Cannabis-related emergency department visits increase among older adults
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From 2005 to 2019, the total number of cannabis-related ED visits in California rose from 366 to 12,167 among older adults, according to study results published in Journal of the American Geriatrics Society.
“The main takeaway for clinicians is that as an increasing number of older adults are starting to use cannabis, especially to treat a range of chronic symptoms, they will need education about the possible risks of cannabis and how to minimize the risks related to its use,” Benjamin H. Han, MD, MPH, geriatrician and addiction medicine physician in the department of medicine at University of California, San Diego, told Healio. “That being said, weighing the benefits vs. the risks of cannabis for older adults can be challenging for clinicians, given the lack of clinical studies.”
In a retrospective trend study, Han and colleagues evaluated ED visits of patients aged 65 years and older related to cannabis in California to analyze trends between 2005 and 2019.
Researchers used data from the California Department of Health Care Access and Information, which included all nonfederal acute care hospitals in the state, to determine the rate of cannabis-related ED visits per 100,000 ED visits in this age group each year.
Researchers then used those data to estimate absolute and relative changes overall and for subgroups, such as those for age, race/ethnicity, sex, payer/insurance, Charlson comorbidity index score and cannabis-related diagnosis code.
When assessing the rate of relevant ED visits for this age group, researchers found a significant increase overall and in every subgroup.
In 2019, researchers observed 12,167 visits for an overall rate of 395 per 100,000 ED visits, which represented a 374.3 absolute increase and a 1,808.2% relative increase compared with 366 visits in 2005, a rate of 20.7 per 100,000 visits.
“While we did expect an increase in cannabis-related ED visits among older adults, we were surprised by the sharp overall increase during the study period,” Han told Healio. “Interestingly though, the rate of increase appears to level off a bit [in 2017] after California enacted Proposition 64, which legalized recreational cannabis.”
Compared with those aged 75 to 84 years and those aged 85 years and older, researchers found that those aged 65 to 74 years had the highest ED visit rate in 2019, with 714.5 per 100,000 ED visits, and the largest rise in absolute increase.
In race/ethnicity subgroup analysis, Black patients showed the highest ED visit rate in 2019 (887.5 per 100,000 ED visits) and largest absolute increase.
Compared with women, researchers observed a greater 2019 ED visit rate among men (598.7 per 100,000 ED visits vs. 235.2 per 100,000 ED visits), although women had a larger relative percent increase than men (2,375.8% vs. 1,531.3%).
Patients without health insurance, as well as patients with a higher Charlson comorbidity index score, had the highest 2019 visits rates and the greatest absolute increases within their subgroups.
Lastly, when categorizing cannabis diagnoses into three groups — cannabis abuse and unspecified use; cannabis dependence; and poisoning by cannabis, lysergide and psychodysleptics — researchers found that the largest absolute (350.4 per 100,000 ED visits) and relative (1,844.2%) increases for the former category. This category also made up most of the ED visits related to cannabis each year, according to researchers.
“For this study, since we relied on claims data, we were very limited in that we do not know what types of cannabis were involved or if ED visits were related to medical or recreational use of cannabis,” Han told Healio. “Hopefully for future studies we will be able to better delineate reasons for why older adults present to the ED for cannabis-related reasons.”
For more information:
Benjamin H. Han, MD, MPH, can be reached at b2han@health.ucsd.edu.
Reference:
- Cannabis-related emergency department visits among older adults on the rise. https://health.ucsd.edu/news/releases/Pages/2023-01-09-cannabis-related-emergency-department-visitis-among-older-adults-on-the-rise.aspx. Published Jan. 9, 2023. Accessed Jan. 10, 2023.