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Mental Health–related Emergency Department Visits Associated With Cannabis in Colorado
Author(s) -
Hall Katelyn E.,
Monte Andrew A.,
Chang Tae,
Fox Jacob,
Brevik Cody,
Vigil Daniel I.,
Van Dyke Mike,
James Katherine A.
Publication year - 2018
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.13393
Subject(s) - cannabis , medicine , emergency department , mental health , psychiatry , confidence interval
Background Cannabis legalization in Colorado resulted in increased cannabis‐associated health care utilization. Our objective was to examine cooccurrence of cannabis and mental health diagnostic coding in Colorado emergency department ( ED ) discharges and replicate the study in a subpopulation of ED visits where cannabis involvement and psychiatric diagnosis were confirmed through medical review. Methods We collected statewide ED International Classification of Diseases, 9th Revision, Clinical Modification diagnoses from the Colorado Hospital Association and a subpopulation of ED visits from a large, academic hospital from 2012 to 2014. Diagnosis codes identified visits associated with mental health and cannabis. Codes for mental health conditions and cannabis were confirmed by manual records review in the academic hospital subpopulation. Prevalence ratios ( PR s) of mental health ED discharges were calculated to compare cannabis‐associated visits to those without cannabis. Rates of mental health and cannabis‐associated ED discharges were examined over time. Results Statewide data demonstrated a fivefold higher prevalence of mental health diagnoses in cannabis‐associated ED visits ( PR = 5.35, 95% confidence interval [ CI ], 5.27–5.43) compared to visits without cannabis. The hospital subpopulation supported this finding with a fourfold higher prevalence of psychiatric complaints in cannabis attributable ED visits ( PR = 4.87, 95% CI = 4.36–5.44) compared to visits not attributable to cannabis. Statewide rates of ED visits associated with both cannabis and mental health significantly increased from 2012 to 2014 from 224.5 to 268.4 per 100,000 (p < 0.0001). Conclusions In Colorado, the prevalence of mental health conditions in ED visits with cannabis‐associated diagnostic codes is higher than in those without cannabis. There is a need for further research determining if these findings are truly attributed to cannabis or merely coincident with concurrent increased use and availability.