In a Massachusetts ER, Patients and Doctors Often Disagreed on Whether Cannabis Caused the Visit

In a post-legalization Massachusetts emergency department survey, cannabis users showed diverse use patterns and frequently disagreed with their treating physicians about whether cannabis contributed to their ED visit, highlighting a communication gap.

Whitledge, James D et al.·The American journal of emergency medicine·2025·Moderate EvidenceCross-Sectional
RTHC-07945Cross SectionalModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Cannabis use was common among ED patients post-legalization, with diverse use patterns including various consumption methods and concomitant substance use. Patients and treating physicians showed discordance when asked whether the ED visit was attributable to cannabis, revealing a gap in patient-provider perception.

Key Numbers

Massachusetts post-legalization (2016). Academic medical center ED. Past-month cannabis users surveyed. Patient-physician discordance on cannabis attribution documented. Diverse consumption patterns and concomitant substance use reported.

How They Did This

Convenience sample survey at an academic medical center ED in Massachusetts. Patients aged 18+ reporting past-month cannabis use were surveyed about use patterns, perceived risks and benefits, concomitant substance use, and post-legalization changes. Both patients and treating physicians were asked about cannabis attribution to the ED visit.

Why This Research Matters

The patient-physician disagreement about cannabis's role in ED visits highlights that both parties may have blind spots — patients may underattribute symptoms to cannabis, while physicians may overattribute. Better clinical tools for assessing cannabis-related presentations are needed.

The Bigger Picture

As cannabis-related ED visits increase nationally following legalization, understanding the disconnect between patients' and providers' views on cannabis's role is essential for improving emergency care, discharge planning, and follow-up counseling.

What This Study Doesn't Tell Us

Convenience sample — not all cannabis-using ED patients captured. Single academic center in Massachusetts. Survey timing relative to clinical status may affect responses. Cannot determine actual cannabis contribution to visits objectively.

Questions This Raises

  • ?How should ED physicians assess cannabis's role in a presentation when patient and physician disagree?
  • ?Would standardized cannabis screening in EDs improve attribution accuracy?
  • ?Does post-legalization normalization lead patients to underreport cannabis-related symptoms?

Trust & Context

Key Stat:
Evidence Grade:
Convenience sample survey from a single ED, providing useful descriptive data but limited by selection bias and single-center design.
Study Age:
Published 2025.
Original Title:
Perceptions and patterns of Cannabis use in emergency department patients following recreational legalization in Massachusetts.
Published In:
The American journal of emergency medicine, 94, 31-36 (2025)
Database ID:
RTHC-07945

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

Are more people going to the ER because of cannabis after legalization?

Cannabis-related ED visits have increased post-legalization nationally. This study found diverse cannabis use patterns among ED patients, but the disagreement between patients and doctors about cannabis's role makes it hard to determine how many visits are truly cannabis-caused.

Why do patients and doctors disagree about cannabis causing the ER visit?

Patients may not connect their symptoms to cannabis use, especially if they use regularly and view it as normal. Doctors may attribute symptoms to cannabis based on clinical judgment even when other causes exist. Both perspectives have valid and flawed elements.

Read More on RethinkTHC

Cite This Study

RTHC-07945·https://rethinkthc.com/research/RTHC-07945

APA

Whitledge, James D; Ganetsky, Michael; Burke Mph, Ryan C; Boyle, Katherine L. (2025). Perceptions and patterns of Cannabis use in emergency department patients following recreational legalization in Massachusetts.. The American journal of emergency medicine, 94, 31-36. https://doi.org/10.1016/j.ajem.2025.04.033

MLA

Whitledge, James D, et al. "Perceptions and patterns of Cannabis use in emergency department patients following recreational legalization in Massachusetts.." The American journal of emergency medicine, 2025. https://doi.org/10.1016/j.ajem.2025.04.033

RethinkTHC

RethinkTHC Research Database. "Perceptions and patterns of Cannabis use in emergency depart..." RTHC-07945. Retrieved from https://rethinkthc.com/research/whitledge-2025-perceptions-and-patterns-of

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.