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Cannabis involvement in posttraumatic stress disorder emergency department visits after cannabis legalization.

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Title: Cannabis involvement in posttraumatic stress disorder emergency department visits after cannabis legalization.
Authors: Perrault‐Sequeira, Laurent (AUTHOR), Pugliese, Michael (AUTHOR), MacDonald‐Spracklin, Rachael (AUTHOR), Xiao, Jennifer (AUTHOR), McCarthy, Stephen (AUTHOR), Myran, Daniel T. (AUTHOR)
Source: American Journal on Addictions. Jul2025, Vol. 34 Issue 4, p404-414. 11p.
Subjects: Post-traumatic stress disorder, Marijuana, Legalization, Hospital emergency services, Substance-induced disorders, Policy analysis, Medical statistics
Geographic Terms: Canada, Ontario
Abstract: Background and Objectives: Individuals with posttraumatic stress disorder (PTSD) have an elevated risk of cannabis use disorder. However, the effect of cannabis legalization on use among individuals with PTSD is unclear. We evaluated changes in cannabis involvement in emergency department (ED) visits for PTSD after medical and nonmedical legalization in Ontario, Canada. Methods: This repeated cross‐sectional study used health administrative data to identify all ED visits for PTSD among Ontario residents aged 10–105 between 2008 and 2022 (n = 15.7 million). We identified PTSD ED visits with a co‐diagnosis of cannabis (main exposure) or alcohol (control condition) and examined changes across four policy periods (medical legalization with restrictions, expanded medical legalization, nonmedical legalization with restrictions, and nonmedical commercial expansion) using Poisson models. Results: Among 381,450 PTSD ED visits, 4593 (1.29%) co‐involved cannabis and 11,625 (3.05%) co‐involved alcohol. Rates of cannabis involvement in PTSD ED visits increased by 151% (Incidence Rate Ratio [IRR]: 2.51; 95% CI: 2.24, 2.82) between the first and last policy periods (0.13 vs. 0.33 per 100,000 individuals), while alcohol‐involvement increased by 58% (IRR: 1.58; 95% CI: 1.47, 1.68). Cannabis involvement in PTSD ED visits increased steadily over the study period, with no significant association between policy periods and this trend. Discussion and Conclusions: Cannabis involvement in PTSD ED visits has increased over time during a period of liberalization of cannabis policy, but may be attributed to increased access and normalization rather than policy changes directly. Scientific Significance: Findings underscore the need for improved detection of and targeted interventions for disordered cannabis use among individuals with PTSD in regions with legalized cannabis. [ABSTRACT FROM AUTHOR]
Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Cannabis involvement in posttraumatic stress disorder emergency department visits after cannabis legalization.
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  Data: <searchLink fieldCode="AR" term="%22Perrault‐Sequeira%2C+Laurent%22">Perrault‐Sequeira, Laurent</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pugliese%2C+Michael%22">Pugliese, Michael</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22MacDonald‐Spracklin%2C+Rachael%22">MacDonald‐Spracklin, Rachael</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Xiao%2C+Jennifer%22">Xiao, Jennifer</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22McCarthy%2C+Stephen%22">McCarthy, Stephen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Myran%2C+Daniel+T%2E%22">Myran, Daniel T.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22American+Journal+on+Addictions%22">American Journal on Addictions</searchLink>. Jul2025, Vol. 34 Issue 4, p404-414. 11p.
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  Data: <searchLink fieldCode="DE" term="%22Post-traumatic+stress+disorder%22">Post-traumatic stress disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Marijuana%22">Marijuana</searchLink><br /><searchLink fieldCode="DE" term="%22Legalization%22">Legalization</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+emergency+services%22">Hospital emergency services</searchLink><br /><searchLink fieldCode="DE" term="%22Substance-induced+disorders%22">Substance-induced disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Policy+analysis%22">Policy analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+statistics%22">Medical statistics</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Canada%22">Canada</searchLink><br /><searchLink fieldCode="DE" term="%22Ontario%22">Ontario</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: Background and Objectives: Individuals with posttraumatic stress disorder (PTSD) have an elevated risk of cannabis use disorder. However, the effect of cannabis legalization on use among individuals with PTSD is unclear. We evaluated changes in cannabis involvement in emergency department (ED) visits for PTSD after medical and nonmedical legalization in Ontario, Canada. Methods: This repeated cross‐sectional study used health administrative data to identify all ED visits for PTSD among Ontario residents aged 10–105 between 2008 and 2022 (n = 15.7 million). We identified PTSD ED visits with a co‐diagnosis of cannabis (main exposure) or alcohol (control condition) and examined changes across four policy periods (medical legalization with restrictions, expanded medical legalization, nonmedical legalization with restrictions, and nonmedical commercial expansion) using Poisson models. Results: Among 381,450 PTSD ED visits, 4593 (1.29%) co‐involved cannabis and 11,625 (3.05%) co‐involved alcohol. Rates of cannabis involvement in PTSD ED visits increased by 151% (Incidence Rate Ratio [IRR]: 2.51; 95% CI: 2.24, 2.82) between the first and last policy periods (0.13 vs. 0.33 per 100,000 individuals), while alcohol‐involvement increased by 58% (IRR: 1.58; 95% CI: 1.47, 1.68). Cannabis involvement in PTSD ED visits increased steadily over the study period, with no significant association between policy periods and this trend. Discussion and Conclusions: Cannabis involvement in PTSD ED visits has increased over time during a period of liberalization of cannabis policy, but may be attributed to increased access and normalization rather than policy changes directly. Scientific Significance: Findings underscore the need for improved detection of and targeted interventions for disordered cannabis use among individuals with PTSD in regions with legalized cannabis. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: <i>Copyright of American Journal on Addictions is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/ajad.70014
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        Text: English
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        PageCount: 11
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      – SubjectFull: Post-traumatic stress disorder
        Type: general
      – SubjectFull: Marijuana
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      – SubjectFull: Legalization
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      – SubjectFull: Hospital emergency services
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      – SubjectFull: Canada
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      – SubjectFull: Ontario
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      – TitleFull: Cannabis involvement in posttraumatic stress disorder emergency department visits after cannabis legalization.
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              M: 07
              Text: Jul2025
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              Y: 2025
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