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Cannabis-Associated Emergency Department Visits in California

Asking older adults about cannabis use and educating them about its effects should be a routine aspect of medical care, according to authors who studied trends in cannabis-related emergency department (ED) visits in California. Such visits are increasing, the authors report, and “are an adverse effect of cannabis use.”

The trend analysis used data from the Department of Healthcare Access and Information to determine the number of cannabis-related ED visits at all acute care hospitals in California from 2005 to 2019. The cannabis-related ED visit rate per 100,000 ED visits per calendar year was determined for all adults aged 65 years or older and for subgroups based on age, demographics, and clinical indicators.

“The cannabis-related ED visit rate increased significantly for adults aged ≥65 and all subgroups (P <0.001),” the authors write. “The overall rate increased from 20.7 per 100,000 visits in 2005 to 395.0 per 100,000 ED visits in 2019, a 1804% relative increase. By race/ethnicity, older Black adults had the highest ED visit rate in 2019 and the largest absolute increase while older males had a higher ED visit rate in 2019 and a greater absolute increase than older women. Older adults with a higher Charlson score had a higher ED visit rate in 2019 and a larger absolute increase during the study period.”

The authors conclude, “The need for acute medical care is an adverse effect of cannabis use among older adults and is increasing sharply in California. Given the higher risk for adverse effects related to cannabis, all older adults, regardless of health status, should be regularly asked about their use of cannabis and assessed for problematic use. Despite the currently limited evidence to help balance the risks and benefits of cannabis use, clinicians should educate and discuss cannabis use in the context of health as part of routine medical care for older adults. This is also important for patients immediately after an acute episode in the ED, so they are aware that cannabis may have contributed to their visit. While there is great interest among older adults in using cannabis to treat chronic symptoms, discussions about the potential health-related harms of cannabis should be had, especially among older adults with multimorbidity.”

Source: Journal of the American Geriatrics Society