Marijuana use and injury events resulting in hospitalization.

PURPOSE Information on the potential relation between marijuana use and the incidence of hospitalized injury is extremely limited. The purpose of this effort was to investigate the potential for this association. METHODS A retrospective study was conducted in a large prepaid Northern California health care program cohort (n = 64,657) that completed baseline questionnaires about health behaviors, including marijuana use, and health status between 1979 and 1985. All injury hospitalizations through December 31, 1991, (n = 965) were identified and validated. RESULTS Using Poisson regression modeling, increased rate-ratios and 95% confidence intervals were identified for all-cause injury hospitalizations for both men and women among current users (1.28; 1.01 to 1.61 and 1.37; 1.04 to 1.79, respectively) relative to nonusers, adjusted for age, cigarette and alcohol use, and other potential confounders. Increased rates of motor vehicle (1.96; 1.23 to 3.14), and assault (1.90, 1.16 to 3.15), injuries were identified among men who were current users; an increased rate of assault was suggestive in women (2.21; 0.92 to 5.19). CONCLUSIONS Though the results must be viewed cautiously, they suggest that marijuana use may be independently associated with increased risk of hospitalized injury. Further study of the physiological and behavioral mechanisms is warranted [corrected].

[1]  H. Kalant,et al.  The Health Effects of Cannabis , 1999 .

[2]  B. Braun,et al.  Marijuana use and medically attended injury events. , 1998, Annals of emergency medicine.

[3]  H. Klonoff,et al.  Marijuana and Driving in Real-Life Situations , 1974, Science.

[4]  B S Shankar,et al.  Marijuana and alcohol use among 1023 trauma patients. A prospective study. , 1988, Archives of surgery.

[5]  Diane C. Thompson,et al.  The validity of self-reported smoking: a review and meta-analysis. , 1994, American journal of public health.

[6]  N. Zinberg,et al.  Acute Effects of Marihuana on Speech , 1969, Nature.

[7]  B. Frank.  Telephone surveying for drug abuse: methodological issues and an application. , 1985, NIDA research monograph.

[8]  J. Tinklenberg,et al.  Marijuana and Immediate Memory , 1970, Nature.

[9]  P. Bech,et al.  Effects of Cannabis and Alcohol on Psychological Tests , 1973, Nature.

[10]  Martin Gw,et al.  Validation of self-reported cannabis use by urine analysis , 1988 .

[11]  D. Yurgelun-Todd,et al.  The residual cognitive effects of heavy marijuana use in college students. , 1996, JAMA.

[12]  J V Moulden,et al.  The prevalence of drugs and alcohol in fatally injured truck drivers. , 1993, Journal of forensic sciences.

[13]  D. Gieringer.  Marijuana, driving, and accident safety. , 1988, Journal of psychoactive drugs.

[14]  Nurco Dn,et al.  A discussion of validity. , 1985 .

[15]  J. M. Nelsen,et al.  Clinical and psychological effects of marihuana in man. , 1968, Science.

[16]  G. Friedman,et al.  Marijuana use and mortality. , 1997, American journal of public health.

[17]  B. Logan,et al.  Drug and alcohol use in fatally injured drivers in Washington State. , 1996, Journal of forensic sciences.

[18]  R. Hughes,et al.  Behavioral effects of marihuana. Experimental studies. , 1970, Archives of general psychiatry.

[19]  Bruce D. Johnson,et al.  The Reliability and Validity of Drug Use Responses in a Large Scale Longitudinal Survey , 1975 .

[20]  L. R. Sutton,et al.  The effects of alcohol, marihuana and their combination on driving ability. , 1983, Journal of studies on alcohol.

[21]  D. Brookoff.  Marijuana and injury: is there a connection? , 1998, Annals of emergency medicine.

[22]  F. D. Del Boca,et al.  Self-reports by alcohol and drug abuse inpatients: factors affecting reliability and validity. , 1992, British journal of addiction.

[23]  G. Edwards.  A Handbook on Drug and Alcohol Abuse , 1976 .

[24]  E. Abel.  Marijuana and Memory , 1970, Nature.

[25]  M. Mattila,et al.  ALCOHOL, DRUGS AND DRIVING , 1976 .

[26]  James M. Robins,et al.  Causal diagrams for epidemiologic research. , 1999 .

[27]  P. Clifford,et al.  Patterns and predictors of simultaneous and concurrent use of alcohol, tobacco, marijuana, and hallucinogens in first-year college students. , 1992, Journal of substance abuse.

[28]  H. Kalant,et al.  Residual learning deficit after heavy exposure to cannabis or alcohol in rats , 1976, Science.

[29]  W. Hawkins,et al.  Gender differences in perception of risk associated with alcohol and drug use among college students. , 1993, Women & health.

[30]  H S Shannon,et al.  Fatal occupational accidents in Ontario, 1986-1989. , 1993, American journal of industrial medicine.

[31]  M. Polen,et al.  Health care use by frequent marijuana smokers who do not smoke tobacco. , 1993, The Western journal of medicine.

[32]  E. R. Harrison,et al.  Self-reported drug use data: what do they reveal? , 1993, The American journal of drug and alcohol abuse.

[33]  E. Abel,et al.  Marihuana and Memory: Acquisition or Retrieval? , 1971, Science.

[34]  M. Copass,et al.  Drug use in trauma victims. , 1989, The Journal of trauma.

[35]  Alison M. Smiley,et al.  Marijuana: On-road and driving simulator studies , 1986 .

[36]  Harrell Av,et al.  Validation of self-report: the research record. , 1985 .

[37]  D. Piomelli,et al.  A second endogenous cannabinoid that modulates long-term potentiation , 1997, Nature.

[38]  D. Yurgelun-Todd,et al.  Evidence for a sex-specific residual effect of cannabis on visuospatial memory. , 1997, Psychotherapy and psychosomatics.

[39]  K. Maull,et al.  Comparability of Alcohol and Drug Use in Injured Drivers , 1992, Southern medical journal.

[40]  R. Norton,et al.  Prevalence and patterns of combined alcohol and marijuana use. , 1988, Journal of studies on alcohol.

[41]  L. Johnston,et al.  Issues of validity and population coverage in student surveys of drug use. , 1985, NIDA research monograph.

[42]  J L Collins,et al.  Youth risk behavior surveillance--United States, 1997. , 1998, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[43]  J. McGahan,et al.  Long-term delta-9-tetrahydrocannabinol treatment. Computed tomography of the brains of rhesus monkeys. , 1984, American journal of diseases of children.

[44]  C. Schuster,et al.  'Hangover' effects the morning after marijuana smoking. , 1985, Drug and alcohol dependence.

[45]  R C Peck,et al.  THE EFFECTS OF MARIJUANA AND ALCOHOL ON ACTUAL DRIVING PERFORMANCE , 1986 .

[46]  Harrell Av.  The validity of self-reported drug use data: the accuracy of responses on confidential self-administered answered sheets. , 1997 .

[47]  J K Wells,et al.  Drugs in fatally injured young male drivers. , 1985, Public health reports.

[48]  N. Solowij,et al.  Do cognitive impairments recover following cessation of cannabis use? , 1995, Life sciences.

[49]  P F Waller,et al.  Crash characteristics and injuries of victims impaired by alcohol versus illicit drugs. , 1995, Accident; analysis and prevention.