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Emergency Department Patients Presenting after Oral versus Inhaled Cannabinoid use: A Retrospective Analysis.

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Oral cannabinoid use leads to more emergency department visits and hospital admissions than inhaled use. Unintentional oral cannabinoid ingestion is also more common, highlighting potential public health concerns.

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Area of Science:

  • Emergency Medicine
  • Clinical Toxicology
  • Public Health

Background:

  • Emergency department (ED) visits related to cannabinoid use are rising.
  • Limited data exists comparing inhaled versus oral cannabinoid routes of administration in ED presentations.

Purpose of the Study:

  • To compare the clinical presentations and outcomes of emergency department visits resulting from inhaled versus oral cannabinoid use.

Main Methods:

  • Retrospective cohort study of ED patients with cannabinoid-related diagnoses (January 2020 - May 2023).
  • Manual chart review to categorize visits by likelihood of acute cannabinoid use.
  • Primary analysis focused on "highly likely" visits, comparing oral versus inhaled routes, with hospital admission as the primary outcome.

Main Results:

  • Of 303 "highly likely" visits, 80.5% were oral and 19.5% were inhaled.
  • Hospital admission occurred in 6.2% of oral users versus 0% of inhaled users (p=0.05).
  • Unintentional cannabinoid use was reported in 26.7% of oral users compared to 6.8% of inhaled users.

Conclusions:

  • Oral cannabinoid use is associated with a higher likelihood of hospital admission and greater ED resource utilization compared to inhaled use.
  • A significant proportion of oral cannabinoid ED visits involve unintentional ingestion.
  • Increased regulation of edible cannabinoid products may be warranted from a public health standpoint.