Cannabis-connected emergency department (ED) visits in the United States in children and young adults 24 years and younger increased during COVID-19, according to new data published today in Morbidity and Mortality Weekly Report.
The report was based on ED visits since 2019, and the authors said cannabis-related ED visits have increased since the COVID-19 pandemic began, with weekly visits higher in 2020, 2021, and 2022, compared to the same weeks in 2019.
Researchers from the Centers for Disease Control and Prevention (CDC) analyzed National Syndromic Surveillance Program (NSSP) data and quantified changes in cannabis-involved ED visit rates and stratified them by age group and sex, among all people under 25 years.
NSSP receives medical record data from about 75% of EDs across 50 US states, the District of Columbia, and Guam, although less than 50% of hospitals in California, Hawaii, Minnesota, and Oklahoma currently participate in the program, the CDC authors wrote.
In total, four periods in each of the 3 COVID-19 years were analyzed: weeks 1 to 11 (which was prepandemic in 2020), weeks 12 to 23 (second half of school year), weeks 24 to 36 (summer), and weeks 37 to 53 (first half of school year). All weeks were compared to corresponding epidemiologic weeks in 2019.
More than 90% of visits in 15- to 24-year-olds
Among adolescents and young adults aged 15 to 24, the average weekly number of cannabis-involved ED visits during the pandemic ranged from 2,275.8 (2020, weeks 12–23) to 2,813.2 (2021, weeks 12–23), compared with 2,117.5 (2019, weeks 1–11) to 2,531.1 (2020, weeks 1–11) during the prepandemic period, the authors wrote.
Teens and young adults 15 to 24 accounted for more than 90% of cannabis-related ED visits. Among children and adolescents aged 11 to 14 years old, the peak, at 209.3 weekly visits, was about 7% of the peak among the older group and occurred 1 year later (2022, weeks 12–23).
ED visits for those 10 and under also soared during the pandemic, likely because of accidental cannabis ingestions. During the pandemic, cannabis-involved ED visit rates among children aged 10 years and younger began declining during the second half of the 2020-21 school year, but peaked in the summer of 2022, a time when more states legalized cannabis products.
Marijuana as pandemic coping?
Of note, female cannabis-involved ED visit ratios surpassed those of males in the first half of the 2020-21 school year (2020, weeks 37–53), and this continued throughout most of the pandemic.
It is important for adults who use cannabis to safely and securely store cannabis products in places inaccessible to children.
"This might indicate that females were more likely than males to use cannabis to cope with pandemic-related stress," the authors said.
Increase in cannabis use likely stems from different factors, the authors noted, including use as a coping mechanism, products with highly concentrated THC (delta-9-tetrahydrocannabinol, marijuana's active ingredient), and packaging of edible products that is confusing to children.
"To protect against unintentional ingestions of cannabis, it is important for adults who use cannabis to safely and securely store cannabis products in places inaccessible to children," the authors said.
