Effects of the 2009 Medical Cannabinoid Legalization Policy on Hospital Use for Cannabinoid Dependency and Persistent Vomiting

Ateş, Mustafa; Herrera, Karina; Liu, Xibei; Gisi, Brandon; Yamashita, Takashi; Han, Kyu Tae; Azab, Mohamed; Mashiana, Harmeet S.; Maklad, Muthena; Farooqui, Muhammad T.; Makar, Ranjit; Yoo, Ji Won

doi:10.1016/j.cgh.2017.06.055

Cited by 21 publications

(25 citation statements)

References 16 publications

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“…However, we specifically chose to use the Colorado SID database as it is likely that reporting of cannabis use is more accurate in states where cannabis use is legal. Our findings are in line with a prior study using the National Inpatient Sample database, which showed persistent increases in cannabis dependency and persistent vomiting following a directive from the Department of Justice in 2009 stating that it would not prosecute people who complied with the state laws allowing its medical use . However, the information from our study is likely to be more accurate compared to using nationwide database that encompasses all states, including those where cannabis use is still illegal.…”

Section: Discussionsupporting

confidence: 89%

“…Our findings are in line with a prior study using the National Inpatient Sample database, which showed persistent increases in cannabis dependency and persistent vomiting following a directive from the Department of Justice in 2009 stating that it would not prosecute people who complied with the state laws allowing its medical use. 23 However, the information from our study is likely to be more accurate compared to using nationwide database that encompasses all states, including those where cannabis use is still illegal. Furthermore, our study addresses the impact from legalisation of recreational cannabis, demographics and factors associated with its cannabis use which were not addressed in the aforementioned study.…”

Section: Discussionmentioning

confidence: 98%

“…However, the information from our study is likely to be more accurate compared to using nationwide database that encompasses all states, including those where cannabis use is still illegal. Furthermore, our study addresses the impact from legalisation of recreational cannabis, demographics and factors associated with its cannabis use which were not addressed in the aforementioned study . The second limitation of our study is that it uses a database largely dependent on physician coding practices, which has inherent variability and limitations .…”

Section: Discussionmentioning

confidence: 99%

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Recent trends in cyclic vomiting syndrome‐associated hospitalisations with liberalisation of cannabis use in the state of Colorado

Bhandari

Jha

Medina

et al. 2019

Internal Medicine Journal

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Background Currently, 33 states in the United States along with the District of Columbia have legalised cannabis in some forms. There is a paucity of data on the impact of legalisation of cannabis use on hospitalisations due to cyclic vomiting syndrome (CVS). Aim To study the trends in CVS‐related hospitalisations and cannabis use in CVS in relation to legalisation of recreational cannabis use in Colorado. Methods All hospital admissions in Colorado between 2010 and 2014 with the diagnosis of CVS were identified using the Colorado State Inpatient Database. Five‐year trends in CVS‐related hospitalisations along with the cannabis use were analysed. Multivariate logistic regression analysis was performed to determine predictors of cannabis use in CVS. Results There was a significant increase in CVS‐related hospitalisations by 46% from 806 in 2010 to 1180 in 2014 when CVS was included as all‐listed diagnoses (P < 0.001). The overall prevalence of cannabis use in CVS (13% with CVS as primary diagnosis and 17% with CVS as all‐listed diagnoses) was much higher than non‐CVS‐related hospitalisations (1.7%) (P < 0.001 for both comparisons). Cannabis use increased dramatically in both CVS and non‐CVS‐related hospitalisations following legalisation of cannabis for recreational use in 2012. Conclusion Our study shows a significant increase in CVS‐related hospitalisations concomitant with an increase in cannabis use with its liberalisation in Colorado. Future studies on the relationship between cannabis use and hyperemesis are warranted, especially with its ongoing legalisation in the United States.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Recent trends in cyclic vomiting syndrome‐associated hospitalisations with liberalisation of cannabis use in the state of Colorado

Bhandari

Jha

Medina

et al. 2019

Internal Medicine Journal

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“…The Drug Abuse Warning Network (DAWN) states that marijuana mentions (the number of times “marijuana” is mentioned in a medical record) have increased 21% from 2009 to 2011 [3]. Since 2009, the rate of persistent vomiting has increased significantly and continues to increase at about 8% a year [5]. CHS cases have been reported from all over the world.…”

Section: Introductionmentioning

confidence: 99%

“…Since 2009, when the US Department of Justice published a memo to the effect that it would not prosecute users or sellers of medical marijuana who complied with their local state laws [4], marijuana use increased and with it, the rate of persistent vomiting increased 17.9% over prelegalization rates [5]. The Drug Abuse Warning Network (DAWN) states that marijuana mentions (the number of times “marijuana” is mentioned in a medical record) have increased 21% from 2009 to 2011 [3].…”

Section: Introductionmentioning

confidence: 99%

Cannabinoid Hyperemesis

Pergolizzi Jr.,

LeQuang,

Bisney

2018

Med Cannabis Cannabinoids

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Cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition in which a long-term cannabis user suffers an episode of intractable vomiting that may last days separated by longer asymptomatic periods of weeks or months. Cannabinoids are often utilized for their antiemetic properties, so CHS can be a puzzling condition, and the diagnosis of CHS may be disputed by patients. Unlike other cyclic vomiting syndromes, CHS can be relieved by hot showers or topical capsaicin. Abstinence from cannabinoids causes CHS to resolve, sometimes in a matter of days or hours. Marijuana users as well as many clinicians are not aware of CHS, and patients may undergo unnecessary tests, scans, and other procedures to get an accurate diagnosis. Symptoms may be severe enough to require hospitalization. With liberalization of marijuana laws and favorable public opinion about the healing properties of cannabis, CHS may be more frequently observed in clinical practice.

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Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map

Sevigny,

Greathouse,

Medhin

2023

Campbell Systematic Reviews

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BackgroundGlobally, cannabis laws and regulations are rapidly changing. Countries are increasingly permitting access to cannabis under various decriminalization, medicalization, and legalization laws. With strong economic, public health, and social justice incentives driving these domestic cannabis policy reforms, liberalization trends are bound to continue. However, despite a large and growing body of interdisciplinary research addressing the policy‐relevant health, safety, and socioeconomic consequences of cannabis liberalization, there is a lack of robust primary and systematic research that comprehensively investigates the consequences of these reforms.ObjectivesThis evidence and gap map (EGM) summarizes the empirical evidence on cannabis liberalization policies. Primary objectives were to develop a conceptual framework linking cannabis liberalization policies to relevant outcomes, descriptively summarize the empirical evidence, and identify areas of evidence concentration and gaps.Search MethodsWe comprehensively searched for eligible English‐language empirical studies published across 23 academic databases and 11 gray literature sources through August 2020. Additions to the pool of potentially eligible studies from supplemental sources were made through November 2020.Selection CriteriaThe conceptual framework for this EGM draws upon a legal epidemiological perspective highlighting the causal effects of law and policy on population‐level outcomes. Eligible interventions include policies that create or expand access to a legal or decriminalized supply of cannabis: comprehensive medical cannabis laws (MCLs), limited medical cannabidiol laws (CBDLs), recreational cannabis laws (RCLs), industrial hemp laws (IHLs), and decriminalization of cultivations laws (DCLs). Eligible outcomes include intermediate responses (i.e., attitudes/behaviors and markets/environments) and longer‐term consequences (health, safety, and socioeconomic outcomes) of these laws.Data Collection and AnalysisBoth dual screening and dual data extraction were performed with third person deconfliction. Primary studies were appraised using the Maryland Scientific Methods Scale and systematic reviews were assessed using AMSTAR 2.Main ResultsThe EGM includes 447 studies, comprising 438 primary studies and nine systematic reviews. Most research derives from the United States, with little research from other countries. By far, most cannabis liberalization research focuses on the effects of MCLs and RCLs. Studies targeting other laws—including CBDLs, IHLs, and DCLs—are relatively rare. Of the 113 distinct outcomes we documented, cannabis use was the single most frequently investigated. More than half these outcomes were addressed by three or fewer studies, highlighting substantial evidence gaps in the literature. The systematic evidence base is relatively small, comprising just seven completed reviews on cannabis use (3), opioid‐related harms (3), and alcohol‐related outcomes (1). Moreover, we have limited confidence in the reviews, as five were appraised as minimal quality and two as low quality.Authors’ ConclusionsMore primary and systematic research is needed to better understand the effects of cannabis liberalization laws on longer‐term—and arguably more salient—health, safety, and socioeconomic outcomes. Since most research concerns MCLs and RCLs, there is a critical need for research on the societal impacts of industrial hemp production, medical CBD products, and decriminalized cannabis cultivation. Future research should also prioritize understanding the heterogeneous effects of these laws given differences in specific provisions and implementation across jurisdictions.

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Effects of the 2009 Medical Cannabinoid Legalization Policy on Hospital Use for Cannabinoid Dependency and Persistent Vomiting

Cited by 21 publications

References 16 publications

Recent trends in cyclic vomiting syndrome‐associated hospitalisations with liberalisation of cannabis use in the state of Colorado

Recent trends in cyclic vomiting syndrome‐associated hospitalisations with liberalisation of cannabis use in the state of Colorado

Cannabinoid Hyperemesis

Health, safety, and socioeconomic impacts of cannabis liberalization laws: An evidence and gap map

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