Cannabis positivity rates in 17 emergency departments across the United States with varying degrees of marijuana legalization
Year: 2023
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Many states in the United States have progressed towards legalization of marijuana including decriminalization, medicinal and/or recreational use. We studied the impact of legalization on cannabis-related emergency department visits in states with varying degrees of legalization. METHODS: Seventeen healthcare institutions in fifteen states (California, Colorado, Connecticut, Florida, Iowa, Kentucky, Maryland, Massachusetts, Missouri, New Hampshire, Oregon, South Carolina, Tennessee, Texas, Washington) participated. Cannabinoid immunoassay results and cannabis-related International Classification of Diseases (ninth and tenth versions) codes were obtained for emergency department visits over a 3- to 8-year period during various stages of legalization: no state laws, decriminalized, medical approval before dispensaries, medical dispensaries available, recreational approval before dispensaries and recreational dispensaries available. Trends and monthly rates of cannabinoid immunoassay and cannabis-related International Classification of Diseases code positivity were determined during these legalization periods. RESULTS: For most states, there was a significant increase in both cannabinoid immunoassay and International Classification of Diseases code positivity as legalization progressed; however, positivity rates differed. The availability of dispensaries may impact positivity in states with medical and/or recreational approval. In most states with no laws, there was a significant but smaller increase in cannabinoid immunoassay positivity rates. CONCLUSIONS: States may experience an increase in cannabis-related emergency department visits with progression toward marijuana legalization. The differences between states, including those in which no impact was seen, are likely multifactorial and include cultural norms, attitudes of local law enforcement, differing patient populations, legalization in surrounding states, availability of dispensaries, various ordering protocols in the emergency department, and the prevalence of non-regulated cannabis products.
Source: Clinical Toxicology
Authors: Nicole V. Tolan, Matthew D. Krasowski, Patrick C. Mathias, Joesph R. Wiencek, Nikolina Babic, Peter R. Chai, Allison B. Chambliss, Ibrahim Choucair, Christiana A. Demetriou, Timothy B. Erickson, Matthew Feldhammer, Deborah French, Bryan D. Hayes, Phillip Kang, Joe M. El-Khoury, Claire E. Knezevic, Andrew Monte, Robert D. Nerenz, Anthony O. Okorodudu, Stephen M. Roper, Alec Saitman, Vamsi Thiriveedhi, Sacha N. Uljon, Alexis Vest, Alison Woodworth, Min Yu, Stacy E. F. Melanson
Institutions: Brigham and Women's Hospital, Harvard University, University of Iowa, University of Iowa Hospitals and Clinics, University of Washington, Vanderbilt University, Vanderbilt University Medical Center, Medical University of South Carolina, Koch Institute for Integrative Cancer Research At MIT, Fenway Health, Massachusetts Institute of Technology, University of Southern California, Yale University, University of Nicosia, University of Florida, University of San Francisco, Massachusetts General Hospital, Johns Hopkins University, University of Colorado Anschutz, Dartmouth–Hitchcock Medical Center, Medical College of Wisconsin, The University of Texas Medical Branch at Galveston, Washington University in St. Louis, University of Kentucky
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4367669040