The legalization of recreational cannabis in Maryland saw a notable uptick in emergency room visits tied to the substance, but health experts remain cautious about jumping to conclusions on the cause.
State Dashboard Highlights Early Trends in Cannabis-Related ER Visits
Maryland’s newly launched health dashboard has shed light on the increase in cannabis-related emergency room visits in the lead-up to recreational legalization. From medical marijuana’s legalization in 2014 to voters approving adult-use cannabis in November 2022, the trajectory toward full legalization came with a visible uptick in ER visits.
Emergency room data showed a marked rise, with visits climbing steadily as the July 2023 legalization date approached. The dashboard reveals that ER admissions fluctuated between 384 and 657 before the months leading up to legalization, where the figure spiked to 928. However, since the law was enacted, cannabis-related ER visits have leveled off, with the last recorded number in October 2023 at 814, still up from 2022 levels.
Despite this upward trend, experts caution against drawing direct correlations between the legalization and the increase in ER visits. According to Dr. Johannes Thrul, a researcher at Johns Hopkins University, these increases began well before the law’s implementation, making it unclear if the surge is truly a direct result of legalization. “I would not feel comfortable saying that this is an effect of legalization,” Thrul stated, adding that other factors may contribute to the rise.
Data Absence Leaves Questions on Why People Visit the ER
While the dashboard offers a wealth of information about the number of cannabis-related ER visits, it leaves a critical gap—there is no data on the reasons why individuals are seeking emergency medical care after using cannabis. Health officials recognize this limitation, and many see the dashboard as just the beginning of a larger effort to understand cannabis’ health impacts.
“We need data to know what’s happening,” said Dr. Nilesh Kalyanaraman, Maryland’s deputy secretary for public health. Kalyanaraman emphasized that the state’s new system is just a first step in gathering meaningful data on how cannabis affects public health. The hope is that this database can evolve and provide more granular insights into the effects of cannabis use.
Experts like Thrul suggest that understanding the reasons behind the ER visits is essential for shaping public health policy. He pointed out that some visits could result from overconsumption, particularly from edibles, which have delayed effects. “Some of those ER visits can be acute cannabis intoxication,” he explained, where individuals overdo it, feel the delayed effects, and end up overwhelmed by anxiety or paranoia.
Cannabis-Related Incidents May Be Linked to Other Injuries
The rising number of cannabis-related ER visits raises concerns about the broader public health implications, including potential injuries caused by the side effects of cannabis use. Dr. Georges Benjamin, executive director of the American Public Health Association, highlighted the risks of cannabis affecting coordination and sensory perception, which may lead to accidents such as car crashes, falls, and pedestrian injuries.
“You should anticipate, with anything that results in altered senses, more challenges with people in automobile crashes, falling off of bikes, distracted walking with results in pedestrian injuries,” Benjamin said. The potential for increased injuries and accidents is a key consideration as the state continues to track cannabis-related health data. Kalyanaraman echoed this concern, suggesting that the state’s future data collection efforts could incorporate information on injuries and accidents linked to cannabis use.
While current data does not yet shed light on these aspects, it is clear that the state is committed to expanding its understanding of cannabis’ effects on public health. “We’re trying to get ahead of the potential consequences of cannabis legalization,” Kalyanaraman explained.
Regional Variations in Cannabis-Related ER Visits
Another area of interest highlighted by the dashboard is the regional variation in cannabis-related ER visits. Baltimore City saw the second-highest rate of cannabis-related ER visits in 2023, with 2,140 visits equating to 378.6 visits per 100,000 city residents. Allegany County had the highest rate, with 481.6 visits per 100,000 residents, a striking contrast to Caroline County, which recorded fewer than 10 visits.
This disparity raises important questions about how cannabis use affects different communities across Maryland. The reasons for these variations remain unclear, but health officials are hoping that further analysis will provide insight into the underlying causes. “There’s still a lot to figure out about why these numbers are different by location,” said Kalyanaraman.
A Cautious Approach to Cannabis Consumption
Despite the excitement surrounding the new cannabis laws, health officials have urged residents to approach cannabis use carefully. Kalyanaraman emphasized that while recreational cannabis is legal, its use still carries health risks, particularly when it comes to smoking. Smoking cannabis can lead to long-term lung issues and other inflammatory conditions, as noted by both Kalyanaraman and Benjamin.
“There’s no safe way to smoke anything,” Benjamin warned, suggesting that consumers should consider alternatives to smoking, such as edibles or vaping, though these come with their own set of risks. Thrul, for his part, recommended a cautious approach to consumption. “The harm reduction around cannabis is ‘go slow,’” he advised. “Wait for the effects to develop, and then decide if you want to do more.”
As Maryland adjusts to the full implementation of its cannabis laws, experts agree that education and harm reduction strategies will be key in managing the potential health impacts of cannabis use.
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