Patients presenting to the ER for psychosis with positive THC screens were more likely to require physical restraints and emergency medications but not more likely to be hospitalized.
Emergency medicine physicians, psychiatrists, and clinical researchers studying cannabis and psychosis interactions.
2,134 ED visitsfor acute psychosis analyzed, with THC-positive patients showing greater acute agitation markers
What the researchers found
Positive THC screens during psychosis-related ED visits were associated with significantly greater risk of physical restraint, parenteral antipsychotic, and benzodiazepine administration compared to negative or no THC screen.
Why it matters
Understanding how cannabis use affects the acute management of psychosis in emergency settings can help clinicians better prepare for and manage these presentations.
The numbers in context
2,134 ED visits for acute psychosis examined between March 2019 and February 2021. THC-positive visits had higher rates of restraints and parenteral medication use. No significant association with psychiatric hospitalization or 90-day repeat visits.
How the study worked
Retrospective study examining ED visits for acute psychosis, comparing outcomes based on urinary THC screen results (positive vs. negative vs. no screen).
Who was studied
Patients presenting to a single emergency department for acute psychosis between March 2019 and February 2021 (2,134 visits).
What this study cannot tell us
Retrospective design limits causal inference. Urinary THC only indicates recent use, not intoxication at presentation. Patients without THC screening may differ systematically from those screened.
How to read the evidence
Retrospective single-center study provides useful clinical associations but cannot establish causation.
When this study was published
Covers the period March 2019 through February 2021.
The bigger picture
As cannabis use increases, emergency departments may see more acute psychosis presentations complicated by THC. This data supports routine THC screening to help predict acute agitation risk.
Replication
Single-center retrospective study; multi-center replication would strengthen findings.
Funding
Not specified in abstract
Conflicts of interest
Not specified in abstract
Questions still open
- Does the type or potency of cannabis used affect the severity of psychotic presentations?
- Would routine THC screening change clinical management approaches in psychiatric emergencies?
Read the original research
Cannabis use among patients presenting to the emergency department for psychosis: Associations with restraint use, medication administration, psychiatric hospitalization, and repeat visits.
Psychiatry research, 323, 115151
Citation
Gouse, Brittany M; Boliver, Elijah E; Oblath, Rachel; Camacho, Luisa; Brown, Hannah E. (2023). Cannabis use among patients presenting to the emergency department for psychosis: Associations with restraint use, medication administration, psychiatric hospitalization, and repeat visits.. Psychiatry research, 323, 115151. https://doi.org/10.1016/j.psychres.2023.115151