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Cannabis-related emergency department visits at a glance.

Cannabis-Related Hospitalizations and Emergency Department Visits at a Glance

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Release date: December 2018

Highlights

  • This report demonstrates the burden of cannabis use on the health system by examining the rates of cannabis-related hospitalizations and emergency department (ED) visits in Durham Region residents.
  • Between 2008 and 2017, the rate of cannabis-related hospitalizations increased in males and in females in Durham Region and Ontario. However; in the past two years, the rate of increase slowed in Ontario while Durham Region’s rates declined between 2016 and 2017. In 2017, there were 90 cannabis-related hospitalizations in Durham Region residents.
  • The rate of cannabis-related ED visits also showed a steady increase between 2008 and 2017 in Durham Region and Ontario. By 2017, there were 504 cannabis-related ED visits in Durham Region residents.
  • Hospitalization and ED visit rates were consistently higher in males than females.
  • The rates in youth aged 15 to 19 were consistently higher than any other age group. Durham Region youth accounted for half of the hospitalizations and almost one-quarter of the ED visits in 2017. Cannabis-related hospitalization rates in Durham Region youth were consistently higher than provincial rates.
  • Durham Region residents aged 20 to 34 had the second highest rate of cannabis-related ED visits, accounting for over half of the ED visits in 2017.
  • One-in-ten (10%) of the hospitalizations was due to cannabis poisoning while 14% were due to mental and behaviour disorders related to cannabis use, such as intoxication, harmful use and dependence. In the remaining 76% of hospitalizations, cannabis was not the most responsible diagnosis for the hospitalization but was listed as a comorbidity.

Figure 1: Age-standardized cannabis-related hospitalization rates per 100,000 in Durham Region and Ontario, by sex, between 2008 and 2017

Chart showing cannabis-related hospitalization rates per 100,000 in Durham Region and Ontario.

Data table for figure 1
Table 1: Counts and age-standardized cannabis-related hospitalization rates per 100,000 in Durham Region and Ontario, by sex, between 2008 and 2017
StatisticCalendar year
2008200920102011201220132014201520162017
Durham Region Females rate 5.8 4.4 8.3 8.7 8.0 8.5 12.8 14.2 14.6 11.2
Durham Region Females count 20 15 27 30 27 29 42 48 49 38
Durham Region Males rate 14.4 9.7 10.3 10.9 11.2 14.7 14.6 16.7 18.1 15.1
Durham Region Males count 49 33 36 37 40 52 51 57 62 52
Ontario Females rate 6.2 6.5 7.2 7.6 10.0 12.3 13.2 15.2 19.6 19.7
Ontario Females count 413 431 481 513 670 823 882 1,013 1,296 1,322
Ontario Males rate 7.7 7.8 9.4 11.0 12.1 14.6 16.4 16.8 18.9 20.9
Ontario Males count 514 521 635 748 824 992 1,112 1,136 1,286 1,448
Source: Inpatient discharges, Ontario Ministry of Helth and Long-Term Care, intelliHEALTH Ontario

Figure 2: Age-standardized cannabis-related ED visit rates per 100,000 in Durham Region and Ontario, by sex, between 2008 and 2017

Chart showing cannabis-related ED visit rates by sex.

Data table for figure 2
Table 2: Counts and age-standardized cannabis-related ED visit rates per 100,000 in Durham Region and Ontario, by sex, between 2008 and 2017
StatisticCalendar year
2008200920102011201220132014201520162017
Durham Region Females rate 9.8 10.7 14.6 21.3 23.5 29.5 32.8 31.9 45.8 56.0
Durham Region Females count 32 33 47 70 80 98 110 106 153 190
Durham Region Males rate 26.5 21.1 33.2 44.1 51.9 40.5 54.9 55.9 64.3 91.4
Durham Region Males count 87 68 111 143 174 135 186 189 220 314
Ontario Females rate 11.9 11.1 13.0 17.1 20.7 23.1 27.4 32.5 43.4 58.0
Ontario Females count 792 736 868 1,147 1,391 1,557 1,845 2,178 2,939 3,990
Ontario Males rate 26.9 25.6 32.1 39.8 43.1 48.0 57.1 60.8 76.9 102.2
Ontario Males count 1,778 1,695 2,147 2,675 2,921 3,277 3,905 4,162 5,324 7,197
Source: Ambulatory visits, Ontario Ministry of Helth and Long-Term Care, intelliHEALTH Ontario

Figure 3: Age-specific cannabis-related hospitalization rates per 100,000 in Durham Region and Ontario, individuals aged 15 to 19, 20 to 34 and 35 years and older, between 2008 and 2017

Chart showing cannabis-related hospitalization rates ages 15 to 19, 20 to 34 and 35 years and older.

Data table for figure 3
Table 3: Counts and age-specific cannabis-related hospitalization rates per 100,000 in Durham Region and Ontario, individuals aged 15 to 19, 20-34 and 35 years older, between 2008 and 2017
StatisticCalendar year
2008200920102011201220132014201520162017
Durham Region 15-19 Rate 83.6 51.5 63.7 67.6 87.2 110.2 127.9 137.5 154.6 103.1
Durham Region 15-19 Count 40 25 31 33 42 52 59 62 68 45
Durham Region 20-34 Rate 7.9 9.5 16.1 15.8 11.3 10.3 16.2 16.7 16.2 12.2
Durham Region 20-34 Count 9 11 19 19 14 13 21 22 22 17
Durham Region 35 and older Rate 5.2 2.7 3.5 3.4 2.2 3.3 3.0 4.0 4.2 5.4
Durham Region 35 and older Count 17 9 12 12 8 12 11 15 16 21
Ontario 15-19 Rate 38.9 41.7 52.6 59.7 72.4 88.0 94.7 101.9 123.8 126.3
Ontario 15-19 Count 345 372 471 536 644 772 816 861 1,033 1,056
Ontario 20-34 Rate 10.7 11.9 12.5 12.8 16.5 19.3 20.9 23.1 27.9 30.1
Ontario 20-34 Count 279 312 333 345 453 539 592 661 814 904
Ontario 35 and older Rate 3.3 2.8 3.4 4.1 4.2 5.2 6.1 6.4 7.0 8.0
Ontario 35 and older Count 239 210 256 307 319 405 478 509 566 657
Source: Inpatient discharges, Ontario Ministry of Helth and Long-Term Care, intelliHEALTH Ontario

Figure 4: 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 2008 and 2017

Chart showing cannabis-related ED visit rates ages 15 to 19, 20 to 34 and 35 years and older.

Data table for figure 4
Table 4: Counts and age-specific cannabis-related ED visit rates per 100,000 in Durham Region and Ontario individuals aged 15 to 19, 20-34 and 35 years older, between 2008 and 2017
StatisticCalendar year
2008200920102011201220132014201520162017
Durham Region 15-19 Rate 94.0 59.8 139.7 141.5 213.9 146.3 225.6 204.0 243.3 268.2
Durham Region 15-19 Count 45 29 68 69 103 69 104 92 107 117
Durham Region 20-34 Rate 41.3 39.9 55.3 91.9 82.1 94.4 106.2 103.2 135.4 198.9
Durham Region 20-34 Count 47 46 65 110 101 119 137 136 183 276
Durham Region 35 and older Rate 5.2 5.4 6.5 7.8 11.3 11.1 13.9 16.1 19.3 24.7
Durham Region 35 and older Count 17 18 22 27 40 40 51 60 73 95
Ontario 15-19 Rate 89.2 85.5 108.2 131.1 146.6 156.7 182.2 201.8 243.1 313.4
Ontario 15-19 Count 791 762 969 1,177 1,303 1,374 1,570 1,705 2,028 2,619
Ontario 20-34 Rate 43.5 41.0 50.3 66.5 75.6 86.5 101.0 110.3 147.5 193.0
Ontario 20-34 Count 1,126 1,070 1,330 1,784 2,070 2,408 2,853 3,147 4,305 5,782
Ontario 35 and older Rate 7.1 6.5 7.9 9.7 10.6 11.7 14.7 17.0 21.8 31.1
Ontario 35 and older Count 513 479 584 732 805 902 1,155 1,351 1,754 2,532
Source: Ambulatory visits, Ontario Ministry of Helth and Long-Term Care, intelliHEALTH Ontario

Figure 5: Per cent of most responsible diagnosis codes, by diagnosis category, in Durham Region and Ontario between 2008 and 2017

Per cent of most responsible diagnosis codes, by diagnosis category.

Data table for figure 5
Table 5: Per cent of most responsible diagnosis codes, by diagnosis category, in Durham Region and Ontario between 2008 and 2017
LocationDiagnosis Category2008200920102011201220132014201520162017
Durham RegionCannabis Poisoning 0 2.1 0 6.0 1.5 1.2 0 3.8 9.9 10
Cannabis-Related Mental and Behavioural Disorder 29.0 18.8 25.4 20.9 17.9 27.2 34.4 21.9 18.0 14.4
Other 71.0 79.2 74.6 73.1 80.6 71.6 65.6 74.3 72.1 75.6
OntarioCannabis Poisoning 1.1 1.9 1.8 1.5 1.5 1.6 1.6 2.6 2.2 2.2
Cannabis-Related Mental and Behavioural Disorder 8.1 7.8 10.6 10.9 9.0 9.6 9.6 9.6 10.2 9.7
Other 90.8 90.3 87.6 87.5 89.5 88.8 88.8 87.8 87.6 88.1
Source: Inpatient discharges, Ontario Ministry of Helth and Long-Term Care, intelliHEALTH Ontario

Data Sources

Hospitalization and ED visit data are collected by the Canadian Institute for Health Information (CIHI) on a fiscal year basis. For hospital visits, the main diagnostic code is the “most responsible diagnosis” (MRD) that is deemed to be the clinically significant reason for the visit. For ED visits, the main diagnostic code is the “main problem” (MP). Hospitalization and 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 hospitalization or ED visit occurred. Ontario residents treated outside of the province were excluded. Data were reported by calendar year, based on the year of the hospitalization or ED visit. This report includes hospitalization and ED visit indicators with relevance to public health programming.

Cannabis-related hospitalizations and 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 MRD/MP 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. Hospitalizations to designated adult mental health hospital beds were not included in this analysis. ED visits where the health care provider documented uncertainty in the diagnosis (diagnosis prefix Q) and ED visits that resulted in a transfer to another ambulatory care facility were included in the counts. Hospitalization and ED visits for mental and behavioural disorders due to multiple drug use (F19) were excluded. Multiple codes can exist for each hospitalization or ED visit. As such, a unique visit number, DAD key (hospitalizations) or NACRS key (ED visits), was used to count the number of hospitalizations or visits where at least one of the above codes was captured as the MRD/MP or comorbidity. In Figure 5, there is no distinction between prescription and illegal cannabis use.

Definitions

Figures and tables are provided for the following indicators:

  • Age-standardized cannabis-related Hospitalization and ED visit rates by sex
  • Age-specific cannabis-related Hospitalization and ED visits rates in individuals aged 15 to19 years, 20 to 34 years and 35 years and older

Age-standardized Hospitalization/ED visit rate

An age-standardized Hospitalization/ED visit rate is the number of Hospitalization/ED visits per 100,000 that would occur if the population had the same age distribution as the 2011 Canadian population. This rate provides a single summary number that allows populations with different age compositions to be compared.

Age-specific Hospitalization/ ED visit rate

This rate is the total number of Hospitalizations/ED visits in a specified age group per 100,000 population in that age group. The numerator and denominator refer to the same age group.

For more information

Focused Report - Cannabis-Related Emergency Department Visits

Statistics Canada’s Cannabis Stats Hub

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