title: Marijuana and acute health care contacts in Colorado.
abstract: Over 22 million Americans are current users of marijuana; half of US states allow medical marijuana, and several allow recreational marijuana. The objective of this study was to evaluate the impact marijuana has on hospitalizations, emergency department (ED) visits, and regional poison center (RPC) calls in Colorado, a medical and recreational marijuana state. This is a retrospective review using Colorado Hospital Association hospitalizations and ED visits with marijuana-related billing codes, and RPC marijuana exposure calls. Legalization of marijuana in Colorado has been associated with an increase in hospitalizations, ED visits, and RPC calls linked with marijuana exposure. From 2000 to 2015, hospitalization rates with marijuana-related billing codes increased from 274 to 593 per 100,000 hospitalizations in 2015. Overall, the prevalence of mental illness among ED visits with marijuana-related codes was five-fold higher (5.07, 95% CI: 5.0, 5.1) than the prevalence of mental illness without marijuana-related codes. RPC calls remained constant from 2000 through 2009. However, in 2010, after local medical marijuana policy liberalization, the number of marijuana exposure calls significantly increased from 42 to 93; in 2014, after recreational legalization, calls significantly increased by 79.7%, from 123 to 221 (p<0.0001). The age group <17years old also had an increase in calls after 2014. As more states legalize marijuana, it is important to address public education and youth prevention, and understand the impact on mental health disorders. Improvements in data collection and surveillance methods are needed to more accurately evaluate the public health impact of marijuana legalization.
authors.affiliation: Section of Emergency Medicine, Medical Toxicology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Rocky Mountain Poison and Drug Center, Denver Health Hospital, Denver, CO, United States. Electronic address: George.wang@childrenscolorado.org.
authors.forename: George Sam
authors.initials: GS
authors.lastname: Wang
authors.affiliation: Colorado Department of Public Health and Environment, Denver, CO, United States.
authors.forename: Katelyn
authors.initials: K
authors.lastname: Hall
authors.affiliation: Colorado Department of Public Health and Environment, Denver, CO, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Vigil
authors.affiliation: Rocky Mountain Poison and Drug Center, Denver Health Hospital, Denver, CO, United States; University of Colorado School of Pharmacy, Anschutz Campus, Aurora, CO, United States.
authors.forename: Shireen
authors.initials: S
authors.lastname: Banerji
authors.affiliation: Section of Emergency Medicine, Medical Toxicology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States; Rocky Mountain Poison and Drug Center, Denver Health Hospital, Denver, CO, United States; University of Colorado School of Pharmacy, Anschutz Campus, Aurora, CO, United States; Department of Emergency Medicine, Medical Toxicology, University of Colorado Hospital, University of Colorado Anschutz Medical Campus, United States.
authors.forename: Andrew
authors.initials: A
authors.lastname: Monte
authors.affiliation: Colorado Department of Public Health and Environment, Denver, CO, United States.
authors.forename: Mike
authors.initials: M
authors.lastname: VanDyke
mesh_terms: D000293:Adolescent; D000328:Adult; D002188:Cannabis; D003120:Colorado / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007880:Legislation, Drug; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology*; D001523:Mental Disorders / Q000453:epidemiology; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies
keywords: Cannabis; Colorado; Emergency department; Emergency room; Hospitalizations; Legalization; Marijuana; Poison center