Syndromic Surveillance of Emergency Department Visits for Acute Adverse Effects of Marijuana, Tri-County Health Department, Colorado, 2016-2017

Marx, Grace E; Chen, Yushiuan; Askenazi, Michele; Albanese, Bernadette

doi:10.1177/0033354919826562

Cited by 10 publications

(7 citation statements)

References 21 publications

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“…Monitoring for substance abuse is common among ESSENCE users. The Tri-County Health Department in Colorado uses its system to investigate the adverse effects of marijuana use [ 47 ]. The Florida State Department queries for ED visits resulting from synthetic marijuana [ 48 ] and for novel street drugs, such as Flakka, as they become known public health problems [ 49 ].…”

Section: Resultsmentioning

confidence: 99%

Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE): Overview, Components, and Public Health Applications

Burkom¹,

Loschen²,

Wojcik³

et al. 2021

JMIR Public Health Surveill

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Background The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) is a secure web-based tool that enables health care practitioners to monitor health indicators of public health importance for the detection and tracking of disease outbreaks, consequences of severe weather, and other events of concern. The ESSENCE concept began in an internally funded project at the Johns Hopkins University Applied Physics Laboratory, advanced with funding from the State of Maryland, and broadened in 1999 as a collaboration with the Walter Reed Army Institute for Research. Versions of the system have been further developed by Johns Hopkins University Applied Physics Laboratory in multiple military and civilian programs for the timely detection and tracking of health threats. Objective This study aims to describe the components and development of a biosurveillance system increasingly coordinating all-hazards health surveillance and infectious disease monitoring among large and small health departments, to list the key features and lessons learned in the growth of this system, and to describe the range of initiatives and accomplishments of local epidemiologists using it. Methods The features of ESSENCE include spatial and temporal statistical alerting, custom querying, user-defined alert notifications, geographical mapping, remote data capture, and event communications. To expedite visualization, configurable and interactive modes of data stratification and filtering, graphical and tabular customization, user preference management, and sharing features allow users to query data and view geographic representations, time series and data details pages, and reports. These features allow ESSENCE users to gather and organize the resulting wealth of information into a coherent view of population health status and communicate findings among users. Results The resulting broad utility, applicability, and adaptability of this system led to the adoption of ESSENCE by the Centers for Disease Control and Prevention, numerous state and local health departments, and the Department of Defense, both nationally and globally. The open-source version of Suite for Automated Global Electronic bioSurveillance is available for global, resource-limited settings. Resourceful users of the US National Syndromic Surveillance Program ESSENCE have applied it to the surveillance of infectious diseases, severe weather and natural disaster events, mass gatherings, chronic diseases and mental health, and injury and substance abuse. Conclusions With emerging high-consequence communicable diseases and other health conditions, the continued user requirement–driven enhancements of ESSENCE demonstrate an adaptable disease surveillance capability focused on the everyday needs of public health. The challenge of a live system for widely distributed users with multiple different data sources and high throughput requirements has driven a novel, evolving architecture design.

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Section: Resultsmentioning

confidence: 99%

Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE): Overview, Components, and Public Health Applications

Burkom¹,

Loschen²,

Wojcik³

et al. 2021

JMIR Public Health Surveill

View full text Add to dashboard Cite

show abstract

“…There is also evidence on the harms of marijuana secondhand smoke on cardiovascular health 67,68 . Use of high‐potency cannabis concentrate products has also been associated with negative consequences like psychosis and emergency department visits 69 . These public health outcomes should be considered and used to inform policy decisions.…”

Section: Discussionmentioning

confidence: 99%

County‐Level Recreational Marijuana Policies and Local Policy Changes in Colorado and Washington State (2012‐2019)

2021

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In 2012, Colorado and Washington were the first states to legalize recreational marijuana through voter‐initiated ballots. In these states, counties could restrict or ban local marijuana facilities through a variety of regulatory methods such as ordinances and zoning. County‐level recreational marijuana policies in Washington and Colorado vary substantially, with 69.2% of Washington counties and 23.4% of Colorado counties allowing all types of recreational marijuana facilities as of April 1, 2019. After Colorado and Washington legalized recreational marijuana, many counties modified their marijuana policies over time, with shifts in county policy often preceded by advocacy and information‐seeking activities. Context In 2012, Colorado and Washington were the first states to legalize recreational marijuana. Both allowed local governments to further regulate the availability of marijuana facilities in their jurisdictions. As early adopters, these states are important quasi‐natural experiments to examine local marijuana policy and policy change processes, including key stakeholders and arguments. Methods We conducted a policy scan of county‐level recreational marijuana ordinances and regulations in Colorado and Washington. Data collected included policy documents from counties in both states and newspaper articles. We used a mixed‐methods approach to describe the types of county‐level recreational marijuana policies enacted by April 1, 2019; identify key policy stakeholders involved in local policy debates; and explore arguments used in support or opposition of county policies. We also selected four counties that represent three county policy environments (all marijuana facility types allowed, some marijuana facility types allowed, all marijuana facility types prohibited) and described the policy changes within these counties since recreational marijuana was legalized. Findings By April 1, 2019, Colorado counties were less likely than Washington counties to allow marijuana facilities—48.4% of Colorado counties prohibited recreational marijuana facilities in their jurisdiction compared to 23.1% of Washington counties. Since state legalization, several counties in both states have made substantial marijuana facility policy modifications, often preceded by information‐seeking activities. Primary stakeholders involved in policy debates included elected officials, law enforcement, individual growers/farmers, marijuana business license applicants, parents, and residents. Proponents referenced local economic gain, reduced crime, and potential health benefits of marijuana as arguments in favor of permitting local facilities, whereas opponents pointed to economic loss, negative health and public health issues, public safety concerns, and existing federal law. Both sides referenced local public opinion data to support their position. Conclusions By early 2019, a patchwork of local marijuana policies was in place in Colorado and Washington. We identify key areas of policy and public health research needed to inform future lo...

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“…[1][2][3] However, most studies are retrospective and identify cannabis-related visits using diagnosis codes or THC-positive urine drug immunoassays. [2][3][4][5] These identification methods are limited; ICD codes are infrequently used in adult ED cases of exposure to drugs of abuse 6,7 and clinicians may not explicitly document diagnosis of drug use, even when highly suspected or confirmed by patients. A positive urine screen implies drug exposure but does not necessarily provide evidence of intoxication or a relationship between exposure and the ED visit.…”

Section: The Burden Of Cannabis-attributed Pediatric and Adult Emergency Department Visitsmentioning

confidence: 99%

The burden of cannabis‐attributed pediatric and adult emergency department visits

Hendrickson

Dilley

Hedberg

et al. 2021

Academic Emergency Medicine

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Syndromic Surveillance of Emergency Department Visits for Acute Adverse Effects of Marijuana, Tri-County Health Department, Colorado, 2016-2017

Cited by 10 publications

References 21 publications

Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE): Overview, Components, and Public Health Applications

Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE): Overview, Components, and Public Health Applications

County‐Level Recreational Marijuana Policies and Local Policy Changes in Colorado and Washington State (2012‐2019)

The burden of cannabis‐attributed pediatric and adult emergency department visits

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