Associations between cannabis-related hospital visits and psychotic disorder-related hospital visits in Arizona from 2016 to 2022

Alana M Colby; Sivan Barashy; Matt L Miller; Haley M Hummel; Chung Jung Mun; Madeline H Meier

doi:10.1016/j.drugalcdep.2025.112717

Associations between cannabis-related hospital visits and psychotic disorder-related hospital visits in Arizona from 2016 to 2022

Drug Alcohol Depend. 2025 Aug 1:273:112717. doi: 10.1016/j.drugalcdep.2025.112717. Epub 2025 May 20.

Authors

Alana M Colby¹, Sivan Barashy¹, Matt L Miller¹, Haley M Hummel², Chung Jung Mun³, Madeline H Meier⁴

Affiliations

¹ Department of Psychology, Arizona State University, Tempe, AZ, USA.
² School of Psychological Science, Oregon State University, Corvallis, OR, USA.
³ Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
⁴ Department of Psychology, Arizona State University, Tempe, AZ, USA. Electronic address: Madeline.Meier@asu.edu.

PMID: 40446496
DOI: 10.1016/j.drugalcdep.2025.112717

Abstract

Objective: This study investigated time trends in cannabis-related hospital visits and in the tendency for cannabis-related hospital visits to involve a psychotic disorder diagnosis in Arizona from 2016 to 2022. For comparison, a parallel investigation was conducted for alcohol-related hospital visits.

Methods: Data were emergency department (ED) and inpatient hospital visits in Arizona from 2016 to 2022 (N = 21,934,060 visits). Exposures were cannabis-related and alcohol-related visits. The outcome was psychotic disorder-related visits. Visits were classified as cannabis-, alcohol-, or psychotic disorder-related based on Clinical Classifications Software Refined groupings of ICD-10-CM codes. Analyses used Poisson regression to test time trends in cannabis-psychotic disorder and alcohol-psychotic disorder associations, and to test whether sex, age, and visit type (ED or inpatient visit) moderated these associations. The unit of analysis was visits.

Results: Cannabis and alcohol-related hospital visits increased 4.1 % and 1.6 % per year, on average. Across time, cannabis-related visits and alcohol-related visits were ~7 and 3 times as likely, respectively, to involve a psychotic disorder as cannabis-unrelated and alcohol-unrelated visits. Associations were attenuated but significant after adjusting for covariates. Cannabis-psychotic disorder associations were fairly stable from 2016 to 2022, whereas alcohol-psychotic disorder associations decreased over time. There were few sex and age differences in time trends, but, across time, cannabis-psychotic disorder associations were significantly larger for visits by females and adolescents.

Conclusion: The cannabis-psychotic disorder association was large and stable from 2016 to 2022, suggesting the need for mental health screening among people who use cannabis and for coordinated care pathways from the hospital to treatment for cannabis use and psychotic disorders.

Keywords: Alcohol; Cannabis; Emergency department; Psychosis; Psychotic disorder.

MeSH terms

Adolescent
Adult
Arizona / epidemiology
Emergency Service, Hospital* / statistics & numerical data
Emergency Service, Hospital* / trends
Female
Hospitalization* / statistics & numerical data
Hospitalization* / trends
Humans
Male
Marijuana Abuse* / epidemiology
Middle Aged
Psychotic Disorders* / epidemiology
Psychotic Disorders* / therapy
Young Adult