Tobacco Cessation and Prevention: Tobacco Cessation and Prevention |

Getting High - The New America: Trends of Cannabis Use Over the Past Decade From the National Inpatient Sample FREE TO VIEW

Paris Charilaou, MD; Kanishk Agnihotri, MD; Pablo Garcia, MD; Apurva Badheka, MD; Balaji Yegneswaran, MD
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Saint Peter's University Hospital, New Brunswick, NJ

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1298A. doi:10.1016/j.chest.2016.08.1413
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SESSION TITLE: Tobacco Cessation and Prevention

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Cannabis has been a highly-debated and controversial issue nationwide. Its medicinal use has been decriminalized in 13 states so far, and talks about further legalization of its recreational use is under way. In this study, we examine the incidence of admissions with current cannabis usage in a 10-year National Inpatient Sample (NIS) from 2002 to 2011 and its relation to various demographic factors.

METHODS: We utilized the NIS database from 2002 to 2011, ages ≥ 18 years (66268963 admissions). The variable “cannabis use=1” was computed with the discharge diagnoses equal to any of the ICD-9 codes “304.30”, “304.31” and “304.32” (unspecified, continuous and episodic use, respectively). Prevalence of cannabis use in this 10-year snapshot, as well as its yearly incidence, were analyzed in correlation with age groups, gender, insurance, race, income classes, and pregnancy status. Continuous variables were analyzed using t-tests and ANOVA for trends. Categorical/ordinal variables were analyzed with the chi-square test and Cochran-Armitage test for trend.

RESULTS: The overall prevalence of reported cannabis use over this 10-year sample was 0.152% (n=101084). The annual incidence of admissions with cannabis use has increased from 2002 to 2011 (0.11% to 0.20% respectively; p<0.0001 for trend). The mean age of non-cannabis users was 57±21 years compared to 34±11 years of cannabis users (p<0.001). Ages 30-49 were the majority of admissions with cannabis use in 2002 (55.2%), with ages 18-29 trending upwards (p<0.0001), while ages 30-49 trending down (p<0.0001), resulting in a similar proportion of cannabis users by 2011 (43.3% and 43.1% respectively; p=0.777). The age group 50-69 has shown a steady increase from 6.4% in 2002 to 13.4% in 2011 (p<0.0001). Among all cannabis users, 67.1% were males and 32.9% were females, out of which 9.6% were pregnant. There was no significant trend in the annual incidence of pregnancy admissions with cannabis use, from 2002 to 2010 (p=0.38). The majority of cannabis users were White (57.2%), followed by Blacks (28.2%), Hispanics (8.6%), Native Americans (1.3%) and Asian/Pacific Islanders (0.7%). Among the cannabis users, the majority had Medicaid (38.0%) and Self-Pay (17.2%), whereas the majority of non-cannabis users had Medicare (44.8%) and Private Insurance (32.0%). Increasing income class was associated with lower proportion of cannabis users (p<0.0001).

CONCLUSIONS: Evidently, the incidence of cannabis use in the USA is rising, becoming more popular among adults under 30 years of age and less common among adults of ages 30-49. Cannabis incidence in middle-aged adults has more than doubled in a period of 10 years. Furthermore, there seems to be a strong socioeconomic link between income class and cannabis use.

CLINICAL IMPLICATIONS: Cannabis prevalence and trends in the inpatient setting have not been described in detail so far. We highlight the increasing trend in cannabis use in the inpatient population and its association with specific socioeconomic classes. Cannabis use has long been associated with increased organic and psychiatric comorbidity - physicians can now better anticipate any complications in hospital stay, ranging from social issues in discharge planning, to disease exacerbations.

DISCLOSURE: The following authors have nothing to disclose: Paris Charilaou, Kanishk Agnihotri, Pablo Garcia, Apurva Badheka, Balaji Yegneswaran

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