(C-247) Cannabis-Related Healthcare Encounters among Commercially Insured Adults Aged 18-64 Years Contributing Data to the US Food And Drug Administration’s Sentinel, 2017-2022

Background: The increasing number of state, local, tribal, and territorial bodies enacting laws allowing medical or both medical and nonmedical adult use of cannabis and the passage of the 2018 Farm Bill have paved the way for a booming cannabis market.

Objectives: To assess temporal trends in cannabis-related healthcare encounters among commercially insured adults.

Methods: We conducted a descriptive study using administrative claims from 4 national health insurers contributing to the US Food and Drug Administration’s Sentinel Distributed Database. We identified encounters for cannabis-related disorders or poisonings using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes F12x or T40.7x. Between 2017–2022, persons aged 18–64 years, with known sex, and continuous medical coverage (gaps ≤45 days permitted) in the 183 days before the qualifying cannabis-related encounter, comprised the study population. We estimated annual rates of cannabis-related encounters per 10,000 eligible person-years with 95% confidence intervals (CI), overall and stratified by care setting, age group, and cannabis legal status, as determined by the latest cannabis laws implemented in the person’s most recent state/territory of residence at the start of the calendar year. We assessed trends using Mann-Kendall tests (Ƭ; p< 0.05).

Results: Among 115,187,493 commercially insured eligible persons, 963,345 (0.8%) persons contributed 5,601,233 cannabis-related encounters. Annual rates of cannabis-related encounters increased from 44.0 per 10,000 eligible person-years (95% CI: 43.8, 44.2) in 2017 to 75.1 per 10,000 eligible person-years (95% CI: 74.8, 75.4) in 2022 (Ƭ=1.0; p=0.01). Outpatient and emergency department encounters largely accounted for the upward trend, while inpatient encounters appeared to reach a plateau starting in 2020 (Ƭ=0.87; p=0.02). Increasing trends were observed across all age groups. We did not identify differences by cannabis legal status at the state/territory of residence.

Conclusions: Our results are consistent with a rapidly evolving landscape where cannabis use, state regulatory status, and product potencies are increasing, and the public perception of its risk is decreasing. However, the observed increase in cannabis-related healthcare encounters appears to be lower than what would be expected based on results from US surveys and suggest the need for providers to engage patients in conversation, continue to screen for cannabis use and, if appropriate, refer or provide services for diagnosis and treatment of cannabis use disorder.

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The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by FDA/HHS, or the US Government.