Older adults’ marijuana use, injuries, and emergency department visits

Choi, Namkee G.; Marti, C. Nathan; DiNitto, Diana M.; Choi, Bryan Y.

doi:10.1080/00952990.2017.1318891

Cited by 59 publications

(52 citation statements)

References 23 publications

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“…Studies including relative measures showed frequency of ED utilization of three to 10 times that of comparison groups not using illicit drugs . Exceptions were a study in rural Taiwan, showing that people who inject heroin had a similar rate of ED presentation as the general population , and a study of older people who use cannabis in the United States showing similar odds of ED presentation as those who do not use cannabis .…”

Section: Resultsmentioning

confidence: 97%

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Lewer

Freer

King³

et al. 2020

Addiction

111

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Aims To summarize evidence on the frequency and predictors of health-care utilization among people who use illicit drugs. Design Systematic search of MEDLINE, EMBASE and PsychINFO for observational studies reporting healthcare utilization published between 1 January 2000 and 3 December 2018. We conducted narrative synthesis and meta-analysis following a registered protocol (identifier: CRD42017076525). Setting and participants People who use heroin, powder cocaine, crack cocaine, methamphetamine, amphetamine, ecstasy/3,4-methylenedioxymethamphetamine (MDMA), cannabis, hallucinogens or novel psychoactive substances; have a diagnosis of 'substance use disorder'; or use drug treatment services. Measurements Primary outcomes were the cumulative incidence (risk) and rate of care episodes in three settings: primary care, hospital admissions (in-patient) and emergency department (ED).Findings Ninety-two studies were included, 84% from North America and Australia. Most studies focused on people using heroin, methamphetamine or crack cocaine, or who had a diagnosis of drug dependence. We were able to conduct a meta-analysis of rates across 25 studies reporting ED episodes and 25 reporting hospital admissions, finding pooled rates of 151 [95% confidence interval (CI) = 114-201] and 41 (95% CI = 30-57) per 100 person-years, respectively; on average 4.8 and 7.1 times more often than the general population. Heterogeneity was very high and was not explained by drugs used, country of study, recruitment setting or demographic characteristics. Predictors of health-care utilization were consistent across studies and included unstable housing, drug injection and mental health problems. Opioid substitution therapy was consistently associated with reduced ED presentation and hospital admission. There was minimal research on health-care utilization by people using ecstasy/MDMA, powder cocaine, hallucinogens or novel psychoactive substances.Conclusions People who use illicit drugs are admitted to emergency department or hospital several times more often than the general population.

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Section: Resultsmentioning

confidence: 97%

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Lewer

Freer

King³

et al. 2020

Addiction

111

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“…Although better health was reported, older marijuana users have reported utilization of the emergency department ( Choi, Marti, DiNitto, & Choi, 2017 ; Schlaerth, Splawn, Ong, & Smith, 2004 ). In contrast to nonusers, marijuana use has been associated with injury among those in the older adult population, and injury has been associated with emergency department visits ( Choi, Marti, et al, 2017 ). Injury served as a mediator for the increased likelihood of emergency department utilization among marijuana users.…”

Section: Resultsmentioning

confidence: 99%

“…Marijuana use can negatively affect the health of those in the older adult population beyond abuse and dependence. Marijuana use has been associated with injury ( Asbridge et al, 2014 ; Blows et al, 2005 ; Choi, Marti, et al, 2017 ; Wettlaufer et al, 2017 ), mental health problems ( Choi et al, 2016 ; Choi et al, 2016a ; Hall & Degenhardt, 2009 ; Manrique-Garcia et al, 2012 ), cardiovascular disease ( Alshaarawy & Elbaz, 2016 ; Hackam, 2015 ; Hemachandra, McKetin, Cherbuin, & Anstey, 2016 ; Lindsay, Foale, Warren, & Henry, 2005 ; Reece, Norman, & Hulse, 2016 ), respiratory problems ( Howden & Naughton, 2011 ; Macleod et al, 2015 ; Martinasek, McGrogan, & Maysonet, 2016 ; Moore, Augustson, Moser, & Budney, 2005 ), metabolic syndrome ( B. A. Yankey, Rothenberg, Strasser, White, & Okosun, 2017 ; B. N. Yankey, Strasser, & Okosun, 2016 ), cancer ( Aldington et al,2008a , 2008b ; Zhang et al, 1999 ), unhealthy diet ( Foltin, Fischman, & Byrne, 1988 ; Smit & Crespo, 2001 ), and drug–drug interactions ( Lasota, 2015 ; Mahvan et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Marijuana Use Among Adults 50 Years or Older in the 21st Century

Lloyd

Striley

2018

Gerontology and Geriatric Medicine

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Background: Marijuana is the most commonly used illicit drug among older adults. As an older population grows in the United States that has a tolerant attitude toward marijuana use, the dynamics of marijuana use and the effects of marijuana on personal, social, and health outcomes among older adults require attention. Objectives: This review summarizes epidemiological literature on marijuana use among older adults. Method: A literature search was conducted using PubMed, AgeLine, and an online search engine from January 2000 to December 2017, resulting in 18 articles. Results: The greatest increase in marijuana use was observed among those in the older adult population 50 years or older, and those 65 years or older had the greatest increase in marijuana use in the older adult population. Common correlates of marijuana use among those in the older population included being male, being unmarried, having multiple chronic diseases, having psychological stress, and using other substances such as alcohol, tobacco, other illicit drugs, and prescription drugs. Conclusion: The increased use of marijuana in older populations requires surveillance and additional research to understand the use and effects of marijuana in older populations to avoid negative health outcomes.

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“…These negative effects may also be increasingly common as OA are exposed to the exponential rising potency of THC and ratio of THC to CBD [53]. While OA marijuana use (particularly edibles) is associated with increased injury, emergency department visits, and driving under the influence [54][55][56], OA perceive less risk from using marijuana compared to their younger counterparts, particularly among frequent users, medical marijuana users, and in states where marijuana has been legalized [57]. Gerontology 2020;66:249-258 DOI: 10.1159/000504363…”

Section: Painmentioning

confidence: 99%

Substance Use among Older Adults: An Update on Prevalence, Etiology, Assessment, and Intervention

Kuerbis

2019

Gerontology

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The global population is aging, and as the population ages, high-risk alcohol and other drug use, particularly cannabis and prescription medications, is growing among older adults (OA). OA, defined here as 50 years of age and older, have a number of unique vulnerabilities to drug and alcohol use due to both biological as well as psychosocial factors compared to younger adults. Understanding the wide spectrum of these vulnerabilities is important to assessment, diagnosis, and intervention. Specific techniques, assessment tools, and interventions known to be effective in OA are reviewed.

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Older adults’ marijuana use, injuries, and emergency department visits

Abstract: Healthcare providers should screen for marijuana and other substance use among older adults and provide education about associated injury risks.

Cited by 59 publications

References 23 publications

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Marijuana Use Among Adults 50 Years or Older in the 21st Century

Substance Use among Older Adults: An Update on Prevalence, Etiology, Assessment, and Intervention

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