Chronic health conditions, acute health events, and healthcare utilization among adults over age 50 in Hawai’i who use cannabis: A matched cohort study

• Published in: Drug and alcohol dependence Vol. 234; p. 109387
• Main Authors: Phillips, Kristina T., Pedula, Kathryn L., Choi, Namkee G., Tawara, Kylee-Ann K., Simiola, Vanessa, Satre, Derek D., Owen-Smith, Ashli, Lynch, Frances F., Dickerson, John
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2022; Elsevier Science Ltd
• Subjects: Adults; Age; Aged; Aging; Analgesics, Opioid; Cancer; Cannabis; Cannabis - adverse effects; Cardiovascular disease; Cardiovascular diseases; Cerebral infarction; Chronic Disease; Chronic illnesses; Chronic obstructive pulmonary disease; Chronic Pain; Cohort analysis; Cohort Studies; Coronary artery disease; Electronic health records; Electronic medical records; Emergency medical care; Emergency medical services; Emergency services; Hallucinogens; Hawaii - epidemiology; Health care; Health outcomes; Health risks; Health services; Health services utilization; Health status; Healthcare utilization; Heart attacks; Heart diseases; Hospitalization; Humans; Hypertension; Injuries; Inpatient care; Marijuana; Medical diagnosis; Middle Aged; Myocardial Infarction; Older adults; Older people; Pacific Islander people; Pain; Patient Acceptance of Health Care; Signs and symptoms; Stroke; Utilization; Vomiting; Hawaii; Marijuana; Cannabis; Health outcomes; Healthcare utilization; Older adults
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2022.109387

Research on cannabis-related health outcomes in diverse older adults is limited. The current study utilized a matched cohort study design to compare older adults in Hawai’i with identified cannabis diagnoses and matched controls on chronic health conditions, acute health events, and healthcare utilization from 2016 to 2020. Patients age 50 + were identified using ICD-10 diagnostic codes for cannabis use, abuse, and dependence using electronic health record data from an integrated health system (Kaiser Permanente Hawai’i). Those with cannabis diagnoses (n = 275) were compared to matched non-using controls (n = 275; based on age, sex) on chronic health conditions (coronary heart disease, hypertension, COPD, chronic non-cancer pain), acute health events (myocardial infarction, respiratory symptoms, stroke, persistent or cyclic vomiting, injuries), and healthcare utilization (outpatient, inpatient, and emergency department visits) following case identification for two years. Participants were 19.3% Native Hawaiian/Pacific Islander, 24.4% Asian, 47.8% White, and 8.5% Other/Unknown, with an average age of 62.8 years (SD=7.3). Adjusting for covariates as possible, participants with a cannabis diagnosis had significantly greater risk of coronary heart disease, chronic non-cancer pain, stroke, myocardial infarction, cyclic vomiting, and injuries, over time, compared to controls. Cannabis use was associated with any and greater frequency of outpatient, inpatient, and emergency department visits. In a diverse sample, older adults who used cannabis had worse health conditions and events and used more health services over a two-year period. Future studies should evaluate cannabis-related health outcomes, effects of cannabis problem severity, as well as implications for healthcare in aging populations. •This matched cohort study compared older adults in Hawai’i who used cannabis to non-users on various health outcomes.•Those with a cannabis diagnosis had higher rates of CHD and chronic non-cancer pain.•Those with a cannabis diagnosis had higher rates of stroke, myocardial infarction, persistent or cyclic vomiting, and injuries.•Cannabis diagnosis was associated with any and greater health service utilization.