Cannabis related Emergency Department (ED) visits in youth: a scoping review

Cannabis use can result in adverse events that lead to visits to the Emergency Department (ED). While pediatric visits for intoxication and studies examining types of visits associated with cannabis use across the age spectrum have been reported, less well studied are the presentations commonly seen specifically in adolescence and early adulthood. Some visit types considered uncommon in adolescents, such as cardiovascular events, may be seen in this population. Our objective with this review is to examine the state of the literature regarding cannabis associated presentations most commonly presenting in youth to help inform ED clinicians about these events and inform our research community about any gaps in knowledge that exist in this area. This review was conducted in accordance with the Joanna Briggs Institute guidance for scoping reviews. The population under study was individuals between the ages of 14 to 25 years who have used cannabis and had an encounter with the Emergency Department related to the cannabis use. Searches were conducted in Ovid MEDLINE, Embase, CINAHL, PsycINFO, and the Cochrane Review databases. Three additional sources were searched: (1) Google Scholar and Semantic Scholar was used to search the grey literature and (2) the MedRxiv repository was used for preprint searching. The data is discussed in narrative form and areas of particular concern for youth health as well as areas requiring further study were noted. The literature screening was conducted by 2 independent reviewers using the Covidence platform and after full text review, 62 papers meeting criteria were included for data extraction. The top mental health issue for youth was suicidal ideation and physical health issues were related to violent assaults with concerning frequencies of cardiovascular events. Studies examining the types and frequencies of ED visits by youth show significant overlap with types of adult presentations with two concerning exceptions. However, this area of study needs greater examination as many of these studies simply list this age group as a subset of a larger study and the depth of cannabis use patterns is often missing. Registered on Open Science Framework June 14, 2024.