Trends of Cannabis Use Disorder in the Inpatient: 2002 to 2011.
The nationwide prevalence of cannabis use/abuse has more than doubled from 2002 to 2011. Whether the outpatient trend is reflected in the inpatient setting is unknown. We examined the prevalence and incidence of cannabis abuse/dependence as determined by discharge coding in a 10-year (2002-2011) National Inpatient Sample, as well as various trends among demographics, comorbidities, and hospitalization outcomes.



Cannabis abuse/dependence was identified on the basis of International Classification of Diseases, 9th Revision, Clinical Modification codes 304.3* and 305.2* in adults aged 18 years or more. We excluded cases coded "in remission." National estimates of trends and matched-regression analyses were conducted.



Overall, 2,833,567 (0.91%) admissions with documented cannabis abuse/dependence were identified, patients had a mean age of 35.12 ± 0.06 years, 62% were male, and there was an increasing trend in prevalence from 0.52% to 1.34% (P <.001). The mean Charlson Comorbidity Index was 0.47 ± 0.006, and inpatient mortality was 0.41%. All of the above demonstrated an increasing trend (P <.001). Mean length of stay was 6.23 ± 0.06 days. The top primary discharge diagnoses were schizoaffective/mood disorders, followed by psychotic disorders and alcoholism. Asthma prevalence in nontobacco smokers had a steeper increase in the cannabis subgroup than in the noncannabis subgroup (P = .002). Among acute pancreatitis admissions, cannabis abusers had a shorter length of stay (-11%) and lower hospitalization costs (-7%) than nonabusers.



Cannabis abuse/dependence is on the rise in the inpatient population, with an increasing trend toward older and sicker patients with increasing rates of moderate to severe disability. Psychiatric disorders and alcoholism are the main associated primary conditions. Cannabis abuse is associated with increased asthma incidence in nontobacco smokers and decreased hospital resource use in acute pancreatitis admissions.
Department of Internal Medicine, Rutgers/Saint Peter's University Hospital, New Brunswick, NJ. Electronic address: paris.charilaou@outlook.com.
Paris
P
Charilaou
Department of Internal Medicine, Rutgers/Saint Peter's University Hospital, New Brunswick, NJ.
Kanishk
K
Agnihotri
Department of Internal Medicine, Rutgers/Saint Peter's University Hospital, New Brunswick, NJ.
Pablo
P
Garcia
Department of Interventional and Structural Heart Disease, The Everett Clinic, Everett, Wash.
Apurva
A
Badheka
Department of Internal Medicine, Rutgers/Saint Peter's University Hospital, New Brunswick, NJ.
Douglas
D
Frenia
Department of Internal Medicine, Rutgers/Saint Peter's University Hospital, New Brunswick, NJ.
Balaji
B
Yegneswaran
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology*; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
Abuse; Acute pancreatitis; Asthma; Cannabis; Chronic obstructive pulmonary disease; Dependence; Hospitalization cost; Inpatient; Marijuana; National Inpatient Sample; Smoking; Trends