Management site and level of health care for cannabis- and synthetic cannabinoid-related poison control center cases involving older adults, 2016–2019

Abstract

Increasing numbers of older adults use cannabis and cannabis-derived products that can have adverse effects. This study examined management site and level of healthcare services for older adult poison control center cases involving cannabis products. Using the American Association of Poison Control Centers’ (PCC) National Poison Data System, 2016–2019, we extracted the 3109 cases aged 50+ for which cannabis was the only or primary substance. Multinomial logistic regression models were fit to examine associations between specific cannabis forms and management/care site (on site [mostly at home], at a healthcare facility [HCF], or no follow-up due to referral refusal or leaving against medical advice) and level of healthcare services for cases managed at a HCF. The results show that between 2016 and 2019, PCC cannabis cases involving older adults increased twofold, largely due to cases of cannabidiol, edibles, and concentrated extracts. Plant form and synthetic cannabinoid cases declined substantially. Compared to plant forms, synthetic cannabinoid cases had 4.22 (95% CI = 2.59–6.89) greater odds of being managed at, rather than outside, a HCF and 2.17 (1.42–3.31) greater odds of critical care unit admission. Although e-cigarette cases, compared to plant form cases, had lower odds of being managed at a HCF, HCF-managed e-cigarette cases had 3.43 greater odds (95% CI = 1.08–10.88) of critical care unit admission. Synthetic cannabinoid cases also had 1.86 (95% CI = 1.03–3.35) greater odds of no follow-up, and the presence of a secondary substance was also a significant factor. Stricter regulations for listing chemical ingredients and providing safety guidelines are needed for cannabis-derived products.

Keywords:

• Cannabis
• cannabis
• edibles
• synthetic cannabinoids
• poison control center
• older adults
• healthcare encounters

Acknowledgements

The American Association of Poison Control Centers made the National Poison Data System (NPDS) available to the authors for this study. This study's findings and conclusions are those of the authors alone and do not necessarily represent the official position of the American Association of Poison Control Centers or participating poison control centers.

Author contributions

All authors contributed to conceptualization. SDB applied for and obtained the de-identified NPDS data and provided overall guidance on the data system and analysis. NGC conducted data analysis and drafted the paper. DMD contributed to editing the paper and provided feedback, and CNM provided statistical consultation. All authors agree to publication of the paper.

Disclosure statement

The authors report no potential conflict of interest.

Additional information

Funding

The authors did not receive any funding for this study.