Cannabis-related ER visits by Ontario youth increased nearly fivefold from 2003 to 2017 | Research

The takeaway

Emergency department visits related to cannabis among Ontario youth aged 10-24 increased 4.8-fold over 14 years, with most visits triaged as severe and hospital admission rates three times higher than non-cannabis visits.

Public health professionals, policymakers, parents, and anyone tracking cannabis-related health trends among young people.

4.8-fold increase in youth cannabis ER visits over 14 years

What the researchers found

Cannabis-related ER visits rose from 3.8 per 10,000 youth in 2003 to 17.9 per 10,000 in 2017 (4.8-fold increase). In 2017, 88.2% of cannabis-related visits were triaged as "more severe" compared to 58.1% of non-cannabis visits, and 19.0% resulted in hospital admission vs. 5.8% for non-cannabis visits.

Why it matters

The steep upward trend in cannabis-related ER visits among young people, combined with high severity ratings and admission rates, signals a growing public health concern that preceded cannabis legalization in Canada.

The numbers in context

14.7 million total ER visits analyzed; 4.8-fold increase in cannabis visits; rates by age in 2017: 25.0/10,000 (ages 19-24), 21.9/10,000 (ages 14-18), 0.8/10,000 (ages 10-13). Males had ≥1.5x higher rates than females.

How the study worked

Population-based retrospective analysis of all emergency department visits in Ontario, Canada from 2003-2017 for youth aged 10-24 years, using ICD-10 codes for cannabis poisoning and mental disorders due to cannabinoids. 14,697,778 total visits examined.

What this study cannot tell us

Administrative data may undercount cannabis involvement. ICD coding practices may have changed over time. Ontario data may not generalize to other provinces. The study ended before legalization, so post-legalization trends are unknown.

How to read the evidence

Large population-based dataset spanning 14 years with nearly 15 million visits analyzed.

When this study was published

Published in 2022 with data from 2003-2017, entirely before Canadian legalization.

The bigger picture

This trend occurred entirely before Canada legalized recreational cannabis in 2018, suggesting factors beyond legal access were driving increases. The data provides a crucial pre-legalization baseline for evaluating policy impacts.

Questions still open

Did the trend accelerate or slow after 2018 legalization? What is driving the increase: higher potency products, more use, or more willingness to disclose? Why are cannabis-related visits so much more likely to be triaged as severe?

Common questions

Which age group had the highest rate of cannabis-related ER visits?

Youth aged 19-24 had the highest rate at 25.0 per 10,000 in 2017, followed closely by 14-18-year-olds at 21.9 per 10,000. The 10-13 age group had very low rates at 0.8 per 10,000.

Were cannabis ER visits more serious than other ER visits?

Yes. In 2017, 88.2% of cannabis-related visits were triaged as "more severe" vs. 58.1% of non-cannabis visits, and cannabis visits were 3.3 times more likely to result in hospital admission.

Read the original research

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

CMAJ open, 10(1), E100-E108

View on PubMed ↗Publisher’s paper ↗

Citation

Bechard, Melanie; Cloutier, Paula; Lima, Isac; Salamatmanesh, Mina; Zemek, Roger; Bhatt, Maala; Suntharalingam, Sinthuja; Kurdyak, Paul; Baker, Melissa; Gardner, William. (2022). Cannabis-related emergency department visits by youths and their outcomes in Ontario: a trend analysis.. CMAJ open, 10(1), E100-E108. https://doi.org/10.9778/cmajo.20210142