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 Between 2005 and 2015, the proportion of emergency department or
urgent care visits by youth ages 13 to 20 for pot-related illnesses
rose from 1.8 per 1,000 visits to 4.9 per 1,000, the study team
reports in Journal of Adolescent Health.
"Most studies evaluating the impact of marijuana legalization on
adolescents' use are survey-based studies to evaluate overall
recreational use," said lead author Dr. George Wang, a pediatrician
at the University of Colorado Anschutz Medical Campus in Aurora.
And those surveys suggest that teen pot use hasn't increased much in
states where the drug is legal, the study team notes.
Marijuana is legal for medical use in 29 states and Washington DC.
Eight states plus Washington DC, including Colorado, have legalized
recreational use as well.
"We wanted to study the immediate health impact on adolescents,
specifically emergency and urgent care visits," Wang said in an
email. "Marijuana-related (emergency department/urgent care) visits
are of significant concern as patients are having significant acute
medical or psychiatric symptoms requiring evaluation."
The researchers analyzed medical records from a children's hospital
system and identified more than 4,000 emergency visits related to
marijuana use between 2005 and 2015.
More than two-thirds of the records included information on the
patient's behavioral health and a similar number included a
psychiatric diagnosis, such as depression, mood disorder and alcohol
abuse, the study found.
Patients had often consumed another substance in addition to
marijuana, with alcohol being the most common. About half of the
patients were sent home after their emergency visit, 30 percent were
admitted to the hospital and the rest were transferred to different
facilities.
"Although reports of overall use have not changed, marijuana
legalization may impact adolescent and youth in other, potentially
more serious, aspects of both their physical and mental health,"
Wang said.
His team continues to stress to pediatricians the importance of
screening for substance use and addiction risk factors at an
appropriate age, he added. "Furthermore, they should continue to
educate families and patients about the potential harms that may
result from use at a young age."
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Dr. Sharon Levy, who wasn't involved in the study, said its results
match her clinical experiences in Massachusetts, where laws are also
changing.
"We are seeing kids use lots of different products that weren't
available when we opened our program nearly 20 years ago," said
Levy, who directs the adolescent substance use and addiction program
at Boston Children's Hospital.
"We see kids using 'dabs,' which is basically highly concentrated
THC oil - and really nothing like the plant material that parents
might think of when they hear the word marijuana," she said in an
email.
The presentation of kids who use marijuana has absolutely changed
over the years, Levy added.
"We see more kids with psychotic symptoms like hallucinations and
delusions and other mental health symptoms. We also see more and
more kids presenting with chronic vomiting," she said.
The key for parents is to stay on message that marijuana is bad for
health and bad for the developing brain, said Levy, who also
"strongly encourages" parents to have clear expectations for their
kids and clear house rules, including no marijuana use.
"It's surprising to me how often I meet parents who don't want their
kids to use marijuana and think they have made that clear, though
when I talk with the kids they haven't really picked up on the
message," she said.
Levy also advises parents to seek out more information so they are
prepared to discuss the topic with their kids and explain what they
are concerned about.
SOURCE: https://bit.ly/2GSNBrP Journal of Adolescent Health, online
March 30, 2018.
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