What type of study is this?

This is a Systematic Review study.

September 10, 2025Open Access

Impact of Legalized Recreational Cannabis on Emergency Department Presentations: A Systematic Review

Key Points

Increased emergency department visits for cannabis-related presentations are confirmed, with multifaceted implications.
Evidence indicates a 2.6-fold rise in pediatric cannabis poisonings and increases in cannabis hyperemesis syndrome cases.
Systematic review across various databases included quantitative data from 60 peer-reviewed studies covering demographics and clinical outcomes.
Urgent health policy adjustments are needed as legalized recreational cannabis elevates the demand on emergency healthcare resources.

Abstract

Background: The advent of recreational cannabis legalization (RCL) has altered public health circumstances globally, and as cannabis and cannabis-related harms are measured, the impact on emergency department (ED) presentations has received growing attention. Countries such as Canada and Uruguay, and jurisdictions including several States in the United States, the European Union, and Oceania have recently adopted RCL; therefore, further understanding of the implications for the healthcare system is warranted. Aim: The objectives of this review are to summarize evidence from 2016 to 2024 about the global impact of RCL on ED presentations, specifically cannabis-related harms, as well as specific population and socio-demographic differences. Methods: A systematic review was conducted in PubMed, EMBASE, PsycINFO, and Web of Science with searches up to November 2024. Of these, sixty studies were peer-reviewed and had longitudinal, cohort, or time-series designs, which resulted in quantitative data collected over the designated review time period. Extracted data included ED visit rates, demographics, clinical outcomes, and health care costs from various regions worldwide. Results: Increased ED visits for cannabis-related presentation due to RCL was reported based on available evidence, including a 2.6-fold increase in ED visits for pediatric poisonings with cannabis, an increase in presentations for cannabis hyperemesis syndrome (CHS), and an increased number of ED visits, in some studies up to 5-fold, due to psychiatric presentations, e.g., psychosis. Demographic factors indicate adolescents, younger adults, and disproportionately marginalized populations are more affected by RCL than others. Some differences in the impact of RCL and cannabis-related issues were noted. Conclusion: RCL is increasing the burden placed on EDs around the world, and they will need to be addressed with tailored health policies, including better state regulation, education, mental health supports, etc.

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