Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2019 Apr 16;170(8):531-537.
doi: 10.7326/M18-2809. Epub 2019 Mar 26.

Acute Illness Associated With Cannabis Use, by Route of Exposure: An Observational Study

Andrew A Monte  1 , Shelby K Shelton  2 , Eleanor Mills  2 , Jessica Saben  2 , Andrew Hopkinson  2 , Brandon Sonn  2 , Michael Devivo  2 , Tae Chang  2 , Jacob Fox  2 , Cody Brevik  2 , Kayla Williamson  2 , Diana Abbott  2
Affiliations
Observational Study

Acute Illness Associated With Cannabis Use, by Route of Exposure: An Observational Study

Andrew A Monte et al. Ann Intern Med. .

Abstract

Background: Little is known about the relative harms of edible and inhalable cannabis products.

Objective: To describe and compare adult emergency department (ED) visits related to edible and inhaled cannabis exposure.

Design: Chart review of ED visits between 1 January 2012 and 31 December 2016.

Setting: A large urban academic hospital in Colorado.

Participants: Adults with ED visits with a cannabis-related International Classification of Diseases, Ninth or 10th Revision, Clinical Modification (ICD-9-CM or ICD-10-CM), code.

Measurements: Patient demographic characteristics, route of exposure, dose, symptoms, length of stay, disposition, discharge diagnoses, and attribution of visit to cannabis.

Results: There were 9973 visits with an ICD-9-CM or ICD-10-CM code for cannabis use. Of these, 2567 (25.7%) visits were at least partially attributable to cannabis, and 238 of those (9.3%) were related to edible cannabis. Visits attributable to inhaled cannabis were more likely to be for cannabinoid hyperemesis syndrome (18.0% vs. 8.4%), and visits attributable to edible cannabis were more likely to be due to acute psychiatric symptoms (18.0% vs. 10.9%), intoxication (48% vs. 28%), and cardiovascular symptoms (8.0% vs. 3.1%). Edible products accounted for 10.7% of cannabis-attributable visits between 2014 and 2016 but represented only 0.32% of total cannabis sales in Colorado (in kilograms of tetrahydrocannabinol) during that period.

Limitation: Retrospective study design, single academic center, self-reported exposure data, and limited availability of dose data.

Conclusion: Visits attributable to inhaled cannabis are more frequent than those attributable to edible cannabis, although the latter is associated with more acute psychiatric visits and more ED visits than expected.

Primary funding source: Colorado Department of Public Health and Environment.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Flow chart of visit selection and review.
ED = emergency department; ICD = International Classification of Diseases.
Figure 2.
Figure 2.. Exposure to edible and inhalable cannabis products in cannabis-attributable visits at UCHED from 2012 to 2016.
Error bars indicate 95% CIs. UCHED = UCHealth University of Colorado Hospital Emergency Department.
See this image and copyright information in PMC

Comment in

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ogden DW. Investigations and Prosecutions in States Authorizing the Medical Use of Marijuana [Memorandum]. Accessed at http://blogs.justice.gov/main/archives/192 on 18 August 2014.
    1. Colo. Const. amend. LXIV.
    1. Zhu H, Wu LT. Trends and correlates of cannabis-involved emergency department visits: 2004 to 2011. J Addict Med. 2016;10:429–36. - PMC - PubMed
    1. Colorado Department of Revenue. Marijuana Sales Reports. Denver: Colorado Department of Revenue; 2018. Accessed at www.colorado.gov/pacific/revenue/colorado-marijuana-sales-reports on 9 July 2018.
    1. Colorado Department of Public Health and Environment. Behavioral Risk Factor Surveillance System and Child Health Survey. Denver: Colorado Department of Public Health and Environment; 2018. Accessed at www.colorado.gov/pacific/cdphe/behaviorsurvey on 7 February 2019.

Publication types