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.
Emergency physicians, ED nurses, hospital administrators in legalized states, and public health researchers.
What the researchers 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.
Why it 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 numbers in context
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 the study worked
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.
What this study cannot 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.
How to read the evidence
Convenience sample survey from a single ED, providing useful descriptive data but limited by selection bias and single-center design.
When this study was published
Published 2025.
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.
Questions still open
- 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?
Common questions
Are more people going to the ER because of cannabis after legalization?
Why do patients and doctors disagree about cannabis causing the ER visit?
Read the original research
Perceptions and patterns of Cannabis use in emergency department patients following recreational legalization in Massachusetts.
The American journal of emergency medicine, 94, 31-36
Citation
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