Sharp Increase in Marijuana-Related ED Visits in Colorado by Nonresidents After Recreational Legalization

Summary and Comment |
February 25, 2016

Sharp Increase in Marijuana-Related ED Visits in Colorado by Nonresidents After Recreational Legalization

  1. Cara Adler

Marijuana-related emergency department visits increased much more steeply among non-Colorado residents (“marijuana tourists”) than residents in the year after retail sales of recreational marijuana began.

  1. Cara Adler

Retail sales of recreational marijuana in Colorado began in 2014. To assess the effect of marijuana tourism on emergency department (ED) visits, researchers at an urban academic hospital in Colorado examined rates of ED visits possibly related to cannabis use among non-Colorado residents and Colorado residents in 2013 and 2014. Such visits increased significantly among nonresidents from 2013 to 2014 (from 85 to 168 per 10,000 ED visits; rate ratio, 1.98), but not among residents (106 to 112 per 10,000 ED visits; rate ratio, 1.05). Statewide hospital data showed similar results for nonresidents (112 to 163; rate ratio, 1.46) and a smaller but significant rise for residents (86 to 101; rate ratio, 1.17).

In a separate article describing the effect of marijuana legalization on emergency care, the authors note that supportive care is the primary management for acute marijuana intoxication and that most adult patients can be discharged from the ED after symptoms improve. They caution that intoxication from ingesting edible marijuana products can cause severe, unpredictable symptoms, including psychosis, and that novice users and children are particularly at risk; younger children can suffer significant central nervous system depression.

Comment

  1. Ali S. Raja, MD, MBA, MPH, FACEP

Colorado is the new Amsterdam. While educational efforts have, thus far, focused on residents of states with legalized medical marijuana, these data show that ED visits related to marijuana use have risen at a significantly greater extent for visitors to Colorado than for its citizens. Clinicians throughout the country, especially those who practice in states where marijuana is now legal, should be prepared for the severity of symptoms and emphasize to their patients that regardless of legality, it is a drug with significant untoward, and for edibles, unpredictable side effects.

Editor Disclosures at Time of Publication

  • Disclosures for Ali S. Raja, MD, MBA, MPH, FACEP at time of publication Speaker's bureau Airway Management Education Center Leadership positions in professional societies Society for Academic Emergency Medicine (Constitution and Bylaws Committee Chair, Program Committee Chair, and Trauma Interest Group Chair); American College of Emergency Physicians (Trauma and Injury Prevention Section Chair)

Citation(s):

Your Comment

(will not be published)

Filtered HTML

  • Allowed HTML tags: <a> <em> <strong> <cite> <blockquote> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Do you have any conflict of interest to disclose?
CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

* Required

Reader comments are intended to encourage lively discussion of clinical topics with your peers in the medical community. We ask that you keep your remarks to a reasonable length, and we reserve the right to withhold publication of remarks that do not meet this standard.

PRIVACY: We will not use your email address, submitted for a comment, for any other purpose nor sell, rent, or share your e-mail address with any third parties. Please see our Privacy Policy.