A Chart Review of Emergency Department Visits Following Implementation of the Cannabis Act in Canada

Abstract

The legalization of cannabis for recreational use remains a controversial topic today. There are multiple known benefits of cannabis which include pain relief and treatment of epilepsy syndromes. However, there are also many associated risks. Shorter-term health consequences include cannabinoid hyperemesis syndrome and cannabis-induced psychosis. These conditions directly impact the influx of patients presenting to emergency departments (ED). This study aims to examine the impact of cannabis legalization on ED presentations. We performed a descriptive study via a retrospective chart review of cannabis-related ED visits in St. John’s, Newfoundland (NL), ranging from six months prior to the date of legalization of cannabis for recreational use, to six months after. We searched the hospital ED visit records using keywords to identify patients who have symptoms relating to cannabis use. We manually reviewed all visit records that included one or more of these terms to distinguish true positives from false-positive cases unrelated to cannabis use. The number of cannabis-related visits increased from 2.56 per 1000 ED visits prior to legalization to 3.56 per 1000 ED visits post legalization (p < 0.01). There was no difference in the age of users between the two groups. Additionally, the most common presenting complaint due to cannabis use was nausea/vomiting (47.7%), followed by anxiety (12.2%). Following the implementation of the Cannabis Act in Canada, the EDs in St. John’s, NL had a significant increase in the number of ED visits related to cannabis use. It is important to determine such consequences to ensure hospitals and public health are prepared to treat the influx of visits and are better equipped to manage the associated symptoms