Abstract
Purpose
Adolescent cannabis use is associated with adverse health outcomes. The impact of
cannabis legalization on adolescent cannabis-related hospitalizations remains unknown.
We sought to assess whether state cannabis legalization is associated with adolescent
cannabis-related hospitalizations.
Methods
We conducted a retrospective cohort study of adolescent (11–17 years) hospitalizations
at children’s hospitals between January 1, 2008 and December 31, 2019 using the Inpatient
Essentials database. We investigated differences in adolescent cannabis-related diagnosis
during a hospitalization by state cannabis legalization status, including states with
no legal use to medical cannabis laws (MCLs) and states with MCLs to nonmedical (>21 years
old) cannabis laws (NMCLs).
Results
Of 1,898,432 adolescent hospitalizations in 18 states and Washington, DC, there were
37,562 (2%) hospitalizations with a cannabis-related diagnosis, with 8,457 (23%) in
states with no legal use, 20,444 (54%) in MCL states, and 8,661 (23%) in NMCL states.
There was an increase in adjusted odds of a cannabis-related hospitalization in MCL
(odds ratio 1.05, 95% confidence interval 1.04–1.06) and NMCL states (odds ratio 1.03,
95% confidence interval 1.02–1.03) between 2008 and 2019. Characteristics associated
with the greatest increase in adjusted odds of a cannabis-related hospitalization
postpolicy change included adolescents without an underlying mental health or other
substance use disorder in MCL and NMCL states (p < .001) and younger age in NMCL states (13 vs. 16 and 17 years old, p = .02 and p = .02).
Conclusions
Cannabis-related adolescent hospitalizations at children’s hospitals are increasing,
with a disproportionate increase postlegalization in states with NMCLs. Interventions
are warranted to increase cannabis use identification and treatment among at-risk
adolescents in the hospital-based setting.
Keywords
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Article info
Publication history
Published online: September 09, 2021
Accepted:
July 21,
2021
Received:
March 8,
2021
Footnotes
Financial Disclosure: The authors have no financial disclosures to report.
Conflicts of interest: The authors have no conflicts of interest to report.
Identification
Copyright
© 2021 Society for Adolescent Health and Medicine. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Contextualizing Cannabis Legalization OutcomesJournal of Adolescent HealthVol. 69Issue 6
- PreviewCannabis (“marijuana”) has a long history of legality and prohibition in the United States. However, it has been federally illegal since the 1970s Controlled Substances Act. The Controlled Substances Act currently categorizes cannabis as a schedule I substance, the most restrictive schedule, quantifying cannabis on par with heroin and indicating a high potential for abuse, no currently accepted medicinal use, and lack of safety for use under medical supervision [1].
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