Cannabis-related emergency room visits increased significantly from 2004 to 2011, especially among teens
Cannabis-related ER visits rose substantially over an eight-year period, with adolescents showing the largest increase in cannabis-only visits and Black Americans disproportionately represented.
Quick Facts
What This Study Found
Between 2004 and 2011, cannabis-only ER visit rates increased from 51 to 73 per 100,000 people aged 12 and older, while cannabis-polydrug visit rates rose from 63 to 100 per 100,000. Both trends were statistically significant.
Adolescents aged 12 to 17 showed the largest increase in cannabis-only ER visits, with a rate difference of 80 per 100,000. Non-Hispanic Black individuals had the most prevalent cannabis-related ER visits across racial and ethnic groups.
Among cannabis-involved visits, older patients were more likely to be hospitalized rather than treated and released, suggesting more severe outcomes with age.
Key Numbers
Cannabis-only ER visits: 51 to 73 per 100,000 (2004-2011, p=0.004). Cannabis-polydrug visits: 63 to 100 per 100,000 (p<0.001). Adolescents aged 12-17 had the largest rate increase (80 per 100,000 difference).
How They Did This
Researchers analyzed data from the Drug Abuse Warning Network (DAWN), a national surveillance system tracking drug-related ER visits from 2004 to 2011. They examined trends in visit rates stratified by cannabis-only versus polydrug involvement, age, and race/ethnicity. Logistic regression was used to identify factors associated with hospitalization.
Why This Research Matters
This data captures a period of shifting cannabis attitudes and early legalization efforts in the US. The disproportionate increase among adolescents and racial disparities in ER presentations highlight populations that may need targeted public health attention as cannabis policy continues to evolve.
The Bigger Picture
Rising cannabis-related ER visits during a period of increasing normalization raises questions about whether greater availability and use naturally leads to more acute incidents, or whether other factors like potency increases, edible products, or changing help-seeking behavior contributed. Understanding these patterns is essential for public health planning in legalized markets.
What This Study Doesn't Tell Us
DAWN data relies on ER reporting, which may vary across facilities. Cannabis "involvement" in an ER visit does not necessarily mean cannabis caused the visit. The data ends in 2011, before most state legalizations took effect. Self-reported substance use in ER settings may be unreliable.
Questions This Raises
- ?Have cannabis-related ER visits continued to increase after 2011 with widespread legalization?
- ?What proportion of these visits involved cannabis as the actual cause versus an incidental finding?
- ?Are the racial disparities in ER visits driven by use patterns, access to care, or policing differences?
Trust & Context
- Key Stat:
- Adolescent cannabis-only ER visits jumped by 80 per 100,000 from 2004 to 2011
- Evidence Grade:
- National surveillance data from DAWN covering eight years. Large sample and systematic data collection, but limited by the observational nature of ER reporting.
- Study Age:
- Published in 2016, covering data through 2011. DAWN was discontinued, but newer surveillance systems have continued tracking cannabis-related ER trends.
- Original Title:
- Trends and Correlates of Cannabis-involved Emergency Department Visits: 2004 to 2011.
- Published In:
- Journal of addiction medicine, 10(6), 429-436 (2016)
- Authors:
- Zhu, He, Wu, Li-Tzy
- Database ID:
- RTHC-01314
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does this mean cannabis is becoming more dangerous?
Not necessarily. Increased ER visits could reflect more people using cannabis, higher-potency products, new forms like edibles, or simply more willingness to seek medical help. The data cannot distinguish between these explanations.
Why were adolescents the most affected group?
The study found adolescents had the largest rate increase but did not determine why. Possible factors include increasing availability, decreasing perceived risk among teens, and lower tolerance leading to more acute reactions.
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Cite This Study
https://rethinkthc.com/research/RTHC-01314APA
Zhu, He; Wu, Li-Tzy. (2016). Trends and Correlates of Cannabis-involved Emergency Department Visits: 2004 to 2011.. Journal of addiction medicine, 10(6), 429-436.
MLA
Zhu, He, et al. "Trends and Correlates of Cannabis-involved Emergency Department Visits: 2004 to 2011.." Journal of addiction medicine, 2016.
RethinkTHC
RethinkTHC Research Database. "Trends and Correlates of Cannabis-involved Emergency Departm..." RTHC-01314. Retrieved from https://rethinkthc.com/research/zhu-2016-trends-and-correlates-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.