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Cannabis Abuse Is Increasing and Associated with Increased Emergency Department Utilization in Gastroenterology Patients

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Abstract

Background

The role of cannabinoids in gastrointestinal diseases is controversial and of great interest, yet their use in patients has not been critically examined.

Aim

To determine the prevalence and effects of cannabis abuse on healthcare utilization, as measured by emergency department (ED) visits, in a large, tertiary gastroenterology practice.

Methods

All patients seen in the gastroenterology clinic at a tertiary care center during a 27-year period (1986–2013) were included in our study to determine the overall prevalence of cannabis abuse. We matched cannabis abusers 1:2 with non-abusing controls to determine the effect of cannabis on ED utilization, our primary outcome. We used multivariate linear regression to adjust for confounders and define the independent effect of cannabis abuse on ED utilization.

Results

Our prevalence study cohort included 190,303 GI clinic patients with an overall cannabis abuse prevalence of 0.80 % (1520 patients). From 1986 to 2012, the prevalence of cannabis abuse in this clinic increased by 0.73 % (0.03 %/year) (p < 0.0001). From the 1520 cannabis abusers identified, 467 patients were randomly selected as cases and were matched to 934 controls. From this retrospective cohort, the median ED visits/year for cannabis abusers was 1.88 versus 0.89 for non-abusers (p < 0.0001). After multivariate adjustment, cannabis abuse was associated with a 1.47-fold increase (95 % CI 1.23–1.76, p < 0.0001) in median ED visits/year.

Conclusions

Reported cannabis abuse in GI clinic patients is less prevalent than in the adult US population, but is increasing. Cannabis abuse among gastroenterology patients is associated with increased ED visits.

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Author’s contribution

John Gubatan, Kyle Staller, and Braden Kuo planned and designed the study and analyzed the data; John Gubatan collected the data; John Gubatan drafted the manuscript; Kenneth Barshop was involved in the matching of control subjects for the study and statistical analyses; all authors interpreted the results and contributed to critical review of the manuscript; John Gubatan had full access to all of the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis.

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Authors and Affiliations

  1. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA

    John Gubatan

  2. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Kyle Staller & Braden Kuo

  3. Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA, USA

    Kyle Staller & Braden Kuo

  4. Pritzker School of Medicine, University of Chicago, Chicago, IL, USA

    Kenneth Barshop

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  1. John Gubatan
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Corresponding author

Correspondence to John Gubatan.

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Conflict of interest

J. Gubatan, K. Staller, and K. Barshop declare no conflict of interest; B. Kuo receives clinical trial support from Vibrant.

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Gubatan, J., Staller, K., Barshop, K. et al. Cannabis Abuse Is Increasing and Associated with Increased Emergency Department Utilization in Gastroenterology Patients. Dig Dis Sci 61, 1844–1852 (2016). https://doi.org/10.1007/s10620-016-4090-9

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  • DOI: https://doi.org/10.1007/s10620-016-4090-9

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