Perceptions and patterns of Cannabis use in emergency department patients following recreational legalization in Massachusetts

Abstract

Introduction

In Massachusetts, cannabis was legalized for recreational use in 2016. Legalization was associated with an increase in cannabis-related emergency department (ED) visits. The purpose of this study was to characterize cannabis use in an ED population in Massachusetts following legalization.

Methods

This was a convenience sample survey study conducted at an academic medical center ED in Massachusetts. Patients aged 18 or older reporting cannabis use within the last month were eligible. Participants were surveyed about cannabis use including: use patterns, risks and benefits, concomitant substance use, and changes in use post-legalization. Patients and treating physicians were asked whether ED visits were attributable to cannabis to determine discordance. Data analysis used descriptive statistics.

Results

Between July 2019 and May 2021, 200 patients were enrolled. Relaxation and analgesia were the most common reported benefits of cannabis. 46 % of patients prescribed an opioid reported decreased opioid use due to cannabis. 31 % reported no perceived risks from cannabis, and 22 % believed cannabis impaired driving. Twenty-one patients presented with a cannabis-related chief complaint per the treating physician; 11 (52.4 %) believed their presentation was due to cannabis. Post-legalization, 28.5 % of patients reported increased cannabis use.

Conclusion

In this study of patients with cannabis use presenting to a Massachusetts ED, the majority did not report increased use following recreational legalization. Patients reported multiple benefits of cannabis, including decreased opioid use, but minimized risks including intoxicated driving. Almost half of patients with cannabis-related symptoms did not attribute them to cannabis. These findings may inform harm-reduction strategies.