Trends of Cannabis Use Disorder in the Inpatient: 2002 - 2011

• Published in: The American journal of medicine Vol. 130; no. 6; pp. 678 - 687.e7
• Main Authors: Charilaou, Paris, MD, Agnihotri, Kanishk, MD, Garcia, Pablo, MD, Badheka, Apurva, MD, Frenia, Douglas, MD, Yegneswaran, Balaji, MBBS
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2017
• Subjects: Abuse; Acute Disease; Acute pancreatitis; Adolescent; Adult; Aged; Alcoholism - epidemiology; Asthma; Asthma - epidemiology; Cannabis; Chronic obstructive pulmonary disease; Comorbidity; Dependence; Female; Hospital Costs; Hospitalization - economics; Hospitalization - statistics & numerical data; Hospitalization cost; Humans; Incidence; Inpatient; Internal Medicine; Length of Stay; Male; Marijuana; Marijuana Abuse - epidemiology; Mental Disorders - epidemiology; Middle Aged; National Inpatient Sample; Pancreatitis - epidemiology; Prevalence; Retrospective Studies; Smoking; Trends; Young Adult; abuse; inpatient; cannabis; marijuana; asthma; hospitalization cost; copd; national inpatient sample; smoking; acute pancreatitis; nis; dependence; trends; Cannabis; Acute pancreatitis; National Inpatient Sample; Abuse; Dependence; Hospitalization cost; Inpatient; Marijuana; Chronic obstructive pulmonary disease; Trends; Asthma; Smoking
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2016.12.035

Abstract Rationale Nationwide prevalence of cannabis use/abuse has more than doubled from 2002 to 2011. Whether the outpatient trend is reflected in the inpatient setting, is unknown. Objectives We examined the prevalence and incidence of cannabis abuse/dependence as determined by discharge coding in a 10-year (2002-2011) National Inpatient Sample, as well as various trends among demographics, comorbidities and hospitalization outcomes. Methods Cannabis abuse/dependence was identified based on ICD-9-CM codes 304.3* and 305.2* in adults ≥18 years of age. We excluded cases coded “in-remission”. National estimates and trend analyses were conducted. Results Overall, 2,833,567 (0.91%) admissions with documented cannabis abuse/dependence were identified, with a mean age 35.12±0.06 years, 62% males and an increasing trend in prevalence from 0.52% to 1.34% (p<0.001). The mean Charlson Comorbidity Index was 0.47±0.006, the mean length of stay (LOS) 6.23±0.06 days and inpatient mortality 0.41%. All of the above demonstrated an increasing trend (p<0.001). The top primary discharge diagnoses were schizoaffective/mood disorders, followed by psychotic disorders and alcoholism. Asthma prevalence in non-tobacco-smokers had a steeper increase among the cannabis than the non-cannabis subgroup (p=0.002). Among Acute Pancreatitis (AP) admissions, cannabis abusers had a shorter LOS (-11%) and lower hospitalization costs (-7%) vs. non-abusers. Conclusions Cannabis abuse/dependence is on the rise in the inpatient population, with and increasing trend towards older and sicker patients with increased rates of moderate-severe disability. Psychiatric disorders and alcoholism are the main associated primary conditions. Cannabis abuse is associated with increased asthma incidence non-tobacco smokers and decreased hospital resource utilization in AP admissions.