Medical cannabis patients showed a brief spike then slight decrease in healthcare visits over 6 months | Research

The takeaway

In a matched cohort study of 9,925 medical cannabis patients and 17,732 controls in Ontario, medical cannabis authorization was followed by a brief initial increase in healthcare visits that faded over six months.

Healthcare policy makers, medical cannabis program administrators, and health economists.

ED visits decreased by 19 per 10,000 patients over 6 months

What the researchers found

Medical cannabis patients had a short-term increase in physician visits and hospitalizations within the first month, but these differences were not statistically significant over the 6-month follow-up. Emergency department visits showed a slight but significant decrease.

Why it matters

This large real-world study provides reassurance that medical cannabis authorization does not lead to sustained increases in healthcare system burden and may even modestly reduce emergency department visits.

The numbers in context

9,925 medical cannabis patients matched with 17,732 controls. Initial increase: 4,330 additional physician visits per 10,000 patients in the first month. ED visits decreased by 19 per 10,000 patients over follow-up (p=0.014).

How the study worked

Matched cohort study comparing 9,925 medical cannabis patients (inhaled or oral) at specialized clinics with 17,732 non-authorized controls in Ontario (2014-2017). Interrupted time series and multivariate Poisson regression analyses were used.

What this study cannot tell us

Six-month follow-up is relatively short. The study could not assess why patients used healthcare services or whether cannabis replaced other treatments. Selection bias is possible since patients who seek medical cannabis may differ from controls.

How to read the evidence

Moderate: large matched cohort with interrupted time series analysis, though limited by 6-month follow-up.

When this study was published

Published in 2020 in Journal of Epidemiology and Community Health.

The bigger picture

The brief initial increase likely reflects appropriate medical monitoring of new cannabis patients, while the subsequent stabilization and slight ED reduction suggest medical cannabis does not create long-term healthcare system strain.

Questions still open

Does the slight ED reduction persist beyond six months? What drives the initial spike in healthcare use, and is it primarily monitoring visits? Would longer follow-up reveal different patterns?

Common questions

Did medical cannabis increase hospital use?

There was a brief initial increase in hospitalizations within the first month, but this was not statistically significant over the 6-month follow-up period. Emergency department visits actually showed a slight decrease.

Why would there be an initial spike in visits?

The authors suggest this likely reflects appropriate follow-up monitoring as patients begin medical cannabis use. This initial increase is expected and did not persist.

Read the original research

Cohort study of medical cannabis authorisation and healthcare utilisation in 2014-2017 in Ontario, Canada.

Journal of epidemiology and community health, 74(3), 299-304

View on PubMed ↗Publisher’s paper ↗

Citation

Eurich, Dean; Lee, Cerina; Zongo, Arsene; Minhas-Sandhu, Jasjett K; Hanlon, John G; Hyshka, Elaine; Dyck, Jason. (2020). Cohort study of medical cannabis authorisation and healthcare utilisation in 2014-2017 in Ontario, Canada.. Journal of epidemiology and community health, 74(3), 299-304. https://doi.org/10.1136/jech-2019-212438