Cannabis-involved emergency department visits among persons aged under 25 years before and during the COVID-19 pandemic
Cannabis-involved emergency department (ED) visits among young persons were higher during the COVID-19 pandemic than during 2019. Large increases in cannabis-involved ED visit rates occurred among children aged ≤10 years, and among persons aged 11–14 years; rates among females aged 11–14 years increased more than they did among males.
To protect youths from unintentional ingestions, it is important that safe cannabis storage practices be employed in households. Local implementation of youth- and young adult–focused evidence-based programs to improve coping with stressors might prevent initiation and continued use of cannabis, and modifications in cannabis packaging might decrease its appeal to youth, as cannabis use policies continue to increase cannabis availability in some states.
During December 30, 2018–January 1, 2023, a total of 539,106 cannabis-involved ED visits occurred among persons aged <25 years (64.9 per 10,000 ED visits) in the United States. During the pandemic, the average number of weekly cannabis-involved ED visits involving persons aged ≤10 years ranged from 30.4 (2020, weeks 12–23) to 71.5 (2022, weeks 24–36), compared with the prepandemic periods (range = 18.7 [2019, weeks 1–11] to 23.2 [2020, weeks 1–11]). Among persons aged 11–14 years, the mean number of weekly cannabis-involved ED visits during the pandemic ranged from 69.8 (2020, weeks 12–23) to 209.3 (2022, weeks 12–23), compared with 90.5 (2019, weeks 24–36) to 138.5 (2020, weeks 1–11) during the prepandemic period. Among adolescents and young adults aged 15–24 years, the average weekly number of cannabis-involved ED visits during the pandemic ranged from 2,275.8 (2020, weeks 12–23) to 2,813.2 (2021, weeks 12–23), compared with 2,117.5 (2019, weeks 1–11) to 2,531.1 (2020, weeks 1–11) during the prepandemic period.
Among children aged <10 years, the pandemic peak in mean weekly visits (71.5) occurred during the summer of 2022 (weeks 24–36). During the pandemic, cannabis-involved ED visit rates among children aged ≤10 years began declining during the second half of the 2020–21 school year (2021, weeks 12–23), but increased thereafter, peaking during the summer of 2022 (weeks 24–36) at 4.0. Cannabis-involved ED visit ratios per 10,000 ED visits in this age group ranged from 2.4 (2021, weeks 37–53) to 5.8 (2021, weeks 1–11).
Among children and adolescents aged 11–14 years, the pandemic peak in mean weekly visits (209.3) occurred during the second half of the 2021–22 school year (2022, weeks 12–23). Beginning in 2020, cannabis-involved ED visits also increased among persons aged 11–14 years, and during this time, visit ratios among females were higher (range = 1.5 [2020, weeks 37–53] to 2.7 [2022, weeks 1–11]) than they were among males (range = 0.9 [2021, weeks 24–36] to 1.6 [2022, weeks 1–11]). Within this age group, visit ratios by sex were not statistically significantly different during the early 2020 pandemic periods; however, beginning in the first half of the 2020–21 school year (2020, weeks 37–53), ED visit rates among females surpassed those among males and remained higher than rates among males throughout the study period.
More than 90% of cannabis-involved ED visits by persons aged <25 years occurred among those aged 15–24 years. The peak in mean weekly cannabis-involved ED visits among this age group (2,813.2) occurred during the second half of the 2020–21 school year (2021, weeks 12–23). Among children and adolescents aged 11–14 years, the peak (209.3) was approximately 7% of the peak among the older group and occurred 1 year later (2022, weeks 12–23). Rates of cannabis-involved ED visits were elevated among persons aged 15–24 years from 2020 through summer 2021 relative to reference periods (visit ratio range = 1.1 [2021, weeks 24–36] to 1.7 [2020, weeks 12–23]); however, rates briefly returned to baseline during the first half of the school year in both 2021 and 2022 (weeks 12–23).
