Marijuana Tourism and Emergency Department Visits in Colorado

Kim, Howard; Hall, Katelyn E.; Genco, Emma K.; Dyke, Mike Van; Barker, Elizabeth; Monte, Andrew A.

doi:10.1056/nejmc1515009

Cited by 68 publications

(42 citation statements)

References 2 publications

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“…If this trend continues into 2016, it may provide evidence of the public learning safe consumption of marijuana products. Further evidence of this learning effect is provided by the discrepancy in the increased rates of ED visits with marijuana-related billing codes for Colorado tourists compared to residents (Kim et al, 2016). …”

Section: Discussionmentioning

confidence: 99%

Marijuana and acute health care contacts in Colorado

Wang

Hall

Vigil

et al. 2017

Preventive Medicine

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Over 22 million Americans are current users of marijuana; half of US states allow medical marijuana, and several allow recreational marijuana. The objective of this study was to evaluate the impact marijuana has on hospitalizations, emergency department (ED) visits, and regional poison center (RPC) calls in Colorado, a medical and recreational marijuana state. This is a retrospective review using Colorado Hospital Association hospitalizations and ED visits with marijuana-related billing codes, and RPC marijuana exposure calls. Legalization of marijuana in Colorado has been associated with an increase in hospitalizations, ED visits, and RPC calls linked with marijuana exposure. From 2000 to 2015, hospitalization rates with marijuana-related billing codes increased from 274 to 593 per 100,000 hospitalizations in 2015. Overall, the prevalence of mental illness among ED visits with marijuana-related codes was five-fold higher (5.07, 95% CI: 5.0, 5.1) than the prevalence of mental illness without marijuana-related codes. RPC calls remained constant from 2000 through 2009. However, in 2010, after local medical marijuana policy liberalization, the number of marijuana exposure calls significantly increased from 42 to 93; in 2014, after recreational legalization, calls significantly increased by 79.7%, from 123 to 221 (p <0.0001). The age group <17 years old also had an increase in calls after 2014. As more states legalize marijuana, it is important to address public education and youth prevention, and understand the impact on mental health disorders. Improvements in data collection and surveillance methods are needed to more accurately evaluate the public health impact of marijuana legalization.

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Section: Discussionmentioning

confidence: 99%

Marijuana and acute health care contacts in Colorado

Wang

Hall

Vigil

et al. 2017

Preventive Medicine

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“…Colorado legalized medical cannabis in 2000 and recreational cannabis in 2014. A recent study of statewide ED visit data (2011-2014) on ICD-codes found an increasing trend in ED visits that were potentially related to CUD in Colorado (Kim et al, 2016). Given the continued wave of cannabis legalization and reports of increased availability of higher-potency cannabis, our findings reinforce the need for research to identify subgroups at risk for CUD and related healthcare utilization.…”

Section: Discussionmentioning

confidence: 99%

Trends and Correlates of Cannabis-involved Emergency Department Visits: 2004 to 2011

Zhu

2016

Journal of Addiction Medicine

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Objectives To examine trends and correlates of cannabis-involved emergency department (ED) visits in the United States from 2004 to 2011. Methods Data were obtained from the 2004-2011 Drug Abuse Warning Network. We analyzed trend in cannabis-involved ED visits for persons aged ≥12 years and stratified by type of cannabis involvement (cannabis-only, cannabis-polydrug). We used logistic regressions to determine correlates of cannabis-involved hospitalization versus cannabis-involved ED visits only. Results Between 2004 and 2011, the ED visit rate increased from 51 to 73 visits per 100,000 population aged ≥ 12 years for cannabis-only use (P-value for trend=0.004) and from 63 to 100 for cannabis-polydrug use (P-value for trend<0.001). Adolescents aged 12-17 years showed the largest increase in the cannabis-only-involved ED visit rate (Rate difference=80 per 100,000 adolescents). Across racial/ethnic groups, the most prevalent ED visits were noted among non-Hispanic blacks. Among cannabis-involved visits, the odds of hospitalization (versus ED visits only) increased with age strata compared with aged 12-17 years. Conclusions These findings suggest a notable increase in the ED visit numbers and rates for both the use of cannabis-only and cannabis-polydrug during the studied period, particularly among young people and non-Hispanic blacks.

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“…This perspective is especially important when new exposures, such as increased cannabis utilization, become more common. Emergency physician observations have yielded increased understanding of the health impact of cannabis, such as tourist ED visits related to marijuana 3 , butane hash oil associated burns 4 , cannabinoid hyper-emesis 5 , and many other conditions. 6 Similarly, Colorado emergency physicians have noted an increase in cannabis associated psychiatric visits to local EDs.…”

mentioning

confidence: 99%

“…31 However, increased health care utilization associated with acute and chronic cannabis use has been observed. 3,32–34 According to the Colorado 2014–2016 Behavioral Risk Factors Surveillance System, the prevalence of current mental health distress (14 or more poor mental health days) was 10.1% and a prior diagnosis of depression was present in 18.4% of Colorado residents. The estimates were significantly higher in those who reported using cannabis regularly over the past 30 days; 17.9% of regular cannabis users had current mental health distress and 29.9% reported a prior diagnosis of depression.…”

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confidence: 99%

Mental Health–related Emergency Department Visits Associated With Cannabis in Colorado

Hall

Monte

Chang

et al. 2018

Academic Emergency Medicine

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Background Cannabis legalization in Colorado resulted in increased cannabis-associated health care utilization. Our objective was to examine cooccurrence of cannabis and mental health diagnostic coding in Colorado emergency department (ED) discharges and replicate the study in a subpopulation of ED visits where cannabis involvement and psychiatric diagnosis were confirmed through medical review. Methods We collected statewide ED International Classification of Diseases, 9th Revision, Clinical Modification diagnoses from the Colorado Hospital Association and a subpopulation of ED visits from a large, academic hospital from 2012 to 2014. Diagnosis codes identified visits associated with mental health and cannabis. Codes for mental health conditions and cannabis were confirmed by manual records review in the academic hospital subpopulation. Prevalence ratios (PRs) of mental health ED discharges were calculated to compare cannabis-associated visits to those without cannabis. Rates of mental health and cannabis-associated ED discharges were examined over time. Results Statewide data demonstrated a fivefold higher prevalence of mental health diagnoses in cannabis-associated ED visits (PR = 5.35, 95% confidence interval [CI], 5.27–5.43) compared to visits without cannabis. The hospital subpopulation supported this finding with a fourfold higher prevalence of psychiatric complaints in cannabis attributable ED visits (PR = 4.87, 95% CI = 4.36–5.44) compared to visits not attributable to cannabis. Statewide rates of ED visits associated with both cannabis and mental health significantly increased from 2012 to 2014 from 224.5 to 268.4 per 100,000 (p < 0.0001). Conclusions In Colorado, the prevalence of mental health conditions in ED visits with cannabis-associated diagnostic codes is higher than in those without cannabis. There is a need for further research determining if these findings are truly attributed to cannabis or merely coincident with concurrent increased use and availability.

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Marijuana Tourism and Emergency Department Visits in Colorado

Cited by 68 publications

References 2 publications

Marijuana and acute health care contacts in Colorado

Marijuana and acute health care contacts in Colorado

Trends and Correlates of Cannabis-involved Emergency Department Visits: 2004 to 2011

Mental Health–related Emergency Department Visits Associated With Cannabis in Colorado

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