Cannabis-Related Hospitalizations and Emergency Department Visits at a Glance

Release date: July 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 hospitalizations and emergency department (ED) visits in Durham Region residents.
• The rate of cannabis-related hospitalizations doubled in males and tripled in females during the ten-year period between 2007 and 2016 for Durham Region. The average annual rate of increase was 15% in Durham Region females and 10% in males. By 2016, there were 111 cannabis-related hospitalizations in Durham Region residents.
• The rate of cannabis-related ED visits steadily increased between 2007 and 2016 in Durham Region residents. The average annual rate of increase was 15% in Durham Region females and males. By 2016, there  were 373 cannabis-related ED visits in Durham Region residents.
• Hospitalization and ED visit rates were consistently higher in males than females.
• Youth aged 15 to 19 accounted for almost two-thirds of hospitalizations and one-third of ED visits. The rate of cannabis-related hospitalizations increased by 250 per cent in Durham Region youth between 2007 and 2016.  The rate of ED visits doubled in this age group during the same time period.  Cannabis-related hospitalization rates in Durham Region youth were consistently higher than provincial rates.
• Mental and behavioural disorders (MBD) were the most common diagnoses, as a percentage of the total cannabis-related hospitalizations, compared to poisonings.

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

Figure 2: Age-standardized cannabis-related ED visit rates per 100,000 in Durham Region and Ontario, by sex, between 2007 and 2016

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 2007 and 2016

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 2007 and 2016

Figure 5: Per cent of most responsible diagnosis codes, by diagnosis category, in Durham Region and Ontario between 2007 and 2016

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, only MRD codes were included in the denominator. There is no distinction between prescription and illegal cannabis use.