Patients already using cannabis legally for medical purposes were especially concerned. They worried that recreational legalization might prompt physicians to stop authorizing cannabis treatments. Or that cannabis producers would abandon the small medical market to pursue the larger recreational one.

After recreational legalization, the medical cannabis system did see declines. Between June 2018 and December 2022, the number of registered patients fell 32 per cent, while product sales fell 29 per cent. Some people thought the medical cannabis system had failed or become obsolete.

As someone who studies the business aspects of cannabis legalization, I wondered about these issues, too. It wasn’t clear how patients, producers or health-care providers would react to recreational legalization. Legal medical use itself had only become accessible a few years earlier.

Accessing medical cannabis

Canada began allowing medical use of cannabis in 1999. But it remained difficult to get until regulations changed during 2014-15.

The new rules allowed any physician to authorize patients to use cannabis. Those patients could then register to buy products online from licensed cannabis producers. Online orders could not exceed a 30-day supply.

(Instead of buying cannabis products, some patients grew their own plants instead. My research hasn’t examined that.)

Under this new procedure, the number of patients registering to buy cannabis soared. They grew from 7,914 in June 2014 to 330,344 in June 2018, nearly one per cent of Canada’s population.

However, registration levels differed greatly between provinces. In June 2018, registrations represented almost three per cent of Alberta’s population, versus only 0.1 per cent of Québec’s.

Interestingly, less than half of registrants bought medical cannabis in any given month. Perhaps they simply didn’t need the full dose. Or maybe they found it too expensive, inconvenient or ineffective.

June 2018 was also when the federal government passed its new cannabis legislation. The law took effect in October 2018, when recreational sales of dried cannabis and cannabis oils began. After initial product shortages were overcome, recreational cannabis sales grew rapidly as more stores opened, even during the COVID-19 pandemic. Consumer choice expanded in December 2019 when edibles and vapes became available.

This is where my new study came in. I analyzed government data on patients’ use of Canada’s medical cannabis system between 2017 and 2022. This included how many patients registered, how often they placed orders, and how much cannabis they bought.

Evolving system usage

I found that as soon as parliament passed the new cannabis law, medical registrations began slowing down, despite recreational legalization still being four months away.

But the response differed noticeably between provinces. For example, registrations kept growing steadily in Québec but plummeted rapidly in Alberta. Other provinces were in between.

My data doesn’t say why those changes occurred. Perhaps Alberta, with its copious cannabis clinics, had many patients only mildly interested in using cannabis medically. Conversely, maybe Québec was still catching up with other provinces on medical use.

When recreational sales started in October 2018, patient registrations seemed unaffected. Their average purchase sizes didn’t change either. But they bought medical cannabis slightly less often.

This might have been due to retail convenience. At that time, medical producers and recreational stores were selling similar products: dried cannabis and cannabis oils. So, perhaps some patients started topping up their supplies occasionally at recreational stores but saw no reason to leave the online medical system completely.

When edibles and other processed products began selling in December 2019, registrations dropped further. But the patients who remained bought medical cannabis slightly more often and in increasingly larger quantities.

Product selections might explain this patient split. Perhaps producers with good edible products retained their customers and received larger orders from them. Conversely, maybe medical producers offering few edibles lost their patients to the recreational shops and their vast product assortments.

In summary, Canada’s medical cannabis system experienced big changes after recreational legalization. But it didn’t disappear.

Will other countries see similar outcomes if they allow recreational cannabis?

A changing world

In Europe, for example, The Netherlands is experimenting with recreational sales. Meanwhile, Germany has legalized recreational use but not retail sales. Will those countries experience medical cannabis changes like Canada did?

Conversely, some countries barely tolerate even medical use. It is very difficult to legally obtain medical cannabis in the United Kingdom, for example, much like in Canada 20 years ago. And France has only conducted a few medical cannabis trials.

Other countries, like Australia and New Zealand, are somewhere in between. They’re seeing rapid growth in legal medical use and illegal recreational use, but haven’t legalized recreationally. That’s roughly where Canada was 10 years ago.

Will Canada’s medical and recreational cannabis experiences make these other countries more interested in legalization, or less? Either way, I hope they can learn from our experiences as they chart their own cannabis paths.

Michael J. Armstrong, Associate Professor, Operations Research, Brock University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Greatest liar, given media tracking of unparalleled numbers of repeated lies and gross exaggerations (upwards of 30,000 during his presidency — and 40 during just one recent campaign rally in Reading, Pa.)

Greatest flyer above the law — from his infamous declaration “I could stand in the middle of Fifth Avenue and shoot somebody, and I wouldn’t lose any voters, OK?” to the Jan. 6, 2021 incitement of an insurrection against the American government, and his ensuing denials of any wrongdoing.

Greatest narcissist — as in

Trump vs. everybody

If Trump tops the charts of American presidents in dubious categories, however, he is not without competition among the other 45.

Dishonesty has long emanated from the White House. Examples include Dwight D. Eisenhower’s denial of CIA involvement in the 1954 coup in Guatemala and Bill Clinton contorting his words about his relationship with Monica Lewinsky.

Other presidents saw themselves as above the law. Andrew Jackson defied an 1832 Supreme Court ruling declaring the removal of Georgia Cherokees illegal: “(Supreme Court Chief Justice) John Marshall has made his decision,” he said. “Now let him enforce it.” Richard Nixon tried to brazenly bluster his way out of the Watergate scandal.

Narcissism, however, is the trait where Trump seemingly leaves his peers in the dust. Not that American presidents have ever been lacking in ego — or its more viral variant, hubris, an extreme and unreasonable feeling of pride and confidence. White House occupants and their aspirants invariably develop elevated self-perceptions and ambitions, since no one leaps into a run for the presidency from the bleachers at a little league game.

Hunger for political power routinely ratchets up through escalating stages, a sequence that might be described as a “compound appetite” process, when each new success encourages more intense cravings for power and/or a bigger sense of entitlement.

Compound interest vs. compound appetite

“Compound interest” — as opposed to “compound appetite” — is a familiar phenomenon for anyone with a savings account or mutual funds: it’s calculated on the principal amount and the accumulated interest from previous periods, and can therefore be referred to as “interest on interest.”

Investing sage Warren Buffett describes compound interest as a snowball growing ever larger as it rolls down a long hill in winter.

Trump’s life story embodies an “appetite” version of this compounding dynamic. His life also demonstrates the dangers an ever larger snowball can pose to anything in its path.

Trump first built on his father’s New York City real estate business, transforming outer borough resources into Manhattan moguldom. He moved on to use media notoriety, financial finagling and multiple bankruptcy manoeuvres to build a global empire of hotels, casinos and golf resorts.

An appetite for the spotlight was then fed by the television success of The Apprentice, cultivating Trump’s tentative yen for political power into the unbridled lust for it that’s now on astonishing display.

A former NBC marketing executive who promoted the show even recently apologized to Americans, saying he “helped create a monster.”

The ‘rest’ vs. the ‘best’

Trump’s snowballing appetites have reached G.O.A.T. proportions in the annals of the American presidency. Ambitious predecessors managed to come to rest (or were made to come to rest) at some higher, safer point on the wintry hills figuratively sloping out from the White House.

The best of them, imperfect human beings though they inevitably were, harnessed ego to fuel and sustain transformative leadership.

George Washington and Franklin D. Roosevelt are examples. Each had a patrician personality and high self-regard, but they both also had self-control and a genuine regard for the democratic principles and public service ideals of their times.

The history of the United States during and immediately after the American Revolution would have been more arduous and uncertain without self-control — and so too would the country’s future during the brutal storms of the Great Depression and the Second World War without a commitment to democratic principles and public service.

Some presidents had more mixed records, with impressive achievements at times undercut by hubris that proved costly to themselves and others. Lyndon B. Johnson, devoted heir to Roosevelt’s New Deal vision of social and economic justice and a masterful engineer of legislative breakthroughs, knew that his stunning Great Society legacy was deeply tarnished by what he called “that bitch of a war” in Vietnam.

Too confident in both American power and his personal abilities to strike a winning balance between military spending and social programs, Johnson joined a parade of presidents who hungered for victory in Vietnam, which he once referred to as that “damn little pissant country.”

Absurdity vs. danger

In Trump’s case, hubris has spawned appetites that have reached a scale swinging between laughable absurdity and profound danger.

On one hand, is there anything he will not stoop to shill to add to his wealth? Recent candidate merchandise includes pieces of the suit he wore at his June debate with President Joe Biden for US$1,485, succeeding the steaks and Trump University diplomas he once hawked.

On the other hand, Trump’s insatiable hunger for power could spawn a second Jan. 6 scenario if he loses next week.

Victory could bring alternative scenarios: Trump has said he would veto a national abortion ban, but does his history of lying portend an escalation of the success he and his allies achieved in overturning Roe v. Wade once campaign pressures are gone?

Could border wall construction segue into mass deportations? Could vulgar insults about opponents and dismissal of serious policy debates result in police or military moves against the so-called “enemies from within” he has railed against for months.

How power corrupts

Trump’s ego/appetite amalgam — and the snowballing dynamic that has taken it to new extremes — is ultimately a variation on a British historian’s famous dictum from the late 1800s about how power corrupts:

“Power tends to corrupt and absolute power corrupts absolutely.”

Although the phenomenon is observable in many arenas — the behaviour of Elon Musk and other Silicon Valley potentates, for instance — it has been vividly illuminated during the 2024 U.S. election campaign.

The presidential election and its aftermath will help clarify whether American politics will return to a more traditional minefield in which presidents navigate between ego and hubris — or if Trump’s compound-appetite leap to power-hungry narcissism will bring new dangers to the United States.

Ronald W. Pruessen, Emeritus Professor of History, University of Toronto

This article is republished from The Conversation under a Creative Commons license. Read the original article.