Cannabis Legalization is Driving an Increase in Related ER Visits
The legalization of both medical use and recreational use of cannabis in the United States has lead to an increase in both availability and potency. The US Substance Abuse and Mental Health Services Administration (SAMHSA) reports approximately a 60% increase in cannabis use between 2002 and 2019. The growth over this period has been linked directly to the availability of cannabis retailers. There are an estimated 31.5m individuals over 12 years of age in the US that used cannabis in the last month, and this is growing by approximately 10% per year.
Legalization has also changed how people consume cannabis, with edibles and concentrates becoming more popular. In particular, edibles have proven popular among new users and have captured a large part of the market: 45% of all Cannabis sales in Colorado in 2016 were for edibles. Growth in the sales of edible cannabis products has outpaced even these trend nationwide - sales of edibles expanded 60% from 2019 to 2020 for an estimated market of $1.23 billion.
However, this increased prevalence of cannabis consumption has resulted in a range of consequences. Hospitalizations as a result of cannabis use are a significant program, with 1.5 million estimated ER visits associated with cannabis in 2017, according to government data. This is over 1% of all visits to the ER during that year. Of all drug-related visits to the ER, cannabis has become the second most common cause after methamphetamines. ER visits were growing on average 13% per year, which implies over 2.5 million cases in the United States in 2022.
In one Colorado medical center, ER visits for cannabis doubled after medical cannabis licenses became available in 2009, and rates increased 72% again following the full legalization. This trend is replicated in calls to Colorado Poison Control. 43% of adults have access to adult-use cannabis currently, so federal legalization could substantially increase the rates of these ER visits.
These ER visits are also not benign in nature. Roughly a quarter of ER visits are for acute psychiatric disturbances, including psychosis, and another third of patients have gastrointestinal distress.
New Problems Require New Tools for Physicians
The growing issue of ER visits associated with cannabis over-intoxication has spurred the development of new therapies to address the issue. Anebulo Pharmaceuticals (NASDAQ: ANEB) is developing an oral medication to reverse the effects of cannabis intoxication.
The drug ANEB-001 is a CB1 antagonist, a class of drug that has been shown to block the effects of cannabis. ANEB-001 prevents THC from binding to the CB1 receptor thereby reversing its effect. This has not done this in people yet, just in vitro and in mice. This drug could be used to reverse intoxication in an ER setting and potentially limit the risk of complications. This is a novel application of the drug, but this is a well-understood class of drugs with well-established safety and efficacy profiles. ANEB-001 will enter Phase II clinical testing in 2021.
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