Trends in Cannabis-Related Hospital Visits in Arizona

Cannabis-related hospital visits in Arizona have increased over time post-legalization, showcasing a concerning rise in cannabis-related healthcare burden, with emergency department (ED) visits being notably costly. Data analysis from 2016-2021 reveals a significant uptick in ED visits related to cannabis abuse, dependence, and poisoning, shedding light on the public health impact and demographics most affected.

• Cannabis
• Hospital Visits
• Arizona
• Healthcare Burden
• Public Health

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1. Trends in Cannabis-Related Hospital Visits in Arizona MADELINE H. MEIER, PHD HALEY HUMMEL, BA ARIZONA STATE UNIVERSITY

2. Cannabis-Related Hospital Visits Given cannabis legalization in the US, several states have leveraged emergency department (ED) data to monitor the cannabis-related healthcare burden ED data show a clear signal: the rate of ED visits related to cannabis (cannabis abuse, cannabis dependence, cannabis poisoning) has increased over time

3. Importance ED visits are among the costliest healthcare visits in the US considered a severe outcome vital for understanding the magnitude of the cannabis-related public health burden

4. What is happening in Arizona? 1. Have cannabis-related hospital visits increased over time? 2. Who is most at risk for a cannabis-related hospital visit? (e.g., youth) 3. What is the cannabis-related mental health burden?

5. Method Data: ADHS data on emergency department and inpatient hospital visits from all Arizona licensed hospitals, 2016-2021. For each visit, up to 26 ICD-10 (International Classification of Diseases) diagnoses are recorded. Records were searched for ICD-10 diagnoses of cannabis-related disorders, mental health disorders, and other substance-use disorders

6. Have Cannabis-Related Hospital Visits Increased Over Time?

7. Changes in the Rate of Hospital Visits Related to Cannabis 300 22% increase from 2016-2021 250 Adult- Use Sales? 200 COVID? 150 100 50 0 2016 2017 2018 2019 2020 2021 Cannabis Alcohol Rates are per 10k Hospital Visits

8. Who is most at risk?

9. Age Group Trends 400 350 300 250 200 150 100 50 0 2016 2017 2018 2019 2020 2021 <10 y 10-17 y 18-24 y 25-34 y 35-44 y 45-54 y 55-64 y 65+ y

10. Age Group Trends Youth ages 10-17 showed the largest increase 400 350 300 250 200 150 100 50 0 2016 2017 2018 2019 2020 2021 <10 y 10-17 y 18-24 y 25-34 y 35-44 y 45-54 y 55-64 y 65+ y

11. What is the Cannabis-Related Mental Health Burden? Analyses tested the association between cannabis and mental health problems Did visits with cannabis-related diagnoses show a higher prevalence of mental health diagnoses than visits without cannabis-related diagnoses?

12. Risk of Mental Illness-Related Hospital Visit for Patients With vs. Without Cannabis Diagnosis Risk for specific mental health disorders was ~3.5 to 7 times higher for people with a cannabis-related disorder compared with people with no cannabis-related disorder 8 7 6 5 4 7x 3 5x 5x 3.5x 2 1 0 Psychosis Mood Anxiety Self-Harm Data are from calendar year 2021

13. Changes in the Rate of Hospital Visits with Cannabis and Mental Illness Diagnoses 90 80 70 60 50 40 30 20 10 0 2016 2017 2018 2019 2020 2021 Rates are per 10k Hospital Visits

14. Next Steps Include other mental health disorders Follow-back and follow-forward analysis Current analyses are cross-sectional hard to know which came first cannabis disorder or mental health disorder Compare cannabis-related mental health risk with alcohol-related mental health risk

15. Comparison with Alcohol-Related Visits 500 450 400 350 300 250 200 150 100 50 0 2016 2017 2018 2019 2020 2021 Cannabis Alcohol

16. Summary and Implications for Prevention Ages 18-24 show the highest rate of hospital visits for cannabis-related disorders Ages 10-17 show the fastest increase in rate of hospital visits for cannabis-related disorders People who visit the hospital with cannabis- related disorders show elevated prevalence of mental health disorders

17. Summary and Implications for Prevention An ounce of prevention is worth a pound of cure Messaging to counter the trend of reduced perceptions of cannabis harms Educating parents to lock up their cannabis, avoid using in front of youth, and avoid sharing war stories of their cannabis use

18. Funding Arizona Biomedical Research Commission Substance Abuse Translational Research Network