Colorado emergency departments are seeing more cannabis-related illnesses since legalization

Four years after legalization in Colorado, emergency departments reported increases in CHS, acute psychosis, cannabinoid catatonia, cardiac events, pediatric exposures, and hash-oil burn injuries.

Randall, Karen et al.·Missouri medicine·2019·Moderate EvidenceReview
RTHC-02249ReviewModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Post-legalization ED presentations include cannabinoid hyperemesis, acute psychosis, cannabinoid catatonia syndrome, acute myo-pericarditis, pediatric ingestions, increases in fatal motor vehicle collisions, and hash-oil burn injuries. THC concentrations have risen dramatically (from 1-3 mg per joint in the 1990s to 18+ mg today). Some patients self-report using 2,000+ mg of THC daily.

Key Numbers

1990s joints: 1-3 mg THC. Current Colorado joints: 18+ mg THC. Some patients self-report 2,000+ mg THC/day. In 2015, 2.6 million new cannabis users, 45% aged 12-17.

How They Did This

Narrative review of cannabis-related health and safety effects observed in Colorado emergency departments over four years of legalization.

Why This Research Matters

Colorado was one of the first states to legalize recreational cannabis, making it a natural experiment. The ED data provides a real-world picture of health consequences that laboratory studies cannot capture.

The Bigger Picture

As more states and countries legalize cannabis, the Colorado experience serves as a preview of potential health system impacts. The dramatic increase in THC potency is a key factor in the severity of presentations.

What This Study Doesn't Tell Us

Narrative review from one state. Does not include systematic data collection or comparison to pre-legalization rates. Some conditions (like CHS) may have been underdiagnosed previously.

Questions This Raises

  • ?Are these increases proportional to the increase in use, or is higher-potency cannabis producing more harm per user?
  • ?Would regulatory limits on THC concentration reduce ED presentations?
  • ?How do other legalized states compare?

Trust & Context

Key Stat:
THC per joint: from 1-3 mg in the 1990s to 18+ mg today
Evidence Grade:
Moderate: firsthand clinical observation from a major legalization state, but narrative review without systematic methodology.
Study Age:
Published in 2019.
Original Title:
Emergent Medical Illnesses Related to Cannabis Use.
Published In:
Missouri medicine, 116(3), 226-228 (2019)
Database ID:
RTHC-02249

Evidence Hierarchy

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

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

What is cannabinoid catatonia syndrome?

A newly described condition seen in Colorado EDs where heavy cannabis users present with a catatonia-like state. It is distinct from traditional catatonia and appears related to high-dose THC exposure.

Does legalization cause more health problems?

This review documents increased ED presentations but cannot definitively attribute them solely to legalization. Increased reporting, higher potency products, and greater use all likely contribute.

Read More on RethinkTHC

Cite This Study

RTHC-02249·https://rethinkthc.com/research/RTHC-02249

APA

Randall, Karen; Hayward, Kathleen. (2019). Emergent Medical Illnesses Related to Cannabis Use.. Missouri medicine, 116(3), 226-228.

MLA

Randall, Karen, et al. "Emergent Medical Illnesses Related to Cannabis Use.." Missouri medicine, 2019.

RethinkTHC

RethinkTHC Research Database. "Emergent Medical Illnesses Related to Cannabis Use." RTHC-02249. Retrieved from https://rethinkthc.com/research/randall-2019-emergent-medical-illnesses-related

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.