This new epidemiological study looked at trends and correlates of Emergency Depart-ment (ED) visits related to cannabis use in the United States. The ED visit rate in-creased for both cannabis-only use (51 to 73 visits per 100,000; p-0.004) and cannabis-polydrug use (63 to 100 per 100,000; p<0.001) in those aged 12 and older. Of note, the largest increase occurred in adolescents aged 12-17, and among persons who identi-fied as non-Hispanic black. Additionally, the odds of hospitalization increased with older age users, as compared to adolescent admissions. These data suggest a heavier burden to both the patient and to the health care system as a result of increasing cannabis use among older adults. The severity of the “burden” is associated with the prevalence of cannabis use, specific cannabis potency and dose (which is increasing over time), the mode of administration, and numerous individual risk factors. The authors hypothesize that the rise in high-potency cannabis may increase the prevalence of addiction and the need for treatment—which, in turn, can lead to an even higher disease burden and healthcare utilization by cannabis users. The authors also advocate for frequent screening for cannabis in the ED, and increasing focus and intervention on adolescents and non-Hispanic black patients whom are statistically at higher risk.

What Does This Matter?

In 2012, Colorado was the first of many states to legalize the sale and recreational use of crude cannabis. The most recent data shows even more unintentional cannabis poi-soning of children and ER visits for cannabis induced psychiatric illness, including psychosis, depression and suicide attempts. In addition, the July 25, 2016 JAMA Network Journal Source reported. “The legalization of recreational marijuana in Colorado was associated with both increased hospital visits and cases at a regional poison center because of unintentional exposure to the drug by children.” The average rate of marijuana-related visits to the children’s hospital has doubled two years after legalization. Moreover, the Regional Poison Center (RPC) reported that since legalization, pediatric marijuana poisoning cases increased more than 5-fold in Colorado.

At present there seems to be no way to avoid the conflict between evidence based medicine and the social and the political movement that is driving public policy regard-ing cannabis.