Older adults' marijuana use, injuries, and emergency department visits

Background: Despite increasing marijuana use among older adults, little research has been done on marijuana's effects on their healthcare use. Objectives: To examine whether (1) marijuana use is associated with the likelihood of emergency department (ED) visits through increased injury risk, and (2) marijuana use patterns are associated with injury risk and ED visits among older adults. Methods: Using the 2012-2013 National Epidemiologic Survey on Alcohol and Related Problems (N = 14,715 aged 50+; 6,379 men and 8,336 women), descriptive statistics were used to compare past-year marijuana users to nonusers on sociodemographic and physical/mental health characteristics. Structural equation modeling was used to simultaneously estimate whether injury mediates past-year marijuana use's association with ED visits. Logistic regression analysis was used to examine associations of marijuana use patterns with injury and ED visits. Results: Past-year injury rates were 18.9% for nonusers and 28.8% for users (3.9% of the 50+ age group), and past-year ED visit rates were 23.5% for nonusers and 30.9% for users (p < .001). Logistic regression models showed that marijuana use was associated with injury (OR = 1.48, 95% CI = 1.18-1.85), and injury was associated with ED visits (OR = 6.14, 95% CI = 1.70-1.93). Mediation analysis found significant indirect effect (z = 2.86, p = .004) and direct effect not significantly differing from zero (OR = 1.16, 95% CI = 0.90-1.50), indicating that marijuana use increases the likelihood of ED visits through increased injury risk. Marijuana use patterns were not associated with injuries or ED visits. Conclusions: Healthcare providers should screen for marijuana and other substance use among older adults and provide education about associated injury risks.