High-intensity cannabis use and hospitalization: a prospective cohort study of street-involved youth in Vancouver, Canada

Abstract

Background There is concern that cannabis use negatively affects vulnerable groups such as youth; however, the relationship between cannabis use and health care utilization has not been well characterized in this population. We longitudinally evaluated the association between daily cannabis use and hospitalization among a prospective cohort of street-involved youth. Methods Data were collected from the At-Risk Youth Study (ARYS) in Vancouver, Canada, from September 2005 to May 2015. Participants were interviewed semi-annually and multivariable generalized estimating equation (GEE) logistic regression was used to examine the relationship between daily cannabis use and hospitalization. Results A total of 1216 participants (31.2% female) were included in this analysis, and 373 (30.7%) individuals reported hospitalization at some point during the study period. In a multivariable GEE analysis, daily cannabis use was not significantly associated with hospitalization (Adjusted Odds Ratio [AOR] = 1.17, 95% Confidence interval [CI] = 0.84, 1.65). We did observe a significant interaction between daily cannabis use and sex (AOR = 0.51, 95% CI = 0.34, 0.77), whereby cannabis use was associated with a decreased odds of hospitalization among males (AOR = 0.60, 95% CI = 0.47, 0.78), yet was not significantly associated with hospitalization among females (AOR = 1.19, 95% CI = 0.84, 1.67). Conclusions The finding that daily cannabis use was not associated with hospitalization among street-involved youth is encouraging given the high rates of cannabis use in this population and the expansion of cannabis legalization and regulation. Future studies, however, are warranted to monitor possible changes in the consequences of cannabis use as cannabis legalization and regulation increase internationally.

Frequencies of emergency department use and hospitalization comparing patients with different types of substance or polysubstance-related disorders

“…Most of these studies omitted service use variables. However, previous ED visits [ 25 , 29 ] and hospitalizations [ 24 , 29 ] and enrollment in a health insurance program [ 23 ] were often found to increase ED use, whereas receiving more days of psychiatric care [ 26 ] and prior drug treatment [ 27 ] increased hospitalization rates.…”

Acute care utilization and its associated determinants among patients with substance‐related disorders: A worldwide systematic review and meta‐analysis

“…After a detailed assessment of 14,348 papers, a total of 32 studies were included in the present study (Adam et al, 2020; Ayangbayi et al, 2017; Binswanger et al, 2008; Campbell et al, 2017; Cederbaum et al, 2014; Chen et al, 2015; Choi et al, 2016, 2018; Clark et al, 2013; Di Giovanni et al, 2020; Frank et al, 2015; Hansagi et al, 2012; Indig et al, 2010; John & Wu, 2017; Knowlton et al, 2005; Laine et al, 2001; Larson et al, 2006; Manuel & Lee, 2017; McDonald et al, 2011; Mejia de Grubb et al, 2020; Palepu et al, 1999; Parthasarathy & Weisner, 2005; Perron et al, 2011; Reddon et al, 2021; Rockett et al, 2005; Siegal et al, 2006; Stein & Anderson, 2003; Turner et al, 2003; Van Doren et al, 2016; Walley et al, 2012; Wu et al, 2012; Zhang et al, 2021). The main exclusion criteria were studies that did not assess ED use or hospitalization and those that did not assess associated variables.…”

“…In eleven studies out of 32 (Adam et al, 2020; Campbell et al, 2017; Cederbaum et al, 2014; Choi et al, 2018; Clark et al, 2013; Frank et al, 2015; Indig et al, 2010; John & Wu, 2017; Parthasarathy & Weisner, 2005; Perron et al, 2011; Turner et al, 2003) and eight studies out of 32 (Campbell et al, 2017; Cederbaum et al, 2014; Choi et al, 2016; Di Giovanni et al, 2020; Laine et al, 2001; Parthasarathy & Weisner, 2005; Reddon et al, 2021; Turner et al, 2003) patients who had MHDs were 1.54 and 1.40 times more likely to report ED use and hospitalization compared to those who did not have MHDs respectively (OR = 1.54, 95% CI = 1.20–1.98) (OR = 1.40, 95% CI = 1.07–1.83). In seven studies out of 32 (Campbell et al, 2017; Cederbaum et al, 2014; Choi et al, 2018; Larson et al, 2006; Parthasarathy & Weisner, 2005; Siegal et al, 2006; Turner et al, 2003) and nine studies out of 32 (Binswanger et al, 2008; Campbell et al, 2017; Cederbaum et al, 2014; Laine et al, 2001; Mejia de Grubb et al, 2020; Parthasarathy & Weisner, 2005; Stein & Anderson, 2003; Turner et al, 2003; Walley et al, 2012) those who had chronic physical illnesses were 1.33 and 1.30 times more likely to have ED use or hospitalization compared to those who did not have chronic physical illnesses, respectively (OR = 1.33, 95% CI = 1.15–1.54) (OR = 1.30, 95% CI = 1.15–1.47) (Figures 6 and 7).…”

“…F I G U R E 4Pooled odds ratio of sociodemographic characteristics associated with emergency department use among substance-related disorders.In four studies out of 32(Cederbaum et al, 2014;Frank et al, 2015;John & Wu, 2017;Manuel & Lee, 2017) and four studies out of 32(Cederbaum et al, 2014;Chen et al, 2015;Choi et al, 2016;John & Wu, 2017) patients with SRDs who had other drug use disorders (e.g., methamphetamine, cocaine) were 1.3.1.4 | Other clinical characteristics associated with ED use and hospitalization among patients with SRDsIn eleven studies out of 32(Adam et al, 2020;Campbell et al, 2017; Cederbaum et al, 2014; Choi et al, 2018; Clark et al, 2013; Frank et al, 2015; Indig et al, 2010; John & Wu, 2017; Parthasarathy &Weisner, 2005;Perron et al, 2011;Turner et al, 2003) and eight studies out of 32(Campbell et al, 2017;Cederbaum et al, 2014;Choi et al, 2016;Di Giovanni et al, 2020;Laine et al, 2001;Parthasarathy & Weisner, 2005;Reddon et al, 2021;Turner et al, 2003) patients who had MHDs were 1.54 and 1.40 times more likely to report ED use and hospitalization compared to those who did not have MHDs respectively (OR = 1.54, 95% CI = 1.20-1.98) (OR = 1.40, 95% CI = 1.07-1.83). In seven studies out of 32(Campbell et al, 2017;Cederbaum et al, 2014;Choi et al, 2018;Larson et al, 2006;Parthasarathy & Weisner, 2005;Siegal et al, 2006;Turner et al, 2003) and nine studies out of 32(Binswanger et al, 2008;Campbell et al, 2017;Cederbaum et al, 2014;Laine et al, 2001;Mejia de Grubb et al,...…”