How Marijuana Legalization Impacts EMS Services

Injury related to marijuana intoxication is sure to increase with marijuana legalization. The EMS experience in Colorado can help prepare municipalities.


Editor’s Note: Updated April 19, 2019.

NEW ORLEANS — As marijuana use increased with marijuana legalization in Colorado, the visits to emergency departments increased. Howard Kim, MD, described the types and incidences of injuries secondary to marijuana intoxication at the EMS World Expo in September 2016.

Kim described the pathophysiology of marijuana toxicity, and presented data from Colorado after the legalization of marijuana for recreational use. The presentation specifically explored the impact of legalized marijuana on trauma from motor vehicle collisions, butane hash oil burns and acute psychosis violence.

In 2016, 27 states allowed for medical use of marijuana and four states -- Washington, Oregon, Colorado and Alaska -- allowed for recreational marijuana use. Four additional states were voting on legalization in November, 2016 and many other states were considering marijuana legalization.

By March, 2019 recreational marijuana was legalized in 10 states and medical marijuana is legal in 33 states. Because of the increasing legalization and usage, EMS providers everywhere are likely to encounter patients with trauma secondary to marijuana intoxication.

Kim’s key takeaways for EMS providers were:

  1. Supportive care for intoxication - Most care for intoxication is supportive. For example, agitation and psychosis is treated with sedation.
  2. Toxicity related trauma - Marijuana toxicity puts patients at risk of traumatic injury. The most common trauma is motor vehicle collisions from alterations in perception and motor dysfunction.
  3. Burns from butane hash oil during production - Colorado experienced a sharp increase in butane hash oil injuries after marijuana legalization. Burn care is similar to other types of burn injuries.
  4. Pediatric accidental ingestion - Colorado has experienced an increased incidence of pediatric marijuana exposures through accidental ingestion of a marijuana edible. Responders should be sure to consider marijuana ingestion and ask if marijuana is in the house.

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