Clearing the air: A study of cannabis-related presentations to urban Alberta emergency departments following legalization
Open accessAbstract
Objectives: Non-medical cannabis recently became legal for adults in Canada. Legalization provides opportunity to investigate the public health effects of national cannabis legalization on presentations to emergency departments (EDs). Our study aimed to explore association between cannabis-related ED presentations, poison control and telemedicine calls, and cannabis legalization. Methods: Data were collected from the National Ambulatory Care Reporting System from October 1, 2013, to July 31, 2019, for 14 urban Alberta EDs, from Alberta poison control, and from HealthLink, a public telehealth service covering all of Alberta. Visitation data were obtained to compare pre- and post-legalization periods. An interrupted time-series analysis accounting for existing trends was completed, in addition to the incidence rate ratio (IRR) and relative risk calculation (to evaluate changes in co-diagnoses). Results: Although only 3 of every 1,000 ED visits within the time period were attributed to cannabis, the number of cannabis-related ED presentations increased post-legalization by 3.1 (range -11.5 to 12.6) visits per ED per month (IRR 1.45, 95% confidence interval [CI]; 1.39, 1.51; absolute level change: 43.5 visits per month, 95% CI; 26.5, 60.4). Cannabis-related calls to poison control also increased (IRR 1.87, 95% CI; 1.55, 2.37; absolute level change: 4.0 calls per month, 95% CI; 0.1, 7.9). Lastly, we observed increases in cannabis-related hyperemesis, unintentional ingestion, and individuals leaving the ED pre-treatment. We also observed a decrease in co-ingestant use. Conclusion: Overall, Canadian cannabis legalization was associated with small increases in urban Alberta cannabis-related ED visits and calls to a poison control centre.
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There is emerging evidence of the potential of RCL to help decrease CUD and multiple substance hospital admissions.
“There is emerging evidence of the potential of RCL to help decrease CUD and multiple substance hospital admissions74,82”
From The Impact of Recreational Cannabis Legalization on Cannabis Use and Associated Outcomes: A Systematic Review (2023) · cites this paper as [74]
The “Presentation pattern and co-ingestant use analysis” section reports lower proportions of co-ingestant use and hospital admission among cannabis-related ED presentations after legalization. It does not report a decrease in cannabis use disorder (CUD), and these proportional changes do not establish a decrease in the number of multiple-substance hospital admissions. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThere was a significant increase in telephone calls to poison control hotlines regarding cannabis after legalization.
“There was also a significant increase in telephone calls to poison control hotlines regarding cannabis (IRR = 1.87).”
From The implementation and public health impacts of cannabis legalization in Canada: a systematic review (2023) · cites this paper as [33]
After legalization, there were small but statistically significant increases in cannabis-related ED visits in Calgary and Edmonton.
“After legalization, there were small but statistically significant increases in cannabis‐related ED visits [incidence rate ratio (IRR) = 1.45].”
From The implementation and public health impacts of cannabis legalization in Canada: a systematic review (2023) · cites this paper as [33]
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- Authors
- Yeung, M. E. M., Weaver, C. G., Janz, K., Haines-Saah, R., & Lang, E.
- Affiliations
- University of Calgary (CA)
- Corresponding author
- Yeung, Matthew E. M.
- Venue
- CJEM
- Published
- 2020-06-19
- Volume
- 22
- Issue
- 6
- Pages
- 776-783
- ISSN
- 1481-8035 (ISSN-L)
- 1481-8043
- OpenAlex
- W3036260144
- Semantic Scholar
- 3b3e52c7cb7a76f9abb5738612f76a1e72dbc2f5
- Cited by
- 56
- References
- 12
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 11 · 2023: 16 · 2022: 11 · 2021: 5 · 2020: 2
- FWCI
- 5.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Canadian Journal of Emergency Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Alberta Health Services
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Keywords
- cannabis legalization, emergency department presentation
- MeSH terms
- Adult, Alberta, Cannabis, Emergency Service, Hospital, Humans, Legislation, Drug, Incidence
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