Abstract
BackgroundOn October 17, 2018, the Cannabis Act decriminalized the recreational use of cannabis in Canada. This study seeks to determine how legalization of cannabis has impacted emergency department (ED) visits for acute cannabis intoxication.MethodsWe conducted a retrospective chart review at an academic ED in Hamilton, Ontario. We assessed all visits with a cannabis-related ICD-10 discharge code 6 months before and after legalization (October 17, 2018) to determine cases of acute cannabis intoxication. The primary outcome was the rate of ED visits. Secondary outcomes included number of visits distributed by age, length of stay, co-ingestions, and clinical course in the emergency department (investigations and treatment).ResultsThere was no difference in the overall rate of ED visits following legalization (2.44 vs. 2.94 visits/1000, p = 0.27). However, we noted a 56% increase in visits among adults aged 18–29 (p = 0.03). Following legalization, a larger portion of patients required observation without interventions (25% vs 48%, p < 0.05). Bloodwork and imaging studies decreased (53% vs. 12%, p < 0.05; 29% vs. 2%, p < 0.05); however, treatment with benzodiazepines increased (24% vs. 51%, p < 0.05).ConclusionsLegalization was not associated with a change in the rate of cannabis-related ED visits in our study. More research is needed regarding changing methods of cannabis ingestion and trends among specific age groups.
Highlights
On October 17, 2018, the Cannabis Act decriminalized the recreational use of cannabis in Canada
There has been an increase in recreational cannabis consumption, especially among young males, with studies demonstrating an increase in use from 14 to 20% [4]
There was a total of 64,152 visits during the 12 months of the study, of which 358 visits had Baraniecki et al BMC Emergency Medicine (2021) 21:32 Fig. 1 Chart review process cannabis International Statistical Classification of Disease (ICD)-10 diagnostic codes
Summary
On October 17, 2018, the Cannabis Act decriminalized the recreational use of cannabis in Canada. By 2016, over 129,000 Canadians were registered users of medical marijuana [2]. On October 17, 2018, the Cannabis Act decriminalized the recreational use of cannabis. There has been an increase in recreational cannabis consumption, especially among young males, with studies demonstrating an increase in use from 14 to 20% [4]. There has been an increase in first-time cannabis users across Canada, especially those 45 and older [4]. Inexperienced users may not be aware of the many effects of cannabis, their physiological tolerance, and the delayed-onset of symptoms seen with some routes of ingestion [5]
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