The Cannabis Act was introduced in Canada and legalized the use of recreational cannabis. The impact of the announcement and implementation of this act on patient self-reporting of cannabis usage has not been explored.

The study objective was to determine if patient self-reported cannabis use increased following the announcement and implementation of legislative changes to legalize recreational cannabis.

A repeated cross-sectional design was used for a retrospective chart review of patients seen at a university-affiliated, pharmacist-led primary care clinic. A convenience sample of patient records were divided into three panels corresponding with the pre-announcement (November 1, 2013 to October 4, 2015), post-announcement (October 5, 2015 to October 16, 2018) and post-implementation (October 17, 2018 to October 17, 2019) of legalized recreational cannabis. Electronic medical record search terms used include: cannabis, marijuana, marihuana, recreational drugs, natur*, medicinal, pot, joint, oil, butter, brownies, edibles, cannabin*, THC, tetrahydro*, sativa, indica (*= string wild card). The frequency of reporting, usage, and queries related to cannabis over different time periods was assessed. ANOVA test and Pearson correlation (chi2) were used to compare the three panels.

Two hundred ninety-eight patient charts were included in the analysis. One hundred, 99 and 99 patient charts corresponded with panels 1, 2 and 3, respectively. At each time-point 6%, 8%, 14% of patients reported cannabis use (p= .03). A significant increase of topical oil and decrease in prescription tablet or capsule usage between panels 1 and 3 (p= .036) were identified.

This study found an increase in patient self-reporting of cannabis use across the three consecutive panels assessed through patient medical records. The change in the product formulations used may reflect the various cannabis products available to the public. Front-line pharmacists are encouraged to initiate conversations regarding cannabis usage as part of routine practice.