Cannabis was the third most common substance in emergency department visits, with sex differences in patterns

Among 10,511 substance-related ED visits, cannabis accounted for 14.4%, making it the third most common substance after alcohol (54%) and opioids (19%), with males presenting older for cannabis and alcohol but younger for opioids than females.

Cannon, Robert D et al.·Clinical therapeutics·2018·Moderate EvidenceRetrospective Cohort
RTHC-01613Retrospective CohortModerate Evidence2018RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Researchers analyzed 10,511 emergency department visits across three Pennsylvania hospitals over 18 months where the final diagnosis involved substance use. Alcohol dominated at 54.3%, followed by opioids at 19.2%, and cannabis at 14.4%.

The overall population was predominantly male (65.6%) with a mean age of 43.6 years. However, sex-specific patterns emerged for different substances. Males with cannabis-related ED visits were older than females with cannabis visits, mirroring the alcohol pattern. For opioids, the relationship reversed: females were older (41.3 years) than males (38.9 years) at opioid-related visits.

Females tended to be younger overall and were more likely to be discharged after their ED visit (36.1% vs 32.3%), while males were more likely to be admitted.

Key Numbers

10,511 substance-related ED visits. Mean age 43.6 years. 65.6% male. Alcohol: 54.3%. Opioids: 19.2%. Cannabis: 14.4%. Females younger overall (42.4 vs 44.3 years, p < 0.001). Females more likely discharged (36.1% vs 32.3%, p < 0.001). Males older for cannabis and alcohol visits; females older for opioid visits (41.3 vs 38.9 years, p < 0.001).

How They Did This

Retrospective electronic data analysis of ED visits at 3 hospitals in northeastern Pennsylvania from January 2016 through July 2017. All visits with substance use diagnosis codes (F10-F19, excluding nicotine) were included. Data captured primary substance, sex, age, date, and disposition. Time series analysis assessed trends by sex.

Why This Research Matters

Emergency departments are often the frontline for managing substance-related crises. Understanding that cannabis accounts for nearly 1 in 7 substance-related ED visits, and that patterns differ by sex and age, can inform resource allocation, screening protocols, and targeted intervention strategies.

The Bigger Picture

This study provides a snapshot of the substance use crisis from the emergency department perspective, where cannabis sits as the third most common substance. While less acutely dangerous than opioids, the volume of cannabis-related ED visits underscores that cannabis use does generate acute clinical presentations requiring medical attention.

What This Study Doesn't Tell Us

The study was limited to three hospitals in one region of Pennsylvania and may not represent national patterns. Only visits coded with substance use diagnoses were captured, potentially missing cases where substance use was not documented. The study could not distinguish between primary cannabis toxicity and cannabis as a secondary finding. Retrospective data abstraction depends on coding accuracy.

Questions This Raises

  • ?What specific presentations bring cannabis users to the emergency department most frequently?
  • ?Has legalization in other states changed the proportion of cannabis-related ED visits?
  • ?How do cannabis-related ED visits compare in severity and cost to alcohol and opioid visits?

Trust & Context

Key Stat:
Cannabis accounted for 14.4% of substance-related ED visits, third after alcohol and opioids
Evidence Grade:
This is a moderate-sized retrospective analysis from a regional hospital system, providing moderate evidence of substance use patterns in the ED setting.
Study Age:
Published in 2018 with 2016-2017 data from Pennsylvania.
Original Title:
Sex Differences in Prevalence of Emergency Department Patient Substance Use.
Published In:
Clinical therapeutics, 40(2), 197-203 (2018)
Database ID:
RTHC-01613

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Do people go to the ER for cannabis?

Yes. Cannabis was the third most common substance in emergency department visits in this study, accounting for 14.4% of all substance-related visits. While less frequent than alcohol (54%) and opioids (19%), it still represents a significant volume of ED encounters.

Are there sex differences in substance-related ER visits?

Yes. Males were more common overall (65.6%) and tended to be older for cannabis and alcohol visits. For opioid-related visits, females were older than males. Females were more likely to be discharged rather than admitted.

Read More on RethinkTHC

Cite This Study

RTHC-01613·https://rethinkthc.com/research/RTHC-01613

APA

Cannon, Robert D; Beauchamp, Gillian A; Roth, Paige; Stephens, Jennifer; Burmeister, David B; Richardson, David M; Balbi, Alanna M; Park, Tennessee D; Dusza, Stephen W; Greenberg, Marna Rayl. (2018). Sex Differences in Prevalence of Emergency Department Patient Substance Use.. Clinical therapeutics, 40(2), 197-203. https://doi.org/10.1016/j.clinthera.2017.12.013

MLA

Cannon, Robert D, et al. "Sex Differences in Prevalence of Emergency Department Patient Substance Use.." Clinical therapeutics, 2018. https://doi.org/10.1016/j.clinthera.2017.12.013

RethinkTHC

RethinkTHC Research Database. "Sex Differences in Prevalence of Emergency Department Patien..." RTHC-01613. Retrieved from https://rethinkthc.com/research/cannon-2018-sex-differences-in-prevalence

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.