Pediatric ER visits with positive cannabis tests rose 71% after legalization

A review of 422 pediatric ER charts found a significant increase in positive cannabinoid tests after cannabis legalization, with 43% of those patients presenting with suicidal ideation.

Harvey, Taylor et al.·Cureus·2022·Moderate EvidenceRetrospective Cohort
RTHC-03904Retrospective CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

71% of cases with positive cannabinoid drug screens presented after cannabis legalization in November 2016. The majority of cases (78%) were ages 15-17. The most common chief complaint was suicidal ideation (43%), followed by vomiting (8%), nausea (5%), trauma (5%), and altered mental status (5%).

Key Numbers

422 charts reviewed. 71% of cases after legalization (Z=7.72, p<.01). 78% were ages 15-17. 43% presented with suicidal ideation. 27% had tachycardia, 18% had hypertension. 28% tested positive for at least one other drug (amphetamine most common at 13%).

How They Did This

Descriptive retrospective chart review of 422 pediatric patients under 18 with positive urine drug screens for cannabinoids in the ED, from March 2013 to June 2020.

Why This Research Matters

The high rate of suicidal ideation among cannabis-positive youth in the ER suggests either a direct relationship between cannabis use and suicidality, or that cannabis use clusters with other risk factors. Either way, it signals a need for clinical vigilance.

The Bigger Picture

The post-legalization increase in cannabis-positive pediatric ER visits, combined with the high rate of suicidal ideation, raises questions about youth access and the intersection of cannabis use with mental health crises.

What This Study Doesn't Tell Us

Retrospective chart review cannot establish causation between cannabis use and suicidal ideation. Single-center study. Positive drug screen does not confirm acute intoxication. Temporal association with legalization does not prove legalization caused the increase.

Questions This Raises

  • ?Is the suicidal ideation related to cannabis intoxication, withdrawal, or an underlying shared risk factor?
  • ?Has the trend continued or accelerated since 2020?

Trust & Context

Key Stat:
43% of cannabis-positive pediatric ER visits involved suicidal ideation
Evidence Grade:
Large retrospective chart review with significant statistical findings, but single-center and unable to establish causation.
Study Age:
Published in 2022, covering March 2013 to June 2020.
Original Title:
Varied Presentations of Pediatric Patients With Positive Cannabinoid Tests.
Published In:
Cureus, 14(3), e23493 (2022)
Database ID:
RTHC-03904

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

Did pediatric ER visits for cannabis increase after legalization?

Yes. In this study of 422 cases, 71% of pediatric patients with positive cannabis tests presented after legalization in November 2016, a statistically significant increase.

What symptoms do teens show in the ER after using cannabis?

The most common presentation was suicidal ideation (43%), followed by vomiting, nausea, trauma, and altered mental status. Tachycardia (27%) and hypertension (18%) were common vital sign abnormalities.

Read More on RethinkTHC

Cite This Study

RTHC-03904·https://rethinkthc.com/research/RTHC-03904

APA

Harvey, Taylor; Gomez, Ramon; Wolk, Brian; Ozcan, Ali. (2022). Varied Presentations of Pediatric Patients With Positive Cannabinoid Tests.. Cureus, 14(3), e23493. https://doi.org/10.7759/cureus.23493

MLA

Harvey, Taylor, et al. "Varied Presentations of Pediatric Patients With Positive Cannabinoid Tests.." Cureus, 2022. https://doi.org/10.7759/cureus.23493

RethinkTHC

RethinkTHC Research Database. "Varied Presentations of Pediatric Patients With Positive Can..." RTHC-03904. Retrieved from https://rethinkthc.com/research/harvey-2022-varied-presentations-of-pediatric

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.