Cannabis legalization may be associated with an increased risk of emergency department (ED) visits for cannabis poisoning in older people, a study in JAMA Internal Medicine has found.
Nathan M. Stall, M.D., Ph.D., of the Sinai Health and the University Health Network in Toronto and colleagues analyzed data from the Ontario Ministry of Health to examine ED visit rates for cannabis poisoning in adults aged 65 and older during three policy periods: prelegalization (January 2015 to September 2018); legalization period 1, which allowed the sale of dried cannabis flowers only (October 2018 to December 2019); and legalization period 2, which also allowed the sale of edible cannabis (January 2020 to December 2022).
Overall, there were 2,322 ED visits for cannabis poisoning in older adults (mean age 69.5 years) during the study period. After adjusting for age, sex, rurality, neighborhood, income, alcohol intoxication, cancer diagnosis, and dementia diagnosis, the researchers found that the rate of ED visits linked to cannabis poisoning among older people doubled in period 1 and tripled in period 2 compared with the prelegalization period.
The researchers offered several possible reasons for the increase following the legalization of edibles; these include a greater likelihood of accidental ingestion, easier access to cannabis products, and lack of age-specific dosing instructions. The researchers acknowledged, however, that they could not determine whether the continued increase was directly related to edible cannabis or a result of broader commercialization of nonmedical cannabis.
Stall and colleagues added that older people are at particularly high risk of adverse effects from cannabis because of age-related physiological changes, potential interactions with other medications, and multimorbidity.
“Overall, this study shows the health outcomes of cannabis legalization and commercialization for older adults and highlights the consequences associated with edible cannabis,” Stall and colleagues wrote. They said that jurisdictions with legalized cannabis should consider measures to mitigate unintentional exposure in older adults and provide age-specific dosing guidance.
For related information, see the Psychiatric Services article “Effects of Recreational Cannabis Legalization on Mental Health: Scoping Review.”
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