Colorado surveillance system validated for tracking marijuana-related ER visits after legalization

Of 453 potential marijuana-related ER visits flagged by surveillance queries in Colorado, 188 (45%) were confirmed as true cases, with edible users and out-of-state visitors disproportionately affected.

Marx, Grace E et al.·Public health reports (Washington·2019·Moderate EvidenceCross-Sectional
RTHC-02164Cross SectionalModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Of 44,942 total ER visits, 1% were flagged as potential marijuana cases; 188 of 422 reviewed records (45%) were confirmed acute adverse effects. 95% reported intentional use. Non-Colorado residents and edible users were significantly overrepresented among confirmed cases compared to non-cases.

Key Numbers

44,942 total ER visits; 453 flagged (1%); 188 confirmed cases; 58% male; 95% intentional use; PPV ranged 36-64% by hospital; edible users and non-residents significantly overrepresented.

How They Did This

Validation study comparing syndromic surveillance queries (ICD-10 codes and keywords) against physician-reviewed medical records at 3 Colorado hospitals during 2016-2017.

Why This Research Matters

Post-legalization monitoring requires validated surveillance tools. This study confirms that existing ER data systems can reliably track marijuana-related visits, enabling evidence-based policy responses.

The Bigger Picture

The overrepresentation of tourists and edible users among confirmed cases aligns with concerns about inexperienced consumers encountering legal cannabis. Surveillance data like this can guide targeted public health messaging.

What This Study Doesn't Tell Us

Three hospitals in one Colorado county, not statewide. PPV varied substantially by hospital. Only captures ER presentations, missing less severe adverse effects managed at home or in urgent care.

Questions This Raises

  • ?Have marijuana-related ER visits continued to rise since 2017?
  • ?Would standardized patient intake questions about cannabis use improve surveillance accuracy?

Trust & Context

Key Stat:
Edibles & tourists overrepresented
Evidence Grade:
Moderate: validated surveillance methodology with physician chart review, but limited to three hospitals.
Study Age:
Published in 2019.
Original Title:
Syndromic Surveillance of Emergency Department Visits for Acute Adverse Effects of Marijuana, Tri-County Health Department, Colorado, 2016-2017.
Published In:
Public health reports (Washington, D.C. : 1974), 134(2), 132-140 (2019)
Database ID:
RTHC-02164

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

How common are marijuana ER visits in Colorado?

About 1% of ER visits at three hospitals were flagged as potentially marijuana-related, with 45% confirmed after physician review.

Who is most likely to end up in the ER from marijuana?

Edible cannabis users and out-of-state visitors (tourists) were significantly overrepresented among confirmed cases.

Read More on RethinkTHC

Cite This Study

RTHC-02164·https://rethinkthc.com/research/RTHC-02164

APA

Marx, Grace E; Chen, Yushiuan; Askenazi, Michele; Albanese, Bernadette A. (2019). Syndromic Surveillance of Emergency Department Visits for Acute Adverse Effects of Marijuana, Tri-County Health Department, Colorado, 2016-2017.. Public health reports (Washington, D.C. : 1974), 134(2), 132-140. https://doi.org/10.1177/0033354919826562

MLA

Marx, Grace E, et al. "Syndromic Surveillance of Emergency Department Visits for Acute Adverse Effects of Marijuana, Tri-County Health Department, Colorado, 2016-2017.." Public health reports (Washington, 2019. https://doi.org/10.1177/0033354919826562

RethinkTHC

RethinkTHC Research Database. "Syndromic Surveillance of Emergency Department Visits for Ac..." RTHC-02164. Retrieved from https://rethinkthc.com/research/marx-2019-syndromic-surveillance-of-emergency

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.