US Cannabis Emergency Department Visits Increased 12% Annually from 2006 to 2014 | Research

The takeaway

Nationwide US data showed cannabis-related ER visits rose an average of 12.1% annually from 2006-2014, with continued increases after 2016, particularly among females, children under 14, and the Midwest region.

Emergency physicians; public health officials; cannabis policy researchers; poison control centers.

12.1% average annual increase in cannabis ER visits (2006-2014)

What the researchers found

Cannabis-associated ER visits increased from 12.3 to 34.7 per 100,000 from 2006-2014 (12.1% annual increase). Rates continued rising 17.3% from 2016-2017 and 11.1% from 2017-2018. The Midwest saw the largest regional increase (36.8%). Female visit rates increased faster than male rates (15.9% vs 8.7%).

Why it matters

ER visits are a concrete, measurable indicator of cannabis-related harm at the population level. The sustained increases across multiple demographics and regions suggest a growing public health burden that parallels expanding cannabis availability.

The numbers in context

Rate rose from 12.3 to 34.7 per 100,000 (2006-2014). Average annual increase: 12.1%. 2016-2017: +17.3%. 2017-2018: +11.1%. Female increase: 15.9% (2017-2018). Midwest: +36.8%. Ages 0-14 and 25+ showed significant increases.

How the study worked

Analysis of the Nationwide Emergency Department Sample (NEDS) from HCUP, covering cannabis-associated ER visits 2006-2018. JoinPoint analysis for trends. Z-tests for annual rate changes. Examined by age, sex, region, and visit characteristics.

What this study cannot tell us

ICD coding changes in 2015 created a discontinuity, requiring separate analysis periods. "Cannabis-associated" includes visits where cannabis is mentioned but may not be the primary reason. Increased ER coding of cannabis could reflect awareness rather than true incidence increases.

How to read the evidence

Strong: nationwide ER data from a standardized federal database covering 12 years.

When this study was published

Published in 2022, covering 2006-2018.

The bigger picture

The pediatric increases (ages 0-14) are particularly alarming and likely reflect accidental edible ingestions. The Midwest surge may reflect market expansion into new regions. Together, these trends argue for prevention strategies alongside cannabis policy reform.

Questions still open

What proportion of the increase is driven by edible products versus smoked cannabis? Have specific state legalization events caused detectable ER visit spikes? Would mandatory product safety standards reduce pediatric exposures?

Common questions

Are more people going to the ER because of cannabis?

Yes. National data show cannabis-related ER visits have been rising steadily since at least 2006, with the rate nearly tripling from 12.3 to 34.7 per 100,000 by 2014 and continuing to rise.

Why are children showing up in the ER for cannabis?

Pediatric exposures are likely driven by accidental ingestion of cannabis edibles, which can look like candy or regular food. This is a known risk as edible products become more available.

Read the original research

Trends and characteristics of cannabis-associated emergency department visits in the United States, 2006-2018.

Drug and alcohol dependence, 232, 109288

View on PubMed ↗Publisher’s paper ↗

Citation

Roehler, Douglas R; Hoots, Brooke E; Holland, Kristin M; Baldwin, Grant T; Vivolo-Kantor, Alana M. (2022). Trends and characteristics of cannabis-associated emergency department visits in the United States, 2006-2018.. Drug and alcohol dependence, 232, 109288. https://doi.org/10.1016/j.drugalcdep.2022.109288