Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.
Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; Department of Pediatrics, Children's Hospital Association, Lenexa, Kansas.
J Adolesc Health. 2021 Dec;69(6):999-1005. doi: 10.1016/j.jadohealth.2021.07.028. Epub 2021 Sep 10.
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.
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).
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).
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.
青少年吸食大麻与不良健康后果有关。大麻合法化对青少年与大麻相关的住院治疗的影响尚不清楚。我们试图评估州大麻合法化是否与青少年与大麻相关的住院治疗有关。
我们使用住院患者基本信息数据库，对 2008 年 1 月 1 日至 2019 年 12 月 31 日期间儿童医院的青少年（11-17 岁）住院情况进行了回顾性队列研究。我们根据州大麻合法化情况，研究了青少年在住院期间与大麻相关的诊断差异，包括没有合法使用医用大麻法（MCL）的州和有 MCL 但没有非医用（>21 岁）大麻法（NMCL）的州。
在 18 个州和华盛顿特区的 1898432 例青少年住院中，有 37562 例（2%）与大麻相关的诊断，其中 8457 例（23%）在没有合法使用的州，20444 例（54%）在 MCL 州，8661 例（23%）在 NMCL 州。在 2008 年至 2019 年期间，MCL 州（比值比 1.05，95%置信区间 1.04-1.06）和 NMCL 州（比值比 1.03，95%置信区间 1.02-1.03）与大麻相关的住院治疗的调整后几率增加。政策变化后，与大麻相关的住院治疗调整后几率增加最大的特征包括 MCL 和 NMCL 州中没有潜在的心理健康或其他物质使用障碍的青少年（p<0.001）和 NMCL 州中年龄较小的青少年（13 岁与 16 岁和 17 岁，p=0.02 和 p=0.02）。
儿童医院青少年与大麻相关的住院治疗在增加，NMCL 州合法化后呈不成比例增加。需要采取干预措施，以增加在医院环境中对高危青少年进行大麻使用识别和治疗。
