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

Hendrickson, Robert G.; Dilley, Julia A.; Hedberg, Katrina; Jeanne, Thomas L.; Love, Jennifer S.; Thompson, James T.; Choo, Esther K.

doi:10.1111/acem.14275

Cited by 3 publications

(4 citation statements)

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“…One study from Oregon showed only 1.8% of visits to the ED were cannabis-related but for one ED site alone this represented $5.6 million in hospital charges. Cannabis adverse events may represent an all or nothing approach to healthcare needs, if the adverse event reached the level of requiring an ED visit, it was a “significant burden” on hospital resources ( 15 ). Another example of how intensive care can be for cannabis intoxicated patients relates to a trauma patient study performed in Los Angeles, California which was not focused on mental health impacts of cannabis, but showed that cannabis use was associated with increased use of mechanical ventilation in trauma patients who had used cannabis ( 16 ).…”

Section: Literature Updatementioning

confidence: 99%

“…One study from Oregon used ICD codes and the electronic medical record with an embedded question asking the clinician to consider if this presentation was cannabis related. This gave 1.6% of classified visits that were cannabis attributable for adults and 0.66% of pediatric visits with cannabis relation but the authors noted that among the charts classified by the question as being cannabis related, only 22% for adults and 17% for pediatric cases had a cannabis related ICD code in the record ( 15 ). This suggests there was a disconnect between the entry of a cannabis related ICD code and the association of the presentation with cannabis use.…”

Section: Literature Updatementioning

confidence: 99%

“…While studies that focus on quality of care have examined possible errors to clinical practice with exhaustion in the ED environment, there is also a component of emotional exhaustion which can affect executive function and potentially allow a greater influence of personal bias as a result ( 62 ). There may also be, as noted by another group, biases in assigning cannabis use codes to certain racial and ethnic groups which might be related to the frequency of cannabis attributable visits ( 15 ). All of this discussion leaves aside the complication that not every patient will report cannabis use in the Emergency possibly due to stigma and given the long half-life of THC in the body, toxicological tests are not always informative.…”

Section: Literature Updatementioning

confidence: 99%

“…Cannabis-associated ED presentations are not numerous, but as the literature base is expanding for this topic, if the cannabis-related presentation reaches the level of requiring urgent care, it is likely to be more complex and costly than alcohol related ones ( 15 ). We continue to espouse a view that, like alcohol, cannabis is best used in moderation and it not suitable for everyone.…”

Section: Where Do We Go From Here?mentioning

confidence: 99%

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Mental health adverse events with cannabis use diagnosed in the Emergency Department: what are we finding now and are our findings accurate?

2023

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We have previously reviewed the types and numbers of cannabis-associated adverse events that have mental health presentations that are encountered in the Emergency Department. A particular challenge in examining these events is disentangling cannabis use adverse events from adverse events associated with use of multiple recreational substances. Since that review was published, cannabis legalization for recreational use has greatly expanded world-wide and with these changes in the legal climate has come clearer information around the frequency of adverse events seen in the Emergency Department. However, as we examined the current state of the literature, we also examined some of research designs and the biases that may be impacting the validity of the data in this field. The biases both of clinicians and researchers as well as research approaches to studying these events may be impacting our ability to assess the interaction between cannabis and mental health. For example, many of the studies performed examining cannabis-related admissions to the Emergency Department were administrative studies that relied on front line clinicians to identify and attribute that cannabis use was associated with any particular admission. This narrative review provides an overview on what we currently know about mental health adverse events in the Emergency Department with a focus on the mental health impacts both for those with and without a history of mental illness. The evidence that cannabis use can adversely impact genders and sexes differently is also discussed. This review outlines what the most common adverse events related to mental health with cannabis use are; as well as noting the most concerning but much rarer events that have been reported. Additionally, this review suggests a framework for critical evaluation of this field of study going forward.

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Section: Literature Updatementioning

confidence: 99%

Section: Literature Updatementioning

confidence: 99%