National survey of 44,000 older adults finds cannabis users have more ER visits but medical-only users drive the pattern | Research

The takeaway

Among over 44,000 Americans aged 50+, past-year cannabis users had higher ER visit rates but did not differ from non-users in total visits or hospitalizations, with medical-only users having the most ER visits.

Geriatricians, primary care providers, healthcare system planners, and older adults using or considering cannabis.

Medical-only users had 38% more ER visits than nonmedical-only users

What the researchers found

Past-year cannabis users had higher rates of any ED visit (30.0%) and hospitalization (14.7%) than never users. However, they did not differ from never users in total number of ED visits or nights hospitalized. Medical-only users had significantly more ED visits than nonmedical-only users (IRR 1.38). Cannabis use characteristics were not associated with hospitalization nights.

Why it matters

With cannabis use rising among older adults, understanding its relationship to healthcare utilization helps inform both clinical practice and health system planning.

The numbers in context

44,007 adults aged 50+; past-year users: 30.0% any ED visit, 14.7% hospitalization. Medical-only users: IRR 1.38 for ED visits vs. nonmedical-only users. Past-year users had more ED visits than prior users (IRR 1.21).

How the study worked

Analysis of 2015-2019 National Survey on Drug Use and Health data (n=44,007 adults aged 50+). Negative binomial regression models compared healthcare utilization by cannabis use status and use reason, controlling for demographics and health characteristics.

What this study cannot tell us

Cross-sectional design. Self-reported cannabis use and healthcare utilization. Cannot determine whether cannabis use or underlying conditions drive ER utilization. No data on reasons for ER visits.

How to read the evidence

Large nationally representative dataset, but cross-sectional and self-reported.

When this study was published

Published in 2022 with 2015-2019 survey data.

The bigger picture

The finding that medical-only users have more ER visits likely reflects their underlying health conditions rather than cannabis-caused problems, highlighting the importance of distinguishing medical from recreational use in health outcomes research.

Questions still open

Are medical cannabis users visiting the ER for cannabis-related issues or their underlying conditions? Would medical cannabis reduce ER visits over time by managing symptoms? Do older cannabis users have different risk profiles than younger users?

Common questions

Do older cannabis users use more healthcare?

They had higher rates of any ER visit (30% vs. lower rates for non-users) but did not have more total ER visits or hospital nights, suggesting they visit the ER at similar frequencies to non-users.

Is medical cannabis driving the increased ER visits?

Medical-only cannabis users had 38% more ER visits than nonmedical-only users, likely reflecting their underlying health conditions rather than cannabis-caused problems.

Read the original research

Associations of Healthcare Service Utilization With Cannabis Use Status, Use Reasons, and Use Characteristics Among Those Age 50 and Older.

Journal of applied gerontology : the official journal of the Southern Gerontological Society, 41(5), 1385-1396

View on PubMed ↗Publisher’s paper ↗

Citation

Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan; Choi, Bryan Y. (2022). Associations of Healthcare Service Utilization With Cannabis Use Status, Use Reasons, and Use Characteristics Among Those Age 50 and Older.. Journal of applied gerontology : the official journal of the Southern Gerontological Society, 41(5), 1385-1396. https://doi.org/10.1177/07334648211069997