Despite national surveys showing no increase in teen marijuana use, marijuana-related emergency and urgent care visits at a Colorado children's hospital nearly tripled from 2009 to 2015, with most visits involving psychiatric diagnoses.
Emergency physicians, pediatricians, cannabis legalization policy makers.
Marijuana-related adolescent ER visits increased from 1.8 to 4.9 per 1,000 visits (2009-2015) in Colorado, a 172% increase.
What the researchers found
Marijuana-related visits increased from 1.8 per 1,000 visits in 2009 to 4.9 per 1,000 in 2015 (p<.0001). Behavioral health evaluation was obtained for 67% of visits, and 71% of those received a psychiatric diagnosis. Ethanol was the most common co-ingestant (12%).
Why it matters
While national survey data suggested no increase in adolescent marijuana use after legalization, this hospital data reveals a different picture: more teens are presenting to emergency departments with marijuana-related problems, many with psychiatric issues.
The numbers in context
4,202 marijuana-related visits from 2005-2015. Rate increased from 1.8 to 4.9 per 1,000 visits (2009-2015). 67% received behavioral health evaluation. 71% of those had a psychiatric diagnosis. 12% involved ethanol co-ingestion.
How the study worked
Retrospective review of marijuana-related visits to a Colorado children's hospital from 2005-2015, identified by ICD codes and urine drug screens, for patients aged 13-20.
What this study cannot tell us
Single hospital system. ICD coding may not capture all marijuana-related visits. Cannot determine causation with legalization. Increased diagnosis could reflect increased screening rather than true increase. Does not distinguish medical from recreational context.
How to read the evidence
Moderate - objective hospital data over 10 years, but single institution with potential for diagnostic and coding changes over time.
When this study was published
Published in 2018. Data through 2015 captures early legalization effects.
The bigger picture
Survey data and hospital data may be capturing different aspects of legalization's impact. While overall use rates may be stable, the potency, form, and context of use may be changing in ways that lead to more emergency presentations.
Questions still open
- Is the increase due to higher-potency products, edibles, or other post-legalization changes? Does increased screening account for some of the rise? Are psychiatric presentations reflecting new use or more acute intoxication from potent products?
Common questions
Did teen marijuana ER visits increase after legalization in Colorado?
What brings teens to the ER for marijuana?
Read the original research
Impact of Marijuana Legalization in Colorado on Adolescent Emergency and Urgent Care Visits.
The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 63(2), 239-241
Citation
Wang, George Sam; Davies, Sara Deakyne; Halmo, Laurie Seidel; Sass, Amy; Mistry, Rakesh D. (2018). Impact of Marijuana Legalization in Colorado on Adolescent Emergency and Urgent Care Visits.. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 63(2), 239-241. https://doi.org/10.1016/j.jadohealth.2017.12.010