ED coding study shows a strong association between cannabis poisoning and mental health diagnoses
A retrospective study based on ICD-10-CM data from 16,884 emergency department (ED) visits found that individuals who received emergency medical care due to cannabis poisoning were substantially more likely than other patients to experience mental health disorders.
Researchers specializing in public health and social work analyzed 2016 data from the Nationwide Emergency Department Sample (NEDS)—the largest, publicly available database of ED visits in the U.S—to gain a better understanding of the characteristics of patients who receive emergency medical care due to cannabis poisoning.
Specifically, they examined NEDS data for 33 million individuals who received emergency medical care in a hospital-based ED in 2016 and identified 16,884 patients who presented for an initial encounter for accidental poisoning by cannabis, reported using ICD-10-CM code T40.7X1A. They then performed a logistic regression to examine the relationship between ED admission for cannabis poisoning, sociodemographic factors, and mental health disorders.
They found that individuals who sought care for cannabis poisoning were more likely to be male, young, and uninsured, and more likely to experience economic hardship, reside in urban central cities, and experience mental health disorders when compared to patients who were admitted for other conditions.
Upon further analysis, researchers found that individuals who received care in an ED for cannabis poisoning were more likely than other patients to be diagnosed with mood and anxiety disorders as well as childhood onset behavioral and emotional disorders. Rates of admission for cannabis poisoning were approximately two times greater among those with psychotic disorders.
The researchers noted that these findings may be limited by the nonspecific nature of ICD-10-CM code T40.7X1A for cannabis poisoning. This code is used to classify patients who present with symptoms brought on by the overconsumption of cannabis; its assignment as opposed to other codes for cannabis abuse is largely up to the provider’s judgment. Additionally, researchers had no way to examine the types of cannabis used and modes of ingestion.
Despite the limitations of ICD-10-CM data, the researchers emphasize that the study addresses an important gap in national data on patients at-risk for cannabis poisoning. They suggest that providers be attuned to the prevention and treatment needs of these high-risk subgroups and perform mental health screenings on patients who seek treatment for cannabis poisoning.