An Unintended Side Effect: Legal Cannabis Places High Demand on Emergency Nurses

August 27, 2019 Cannabis ENA Research Staffing Triage

First-of-its-kind research study shows increased emergency department workload to treat cannabis overdoses.

SCHAUMBURG, Ill. (Aug. 27, 2019) – The legalization of cannabis might be the cause of an unexpected side effect – an increase in emergency department workloads caused by patients in need of treatment for cannabis-related overdoses, according to researchers from the Emergency Nurses Association.

While the health consequences of cannabis usage have been widely researched, this first-of-its-kind study, published Aug. 26 in Public Health Nursing, examines the additional burden placed upon emergency nurses’ workload presented by cannabis overdose patients.

“As more U.S. states move toward the legalization of cannabis, usage has obviously increased rapidly in those areas,” said Director of Emergency Nursing Research Lisa Wolf, PhD, RN, CEN, FAEN. “Our goal was to examine the effects legalization of cannabis has had on emergency departments in those areas.”

The study suggests that in states where recreational use is now legal, emergency departments are seeing more patients who have ingested or inhaled cannabis and present with symptoms of overuse usually within two categories. Most often, patients present with cyclic vomiting syndrome, a well-known associated effect of cannabis abuse. But in more alarming circumstances, symptoms can be consistent with those of respiratory or severe neurological issues, often signaling a stroke diagnosis, especially among geriatric patients.

Because of the stigma surrounding marijuana, patients seldom disclose usage upon admittance to the emergency department, health care workers identifying these symptoms are likely to suspect high patient illness acuity requiring a comprehensive work up to diagnose an ailment that matches the symptoms presented. Such scenarios create a preventable backlog of procedures within the already hectic confines of the emergency department.

“As states across the country rapidly decriminalize or legalize cannabis, the research and evidence weighing the risks and benefits have quickly been outpaced,” said ENA President Patti Kunz Howard, PhD, RN, CEN, CPEN, TCRN, NE-BC, FAEN, FAAN. “Additional research and data are required to further examine and identify procedures to ensure emergency nurses have the tools they need to perform their jobs efficiently and effectively.”

Wolf noted that further research is needed to fully understand the range of unintended consequences associated with legalized cannabis. She pointed to study participants’ responses that relate to the human, health care or operational impact of increase recreational use. Respondents’ common examples included:

  • Regulatory efforts to standardize the formulation
  • Dosing and labeling of cannabis products
  • Educational initiatives for consumers
  • Educational and diagnostic training for health care providers

Wolf will discuss the research findings during a presentation at Emergency Nursing 2019, ENA’s annual education and networking conference, taking place Sept. 29-Oct. 2 in Austin, Texas.

The Emergency Nurses Association is the premier professional nursing association dedicated to defining the future of emergency nursing through advocacy, education, research, innovation, and leadership. Founded in 1970, ENA has proven to be an indispensable resource to the global emergency nursing community. With 50,000 members worldwide, ENA advocates for patient safety, develops industry-leading practice standards and guidelines and guides emergency health care public policy. ENA members have expertise in triage, patient care, disaster preparedness, and all aspects of emergency care. Additional information is available at

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