Sex and Gender
Background: Cannabis (MJ) policy liberalization has led to an increase in the number and types of Emergency Department (ED) visits associated with MJ use. Sex differences exist in the physiologic and psychologic effects of MJ. The objective of this study was to determine if there were sex-based differences in MJ attributable ED visits.
Methods: We performed a retrospective chart review of UCHealth-UCH ED visits between 2012 and 2016. We identified ED visits by MJ ICD 9/10 codes (9,973 visits) and independently reviewed those to identify visits attributable to MJ use (2,563 visits). We categorized MJ-attributable visits by complaint. We identified statistical differences between proportions of male and female populations using Pearson’s chi-squared, where p < 0.05 was significant.
Results: The majority of MJ-attributable visits were from males (65.2%). A greater proportion of females had multiple MJ-attributable visits (58.9%) than men (50.8%, p < 0.001). A greater proportion of women visited the ED for gastrointestinal complaints then men (37.6% vs. 27.1%, p < 0.001); whereas greater proportions of men visited the ED for intoxication (31.7% vs. 25.7%) and psychiatric (26.1% vs. 22.1%) reasons (p < 0.001). Of those categorized as gastrointestinal complaints, a greater proportion of men had a cannabinoid hyperemesis syndrome diagnosis (58.3% vs. 52.5%, p < 0.001). Women with a clinical complaint of intoxication were more likely to report MJ use only (22.7%), while men were more likely to report MJ and alcohol intoxication (19.8%, p < 0.001).
Conclusions: Clear differences exist between the populations of men and women treated in the ED for MJ-attributable reasons. Recognizing these sex-based differences may help inform both treatment and education strategies for patients using marijuana. Future prospective studies will dissect the mechanisms underlying sex-related differences in MJ-attributable ED visits.