BACKGROUND AND AIM: In Uruguay, residents age 18 and older seeking legal cannabis must register with the government and choose one of three supply mechanisms: self-cultivation, non-profit cannabis clubs or pharmacies. This is the first paper to measure the association between type of legal cannabis supply mechanism and traffic crashes involving injuries.
DESIGN: Ecological study using ordinary least squares regression to examine how department-level variation in registrations (overall and by type) is associated with traffic crashes involving injuries.
SETTING: Uruguay.
CASES: 532 department-quarters.
MEASUREMENTS: Quarterly cannabis registration counts at the department level and incident-level traffic crash data were obtained from government agencies. The analyses controlled for department-level economic and demographic characteristics and, as a robustness check, we included traffic violations involving alcohol for departments reporting this information. Department-level data on crashes, registrations and alcohol violations were denominated by the number of residents ages 18 and older.
FINDINGS: From 2013 to 2019, the average number of registrations at the department-quarter level per 10 000 residents age 18 and older for self-cultivation, club membership and pharmacy purchasing were 17.7 (SD = 16.8), 3.6 (SD = 8.6), and 25.1 (SD = 50.4), respectively. In our multivariate regression analyses, we did not find a statistically significant association between the total number of registrations and traffic crashes with injuries (beta = -0.007; P = 0.398; 95% CI = -0.023, 0.01). Analyses focused on the specific supply mechanisms found a consistent, positive and statistically significant association between the number of individuals registered as self-cultivators and the number of traffic crashes with injuries (beta = 0.194; P = 0.008; 95% CI = 0.058, 0.329). Associations for other supply mechanisms were inconsistent across the various model specifications.
CONCLUSIONS: In Uruguay, the number of people allowed to self-cultivate cannabis is positively associated with traffic crashes involving injuries. Individual-level analyses are needed to assess better the factors underlying this association.
Cannabis legalization and traffic injuries: Exploring the role of supply mechanisms
Addiction, 117 (8), 2325-2330. doi: 10.1111/add.15840.