Cannabis presentations to the emergency department after MVC in the era of legalization for recreational use

• Published in: Journal of safety research 2022-02, Vol.80, p.341-348
• Main Authors: Choo, Esther K., Nishijima, Daniel, Trent, Stacy, Eichelberger, Angela, Ye, Yu, Audett, Ariane, Brasel, Karen, Kazmierczak, Steve, Cherpitel, Cheryl J.
• Format: Article
• Language: English
• Subjects: Accidents, Traffic; Alcohol; Alcohol Drinking - adverse effects; Alcohol Drinking - epidemiology; Alcohol use; Alcohols; Cannabis; Cannabis - adverse effects; Cross-Sectional Studies; Electronic health records; Electronic medical records; Emergency care; Emergency medical care; Emergency medical services; Emergency Service, Hospital; Ethanol; Humans; Marijuana; Motor vehicle collisions; Patients; Recreational use; Substance use; Substance use disorders
• ISSN: 0022-4375; 1879-1247
• DOI: 10.1016/j.jsr.2021.12.016

•Self-reported acute cannabis use was low; biosamples suggested a much higher rate.•Usual past-year use and cannabis dependence was high versus prior studies.•Many high-risk crash features were common in MVCs associated with cannabis. Introduction: The objectives of this study were to examine cannabis and alcohol use among injured patients presenting to emergency departments (ED) in cannabis-legal states to capture an expanded profile of cannabis use and evaluate differences in motor-vehicle collision (MVC) characteristics among those using cannabis alone and in combination with alcohol. Methods: This was a cross-sectional study of ED visits by drivers in MVC who presented to one of three study sites. Event-related and usual drug and alcohol use information were obtained using a detailed interviewer-administered computerized questionnaire. We also obtained data from blood and breathalyzer tests and the electronic medical record. We examined frequency and types of acute and past-year cannabis and alcohol use and crash mechanisms and characteristics. Our primary method of determining substance use was self-report; we used biosamples secondarily. Results: Eight percent of drivers reported cannabis use in the 8 h prior to MVC, alone or in combination with alcohol; however, a higher proportion (18%) were positive by biosample. High-risk crash features were common in MVCs associated with cannabis, as they were for alcohol use and co-use of cannabis and alcohol; however, patients injured seriously enough to require admission were less likely to report cannabis use (7% vs. 9%) and more likely to report alcohol use (16% vs. 10%). Conclusions: Cannabis use was common among patients presenting after MVC in this sample of cannabis-legal states. Practical Applications: Differences between self-report and biosample data for cannabis and alcohol use were significant and supports the need to use both means of assessing acute use.