Introduction: The prevalence of cannabis use continues to increase among certain populations in Canada. This study focussed on the increase in cannabis-attributable hospitalizations and emergency department (ED) visits from 2007 to 2020.

Methods: To estimate the counts of hospitalizations and ED visits attributable to cannabis use, we acquired record-level hospital discharge data with ICD-10 diagnostic information for all fiscal years 2006/07 to 2020/21. Diagnostic information was used to associate each record to a health condition category for eight substances, including cannabis. The prevalence of cannabis use was estimated for each province or territory, calendar year, sex and age using national survey information. These estimates were used to adjust relative risk estimates derived from cannabis literature to calculate cannabisattributable fractions, which were in turn used to estimate the proportion of hospitalizations and ED visits that were attributable to cannabis use.

Results: Between 2007 and 2020, the overall rate of cannabis-attributable inpatient hospitalizations increased by 120%, from 6.4 in 2007 to 14.0 per 100 000 in 2020. Cannabis-attributable ED visits increased by 113%, from 52.1 per 100 000 in 2007 to 111.0 per 100 000 in 2019, and then decreased by 12% in 2020. This study found that the increases in hospitalizations and ED visits were partly attributed to neuropsychiatric conditions, particularly hospitalizations due to psychotic disorders and ED visits due to acute intoxication among children and youth.

Conclusion: Ongoing monitoring of cannabis-attributable harms is necessary to understand the harms related to use and the factors that influence the ways in which people use cannabis and seek care. Further research may distinguish the early effects of legalization trends from the early pandemic period data.

简介：在加拿大，某些人群中的大麻使用率持续上升。本研究重点分析了从2007年到2020年间因使用大麻而导致的住院和急诊科（ED）就诊人数的增长。

方法：为了估计与大麻使用相关的住院和急诊科就诊数量，我们获取了记录级医院出院数据及其ICD-10诊断信息，这些数据涵盖了从2006/07到2020/21的所有财政年度。利用诊断信息将每一条记录与包括大麻在内的八种物质的健康状况类别关联起来。使用全国调查信息估计了每个省份或地区、每年、性别和年龄的大麻使用率。这些估计值用于调整从大麻文献中得出的相对风险估计，以计算大麻归因分数（Cannabis-attributable fractions），进而估算由于使用大麻而导致的住院和急诊科就诊的比例。

结果：2007年至2020年期间，与大麻相关的总住院率增长了120%，从2007年的每10万人口6.4例增加到2020年的14.0例。与大麻相关的急诊科就诊次数在2007至2019年间增加了113%，从52.1次/10万人上升到了111.0次/10万人，但在2020年下降了12%。本研究发现住院和急诊科就诊人数的增加部分归因于神经精神疾病，特别是由于精神病障碍导致的住院以及儿童和青少年急性中毒导致的急诊科就诊。

结论：持续监测与大麻相关的伤害是了解使用造成的伤害及其影响人们使用大麻及寻求治疗的因素所必需的。进一步的研究可能有助于区分合法化趋势早期效果与疫情初期数据之间的区别。

关键词：加拿大；急性中毒；大麻；急诊科就诊；住院；精神病障碍。

非专业术语总结

在2020年，加拿大约有5318例因使用大麻导致的住院和37,341次因使用大麻而前往急诊室的病例。研究期间（2007年至2020年），与使用大麻相关的住院率和急诊科就诊次数分别增长了120%和88%，特别是在患有神经精神疾病和意外伤害的人群中，增长率尤为显著。35至64岁年龄段因使用大麻导致的精神病障碍而住院的原始发病率在2019年至2020年间增加了38%。