Cannabis-Related Emergency Department Visits at a Glance

Release date: January 2018

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Highlights

• This report demonstrates the burden of cannabis use on the health system by examining the rates of cannabis-related emergency department (ED) visits in Durham Region residents.
• In 2016, there were 373 cannabis-related ED visits in Durham Region residents. The ED visit rates steadily increased between 2007 and 2016: for Durham Region residents and provincially; for males and females; and for youth, young adults and older adults.
• In 2016, the ED visit rate for Durham Region males was 1.4 times higher than females. The rate in Durham Region youth aged 15 to 19 years old was 12.5 times higher than adults 35 years of age and older.

Figure 1. Age-standardized cannabis-related ED visit rates per 100,000 in Durham Region and Ontario, by sex, between 2007 and 2016

Figure 2. Age-specific cannabis-related ED visit rates per 100,000 in Durham Region and Ontario individuals aged 15 to 19, 20 to 34 and 35 years and older, between 2007 and 2016

Data Sources

ED visit data are collected by the Canadian Institute for Health Information (CIHI) on a fiscal year basis. For ED visits, the main diagnostic code is the “main problem” (MP) that is deemed to be the clinically significant reason for the visit. ED visit data provide only a crude measure of the burden of cannabis use. Data are influenced by factors that are unrelated to health status such as availability and accessibility of care, administrative policies and hospital procedures. This may influence comparisons between areas and over time.

For all indicators, data were analyzed by the residence of the patient, not where the ED visit occurred. Ontario residents treated outside of the province were excluded. Data were reported by calendar year, based on the year of the ED visit. This report includes ED visit indicators with relevance to public health programming.

Cannabis-related ED visits were selected using ICD-10-CA codes T40 (.7) (i.e., poisoning) and F12 (.0-.9) (i.e., mental and behavioural disorders due to acute intoxication, harmful use, dependence, etc. from the use of cannabinoids) whether it was the main problem or comorbidity. This excludes injuries such as from motor vehicle traffic crashes or chronic conditions such as cancer where cannabis may be a contributing factor. In less than 5% of the ED visits, the health care provider documented uncertainty in the diagnosis (diagnosis prefix Q): these visits were included.  Less than 1% of the visits resulted in a transfer to another ambulatory care facility: these visits were included. ED visits for mental and behavioural disorders due to multiple drug use (F19) were excluded. Multiple codes can exist for each ED visit. As such, a unique visit number, NACRS key, was used to count the number of visits where at least one of the above codes was captured as the main problem or comorbidity. In this analysis, there is no distinction between prescription and illegal cannabis use.