Comparison of Perspectives on Cannabis Use Between Emergency Department Patients Who Are Users and Non-users

Many states have legalized the use of cannabis for medical or recreational purposes. Cannabis is commonly used both recreationally and medicinally, with therapeutic applications for conditions including chronic pain, seizure disorders, multiple sclerosis, anxiety, and depression. The purpose of this study was to compare emergency department (ED) patient knowledge of the short- and long-term effects of cannabis between users and non-users, and to understand perspectives and knowledge of cannabis use, to assist in development of public health interventions.

We conducted this prospective survey study at Penn State Health - Milton S. Hershey Medical Center. Inclusion criteria included adult ED patients, ≥ 18 years of age, who had used cannabis in the most recent 30 days, between May to August 2024. The control group consisted of adult ED patients, ≥ 18 years of age, who had not used cannabis in the most recent 30 days. We conducted thematic analysis to identify subjects' knowledge of positive and negative effects of cannabis use.

Of 258 eligible subjects, 169 consented to participate (65.5%). Most identified as female (54.4%) and White (68.1%), with a mean age of 40 years. Most participants reported cannabis use in their lifetime (75.7%). Participants reported a myriad of reasons for using cannabis, including to treat anxiety (N = 67; 40%); pain (N = 65; 38%); recreational use (N = 62; 37%); sleep (N = 48; 28%); and depression (N = 34; 20%). Commonly perceived positive effects of cannabis use included relaxation (18%), pain relief (16%), and improved mental health symptoms (13%). Commonly perceived negative effects of cannabis use included cognitive impairment (11%), addictive potential (7%), pulmonary effects (8%), and worsened mental health symptoms (6%). Cannabis users were less likely to correctly identify negative short-term and long-term consequences of cannabis use, compared to non-users. Cannabis users scored mean 2.51/5 (95% CI 2.11-2.92) for correctness of negative short-term effects, compared to 3.28/5 (95% CI 2.96-3.6) for non-users (P = .004). Cannabis users scored mean 1.78/5 (95% CI 1.44-2.12) for correctness of negative long-term effects, compared to 2.38/5 (95% CI 2-2.76) for non-users (P = .002).

Among ED patients who reported using cannabis, reasons cited for its use included recreation, anxiety, pain, depression, and sleep. Emergency department patients had significant knowledge gaps regarding the effects of cannabis use, and these knowledge gaps were higher among cannabis users. Cannabis users were less likely to correctly identify negative short-term and long-term consequences of cannabis use, compared to non-users.