Cannabis-related emergency department visits increased 7% annually from 2006 to 2014 | Research

The takeaway

Cannabis-associated ED visits in the US increased by 7% annually from 2006-2014, with the highest rates among 12-17 year-olds and uninsured patients.

Emergency physicians, public health planners, and policymakers monitoring cannabis-related health service use.

7% annual increase in cannabis-related ED visits

What the researchers found

Cannabis-associated ED visits increased monotonically at 7% per year. Ages 12-17 had the highest risk, declining with age. Uninsured patients were over 40% more likely to visit the ED than privately insured. The South region had the highest utilization, but the West showed the fastest growth (15.4% to 26% over the study period).

Why it matters

Even before widespread legalization, cannabis ED visits were steadily rising. This provides a baseline for understanding how subsequent policy changes (legalization in many states after 2012) may have accelerated or moderated this trend.

The numbers in context

265,128 cannabis-associated ED visits analyzed. 7% annual increase. Ages 12-17 highest risk. Uninsured 40%+ more likely to visit. West region grew from 15.4% to 26%.

How the study worked

Pooled serial cross-sectional study using 2006-2014 National Emergency Department Sample data. Hierarchical multivariable analysis of 265,128 cannabis-associated ED visits among patients aged 12+.

What this study cannot tell us

National Emergency Department Sample relies on coding accuracy. "Cannabis-associated" does not mean cannabis caused the visit. Could not distinguish primary from incidental cannabis involvement.

How to read the evidence

Moderate: large national dataset with multivariable analysis, but dependent on ED coding accuracy.

When this study was published

Published in 2019.

The bigger picture

The steady increase predates most recreational legalization, suggesting that liberalizing attitudes, increasing potency, and changing demographics were already driving ED visits upward.

Questions still open

Has the rate continued to accelerate after recreational legalization? Are these visits primarily for acute intoxication, psychiatric events, or medical conditions? Would better outpatient cannabis resources reduce ED burden?

Common questions

Does this mean cannabis is becoming more dangerous?

Not necessarily. Increasing ED visits could reflect more use, higher potency products, changing demographics, or more willingness to mention cannabis to healthcare providers. The data alone cannot determine causation.

Why are teenagers at highest risk?

Adolescents may be more susceptible to acute cannabis effects, more likely to use in risky contexts, and less experienced with dosing. They may also be more likely to seek emergency care for cannabis-related anxiety or panic.

Read the original research

Trends and Related Factors of Cannabis-Associated Emergency Department Visits in the United States: 2006-2014.

Journal of addiction medicine, 13(3), 193-200

View on PubMed ↗Publisher’s paper ↗

Citation

Shen, Jay J; Shan, Guogen; Kim, Pearl C; Yoo, Ji Won; Dodge-Francis, Carolee; Lee, Yong-Jae. (2019). Trends and Related Factors of Cannabis-Associated Emergency Department Visits in the United States: 2006-2014.. Journal of addiction medicine, 13(3), 193-200. https://doi.org/10.1097/ADM.0000000000000479