Cannabis-Related Diagnoses Were Associated With 21% Higher Odds of Overdose in Emergency Department Patients
Among 13,477 ED patients with substance-related diagnoses, those with cannabis-related diagnoses had 21% higher odds of experiencing an overdose, with Black, Hispanic, and publicly insured patients disproportionately affected.
Quick Facts
What This Study Found
Cannabis-related diagnosis was associated with 21% higher odds of overdose (aOR=1.21, p<0.05), similar to opioid-related diagnosis (aOR=1.14). Overdose odds were higher for ages 40-54 (aOR=1.37), Black patients (aOR=1.31), Hispanic patients (aOR=1.22), publicly insured (aOR=1.40), and those with mental health diagnoses (aOR=1.13). Female sex (aOR=0.78) and being married (aOR=0.69) were protective.
Key Numbers
13,477 adults with SRD in ED (2020-2023). Cannabis diagnosis: aOR=1.21 for overdose. Opioid diagnosis: aOR=1.14. Ages 40-54: aOR=1.37. Black: aOR=1.31. Hispanic: aOR=1.22. Public insurance: aOR=1.40. Mental health: aOR=1.13. Female: aOR=0.78 (protective). Married: aOR=0.69 (protective).
How They Did This
Cross-sectional study of 13,477 adults with substance-related diagnoses who had ED encounters at UCSD Health from 2020-2023. Bivariate and multiple logistic regression examined factors associated with overdose.
Why This Research Matters
The association between cannabis-related diagnoses and overdose risk is important because cannabis itself rarely causes fatal overdose. This suggests cannabis use disorder may be a marker for polysubstance use and broader vulnerability to drug-related emergencies.
The Bigger Picture
This finding is consistent with cannabis use disorder as a risk marker rather than a direct cause of overdose. It suggests people with CUD may benefit from comprehensive substance use screening and harm reduction interventions during ED visits.
What This Study Doesn't Tell Us
Cross-sectional design at one health system. Cannabis-related diagnosis does not mean cannabis caused the overdose. ICD-10 coding may not capture all substance use. Southern California population may not generalize. COVID-19 period (2020-2023) may have influenced patterns.
Questions This Raises
- ?Is cannabis use disorder a risk factor for polysubstance use that leads to overdose?
- ?Would screening for CUD in ED settings help identify patients at higher overdose risk?
- ?Are the racial disparities driven by systemic factors or differential exposure?
Trust & Context
- Key Stat:
- Cannabis-related diagnoses were linked to 21% higher odds of overdose in ED patients
- Evidence Grade:
- Moderate: large ED dataset with adjusted regression modeling, though single-center cross-sectional design limits generalizability and causal inference.
- Study Age:
- 2025 study using 2020-2023 ED data.
- Original Title:
- Sociodemographic and clinical characteristics associated with overdose among patients with a substance-related diagnosis in the emergency department of Southern California.
- Published In:
- Harm reduction journal, 22(1), 86 (2025)
- Authors:
- Maila, Brian, Zúñiga, María Luisa, Marienfeld, Carla
- Database ID:
- RTHC-07022
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Can cannabis cause an overdose?
Cannabis itself rarely causes fatal overdose. This study found cannabis-related diagnoses were associated with higher overdose risk, likely because cannabis use disorder often co-occurs with other substance use that carries overdose risk.
Why were some racial groups at higher risk?
Black and Hispanic patients had 31% and 22% higher overdose odds respectively. This likely reflects systemic factors including differential access to treatment, socioeconomic disparities, and environmental exposures rather than biological differences.
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Cite This Study
https://rethinkthc.com/research/RTHC-07022APA
Maila, Brian; Zúñiga, María Luisa; Marienfeld, Carla. (2025). Sociodemographic and clinical characteristics associated with overdose among patients with a substance-related diagnosis in the emergency department of Southern California.. Harm reduction journal, 22(1), 86. https://doi.org/10.1186/s12954-025-01233-9
MLA
Maila, Brian, et al. "Sociodemographic and clinical characteristics associated with overdose among patients with a substance-related diagnosis in the emergency department of Southern California.." Harm reduction journal, 2025. https://doi.org/10.1186/s12954-025-01233-9
RethinkTHC
RethinkTHC Research Database. "Sociodemographic and clinical characteristics associated wit..." RTHC-07022. Retrieved from https://rethinkthc.com/research/maila-2025-sociodemographic-and-clinical-characteristics
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.