injuries; Pediatric exposure

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Reference Index (175)
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