@article{ref1,
title="Cannabis-involvement in emergency department visits for self-harm following medical and non-medical cannabis legalization",
journal="Journal of affective disorders",
year="2024",
author="Myran, Daniel T. and Gaudreault, Adrienne and Pugliese, Michael and Tanuseputro, Peter and Saunders, Natasha",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="AIMS: Cannabis use may increase the risk of self-harm, but whether legalization of cannabis is associated with changes in self-harm is unknown. We examined changes in cannabis-involvement in emergency department (ED) visits for self-harm after the liberalization of medical and legalization of non-medical cannabis in Canada. <br><br>METHODS: This repeated cross-sectional study used health administrative data to identify all ED visits for self-harm in individuals aged ten and older between January 2010 and December 2021. We identified self-harm ED visits with a co-diagnosis of cannabis (main exposure) or alcohol (control condition) and examined changes in rates of visits over four distinct policy periods (pre-legalization, medical liberalization, non-medical legalization with restrictions, and non-medical commercialization/COVID-19) using Poisson models. <br><br>RESULTS: The study included 158,912 individuals with one or more self-harm ED visits, of which 7810 (4.9 %) individuals had a co-diagnosis of cannabis use and 24,761 (15.6 %) had a co-diagnosis of alcohol use. Between 2010 and 2021, the annual rate of ED visits for self-harm injuries involving cannabis per 100,000 individuals increased by 90.1 % (3.6 in 2010 to 6.9 in 2021 per 100,000 individuals), while the annual rate of self-harm injuries involving alcohol decreased by 17.3 % (168.1 in 2010 to 153.1 in 2021 per 100,000 individuals). The entire increase in visits relative to pre-legalization occurred after medical liberalization (seasonally adjusted Risk Ratio [a(s)RR] 1.71 95 % CI 1.09-1.15) with no further increases during the legalization with restrictions (a(s)RR 1.77 95%CI 1.62-1.93) or commercialization/COVID-19 periods (a(s)RR 1.63 95%CI 1.50-176). <br><br>CONCLUSIONS: Cannabis-involvement in self-harm ED visits almost doubled over 12 years and may have accelerated after medical cannabis liberalization. While the results cannot determine whether cannabis is increasingly causing self-harm ED visits or whether cannabis is increasingly being used by individuals at high risk of self-harm, greater detection for cannabis use in this population and intervention may be indicated.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2024.01.264",
url="http://dx.doi.org/10.1016/j.jad.2024.01.264"
}