Unintentional Pediatric Marijuana Exposures Prior to and After Legalization and Commercial Availability of Recreational Marijuana in Washington State

Thomas, Anita; Derau, Katie Von; Bradford, Miranda C.; Moser, Emily; Garrard, Alexander; Mazor, Suzan

doi:10.1016/j.jemermed.2019.01.004

Cited by 36 publications

(36 citation statements)

References 10 publications

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“…Cannabis-related visits were more common and increased more quickly among youth aged 14-18 and 19-24 years than among those aged 10-13 years. Similar increases in cannabis-related visits among youths have been reported in other jurisdictions, including the United States, 12,32 Colorado, 33 Washington state 34 and France. 35 In the current study, cannabis-related visits were more severe at presentation than visits for other conditions, and the proportion of cannabis-related visits triaged as severe increased between 2003 and 2017.…”

Section: Discussionsupporting

confidence: 71%

Cannabis-related emergency department visits by youths and their outcomes in Ontario: a trend analysis

Bechard

Cloutier

Lima

et al. 2022

cmajo

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Background: Cannabis-related emergency department visits can be an entry point for youths to mental health and substance use care systems. We aimed to examine trends in cannabis-related emergency department visits as a function of youths' age and sex. Methods:Using administrative data, we examined all visits to emergency departments in Ontario, Canada, from 2003 to 2017, by youth aged 10-24 years (grouped as 10-13, 14-18 and 19-24 yr) to determine trends in cannabis-related emergency department visits. Cannabis-related visits were identified using International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes for cannabis poisoning and mental disorders due to cannabinoids. We categorized presentations as "less severe" versus "more severe" using scores assigned by nurses at triage. Results:We examined 14 697 778 emergency department visits. Cannabis-related visits increased from 3.8 per 10 000 youths (95% confidence interval [CI] 3.5-4.0) in 2003 to 17.9 (95% CI 17.4-18.4) in 2017, a 4.8-fold increase (95% CI 4.4-5.1). Rates increased for both sexes and each age group. Males were more likely to have a visit than females (rate ratios ≥ 1.5 in 2003 and 2017). The number of cannabis-related visits in 2017 was 25.0 per 10 000 (95% CI 24.0-25.9) among youth aged 19-24 years, 21.9 per 10 000 (95% CI 20.9-22.9) among those aged 14-18 years, and 0.8 per 10 000 (95% CI 0.5-1.0) among those aged 10-13 years. In 2017, 88.2% (95% CI 87.3%-89.0%) of cannabis-related visits and 58.1% (95% CI 58.0%-58.2%) of non-cannabis-related visits were triaged as "more severe," (rate ratio 1.52, 95% CI 1.50-1.53). Similarly, in 2017, 19.0% (95% CI 18.0%-20.1%) of cannabis-related visits and 5.8% (95% CI 5.7%-5.8%) of non-cannabis-related visits resulted in hospital admission (rate ratio 3.3, 95% CI 3.1-3.5).Interpretation: Rates of cannabis-related emergency department visit by youths aged 10-24 years increased almost fivefold from 2003 to 2017, with increases in visit severity and hospital admissions. These trends describe an emerging public health problem, and research is needed to identify the causes of this increase and the health and social consequences of cannabis-related visits for these youths.

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Section: Discussionsupporting

confidence: 71%

Cannabis-related emergency department visits by youths and their outcomes in Ontario: a trend analysis

Bechard

Cloutier

Lima

et al. 2022

cmajo

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“… 74 , 75 While there are little data on the association of cannabis use with health care costs, emerging evidence indicates cannabis use is associated with motor vehicle accidents, increased poison control calls, and emergency department visits, suggesting that health system costs are possible. 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 …”

Section: Discussionmentioning

confidence: 99%

Sociodemographic Characteristics Associated With and Prevalence and Frequency of Cannabis Use Among Adults in the US

et al. 2021

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IMPORTANCE Cannabis use has increased, but there are few studies on frequent and daily cannabis use among US adults. Individuals who engage in higher frequency use may suffer more health consequences. OBJECTIVE To examine frequency of cannabis use and associated factors among US adults. DESIGN, SETTING, AND PARTICIPANTS This survey study included data from 21 US states and 2 US territories reported in the Behavioral Risk Factor Surveillance System surveys from 2016 to 2019. Cross-sectional data on US adults ages 18 years and older were used to estimate demographic, socioeconomic, and behavioral risk factors for cannabis use, taking into account the survey strata and sampling weights for the 4 years of combined data. Using a multivariable ordinal logistic analysis, the association of demographic, socioeconomic status, and behavioral risk factors with past month cannabis frequency were examined. EXPOSURES Sociodemographic characteristic, ie, age, gender, race and ethnicity, educational attainment, employment status, and annual household income. MAIN OUTCOMES AND MEASURES Ordinal categorization of number of days of cannabis use in the past 30 days in terms of nonuse, infrequent use (1-5 days), frequent use (6-29 days), and daily use. RESULTS Among the 387 179 respondents, 58 009 (27.9%) were ages 18 to 34 years, 186 923 (50.3%) were ages 35 to 64 years, and 142 225 (21.8%) were age 65 years or older (mean [SD] age, 48.3 [0.1] years). The sample included 28 345 (9.8%) Black, 36 697 (22.6%) Hispanic, and 292 210 (57.3%) White respondents. Smoking was the most common form of cannabis use. The frequency of cannabis use varied significantly by age, gender, race, marital status, education, and employment. Higher frequency cannabis use was associated with younger age (ages 18-34 years: adjusted odds

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“…While we believe that intubation has not been common historically for cannabis exposed pediatric patients, this may be changing. With the combination of increasing availability and access to cannabis products through state legalization [77], higher THC concentrations of cannabis botanicals being grown [16], and the introduction of and familiarity with cannabis concentrates [78], more accidental toxic exposures to pediatric patients seems inevitable [33,[79][80][81][82]. We therefore would advise clinicians to immediately assess for CNS depression and any signs of respiratory compromise in a pediatric patient, particularly in infants and young toddlers exposed to concentrates, and maintain a low threshold for intubation to avoid respiratory insufficiency as a potential complication.…”

Section: Pediatric Exposurementioning

confidence: 99%

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

Takakuwa¹,

Schears

2021

Int J Emerg Med

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Background Cannabis is the most prevalent illegal drug used and the second most common cause of ED drug-related complaints in the USA. Recently, newer more potent strains, concentrated THC products, and consumption methods have become available. Objective Our first objective was to define cannabis use in the USA and provide a summary background on its current preparations, pharmacokinetics, vital sign and physical exam findings, adverse effects, and laboratory testing. Our second objective, using the aforementioned summary as relevant background information, was to present and summarize the care and treatment of the most commonly reported cannabis-related topics relevant to ED physicians. Methods We first performed an extensive literature search of peer-reviewed publications using New PubMed and Cochrane Central Register of Controlled Trials to identify the most commonly reported cannabis-related topics in emergency care. Once the six topic areas were identified, we undertook an extensive narrative literature review for each section of this paper using New PubMed and Cochrane Central Register of Controlled Trials from the inception of the databases to September 30, 2020. Results The six subject areas that were most frequently reported in the medical literature relevant to cannabis-related ED care were acute intoxication/overdose, pediatric exposure, cannabinoid hyperemesis syndrome, cannabis withdrawal, e-cigarette or vaping product use-associated lung injury (EVALI), and synthetic cannabinoids. Conclusion As cannabis becomes more widely available with the adoption of state medical cannabis laws, ED-related cannabis visits will likely rise. While cannabis has historically been considered a relatively safe drug, increased legal and illegal access to newer formulations of higher potency products and consumption methods have altered the management and approach to ED patient care and forced physicians to become more vigilant about recognizing and treating some new cannabis-related life-threatening conditions.

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Unintentional Pediatric Marijuana Exposures Prior to and After Legalization and Commercial Availability of Recreational Marijuana in Washington State

Cited by 36 publications

References 10 publications

Cannabis-related emergency department visits by youths and their outcomes in Ontario: a trend analysis

Cannabis-related emergency department visits by youths and their outcomes in Ontario: a trend analysis

Sociodemographic Characteristics Associated With and Prevalence and Frequency of Cannabis Use Among Adults in the US

The emergency department care of the cannabis and synthetic cannabinoid patient: a narrative review

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