Cannabinoid Poisoning-Related Emergency Department Visits and Inpatient Hospitalizations in Kentucky, 2017 to 2019

Abstract

Background and objectives: Cannabis is the most used federally illicit substance. Due to widespread medicinal use and state-level legalization, public perceptions of cannabis have shifted toward the assumption that cannabis is safe. However, cannabinoids can cause adverse medical complications that may lead people to seek treatment. This study characterized cannabinoid poisoning-related medical encounters, poisoning involving cannabinoids and other psychoactive substances, and cannabinoid poisoning-related cardiac complications. Methods: Administrative billing data for emergency department visits and inpatient hospitalizations in acute care facilities with a discharge date from January 1, 2017 to December 31, 2019 were used to characterize cannabinoid poisoning events in Kentucky, identified by ICD-10-CM diagnosis code T40.7X. Results: There were 1,490 encounters of cannabinoid poisoning; patients were primarily non-Hispanic White males, ages 15–44, who had Medicaid and lived in a metropolitan area. Of those, 31.21% involved poisoning with a second psychoactive substance, primarily stimulants and/or opioids, and 17.72% experienced a cardiac complication. Cannabinoid-polydrug poisoning was associated with inpatient treatment (χ²=199.18, p < 0.001) and cardiac complications (χ²=4.58, p < 0.001). Discussion and Conclusions: These results are consistent with other state-level data. Patients who were diagnosed with cannabis-polydrug poisoning, compared to cannabis alone poisoning, had greater odds of hospital admission and cardiac complications, and longer length of hospital stays. Scientific Significance: The health risks of cannabinoid use must be more broadly recognized, while timely and accurate data need to be shared to guide policies on cannabis access. Future research on cannabinoid poisoning should consider the involvement of other psychoactive drugs.

Keywords:

• Cannabis
• cannabis poisoning
• polydrug use
• polydrug poisoning

Acknowledgments

The authors thank Zhengyan Huang for data technical assistance. The authors acknowledge the support from the Kentucky Cabinet for Health and Family Services for provided data.

Disclosure statement

No conflict of interest has been reported by the authors. The authors alone are responsible for the content and writing of this paper.

Additional information

Funding

This project was supported by Data-Driven Responses to Prescription Drug Misuse in Kentucky (grant no. 2017-P M-BX-K026) awarded by the Bureau of Justice Assistance (BJA) to the Kentucky Injury Prevention and Research Center as bona fide agent for the Kentucky Department for Public Health. The BJA is a component of the Department of Justice’s Office of Justice Program, which includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office of Victims Crime, and the SMART Office. Viewpoints or opinions in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice. This work was also supported, in part, by National Institute on Drug Abuse grants T32 DA035200, R01 DA045700, and R21 DA045101. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.