Senior Surge: Cannabis Legalization Strains Healthcare Systems with Rising Emergency Visit

Since the legalization of cannabis in Canada, emergency departments have witnessed a significant surge in visits by older adults suffering from cannabis poisoning. A recent study published in JAMA Internal Medicine highlights the growing strain on healthcare systems, revealing that these incidents have tripled since the introduction of cannabis edibles in January 2020.

The period from October 2018 to December 2022 marked a pivotal shift in cannabis consumption patterns among older adults. Initially, the legalization of dried cannabis flower saw a doubling of emergency visits. However, the availability of cannabis edibles led to a tripling of these incidents, underscoring the challenges faced by healthcare providers. Dr. Nathan Stall, a geriatrician and lead author of the study, emphasized that many older adults are unaware of the potency of modern cannabis products, leading to unintended overdoses.

The increase in cannabis-related emergencies is placing a significant burden on healthcare services. Emergency departments are not only dealing with the immediate health crises caused by cannabis poisoning but are also facing the complexities of diagnosing these cases. Often, older patients present with symptoms such as confusion, psychosis, and chest pain, which require extensive testing to rule out other causes before cannabis is identified as the culprit.

Dr. Stall noted a common scenario: "An emergency department doctor struggles to diagnose an older patient’s neurological impairment, only to discover via toxicology screening that cannabis is the cause, much to the patient’s surprise."

Edibles pose a particular risk due to their delayed effects and high THC content. Older adults may consume more than intended, mistaking the delay for ineffectiveness. This can result in severe intoxication, especially in individuals with pre-existing health conditions or those on medications. The study revealed that 38% of affected seniors had cancer, 6.5% had dementia, and nearly 17% were also intoxicated with alcohol.

Strain on Emergency Services

The study underscores a critical need for healthcare providers to adapt to the evolving landscape of cannabis use. Emergency services are experiencing increased workload and resource allocation to handle the influx of cannabis-related cases. The need for additional training and resources to manage these specific emergencies is becoming increasingly apparent.

Experts are calling for enhanced education and clearer regulations to mitigate these challenges. There is a pressing need for better labeling of cannabis products, specifically with dosing guidelines tailored for older adults. "In geriatric medicine, we have a mantra: Start low and go slow," Stall advises, emphasizing that this approach should be applied to cannabis use as well.

Furthermore, healthcare providers must engage in open, non-judgmental conversations with older patients about the risks and benefits of cannabis. Ensuring that older adults are informed about the potency and proper usage of cannabis products can significantly reduce the risk of poisoning.

The legalization of cannabis has brought to light the need for a comprehensive approach to managing its effects on older adults. As healthcare systems grapple with the rise in cannabis-related emergencies, it is clear that more must be done to educate, regulate, and support this vulnerable population. Ensuring the safety of older adults in the era of legalized cannabis requires a concerted effort from both healthcare providers and policymakers.

Do you think healthcare systems are adequately prepared to handle the rise in cannabis-related emergencies among seniors?