Brief Commentary: Consequences of Marijuana—Observations From the Emergency Department
Bibliographic record
Abstract
Ideas and Opinions15 January 2019Brief Commentary: Consequences of Marijuana—Observations From the Emergency DepartmentKennon Heard, MD, PhD, Andrew A. Monte, MD, PhD, and Christopher O. Hoyte, MDKennon Heard, MD, PhDUniversity of Colorado School of Medicine, Aurora, Colorado (K.H., A.A.M., C.O.H.)Search for more papers by this author, Andrew A. Monte, MD, PhDUniversity of Colorado School of Medicine, Aurora, Colorado (K.H., A.A.M., C.O.H.)Search for more papers by this author, and Christopher O. Hoyte, MDUniversity of Colorado School of Medicine, Aurora, Colorado (K.H., A.A.M., C.O.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3280 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Editors' Note: This commentary was selected for publication from among 100 submitted manuscripts in response to a call for readers' perspectives on prescribing or recommending marijuana.Cannabis has been available for medical use in Colorado since 2000 and widely available since federal enforcement was minimized in 2009. Nearly 90 000 Colorado residents currently have medical cannabis cards, and approximately one third of users report daily consumption. Although the benefits for medical conditions continue to be debated, we highlight several unintended consequences of increased cannabis availability observed in Colorado emergency departments.Before 2009, very few children were hospitalized for marijuana exposure in ...References1. Wang GS, Roosevelt G, Heard K. Pediatric marijuana exposures in a medical marijuana state. JAMA Pediatr. 2013;167:630-3. [PMID: 23712626] doi:10.1001/jamapediatrics.2013.140 CrossrefMedlineGoogle Scholar2. Kim HS, Hall KE, Genco EK, Van Dyke M, Barker E, Monte AA. Marijuana tourism and emergency department visits in colorado [Letter]. N Engl J Med. 2016;374:797-8. [PMID: 26933869] doi:10.1056/NEJMc1515009 CrossrefMedlineGoogle Scholar3. Nourbakhsh M, Miller A, Gofton J, Jones G, Adeagbo B. Cannabinoid hyperemesis syndrome: reports of fatal cases. J Forensic Sci. 2018. [PMID: 29768651] doi:10.1111/1556-4029.13819 CrossrefMedlineGoogle Scholar4. National Institute on Drug Abuse. Is there a link between marijuana use and psychiatric disorders? 2018. Accessed at www.drugabuse.gov/publications/research-reports/marijuana/there-link-between-marijuana-use-psychiatric-disorders on 12 November 2018. Google Scholar5. Hall KE, Monte AA, Chang T, Fox J, Brevik C, Vigil DI, et al. Mental health-related emergency department visits associated with cannabis in Colorado. Acad Emerg Med. 2018;25:526-537. [PMID: 29476688] doi:10.1111/acem.13393 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Colorado School of Medicine, Aurora, Colorado (K.H., A.A.M., C.O.H.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3280.Corresponding Author: Kennon Heard, MD, PhD, 12401 E. 17th Avenue, Campus Box B-215, Aurora, CO 80045; e-mail, kennon.[email protected]edu.Current Author Addresses: Dr. Heard: 12401 E. 17th Avenue, Campus Box B-215, Aurora, CO 80045.Drs. Monte and Hoyte: 12401 E. 17th Avenue, Aurora, CO 80045.Author Contributions: Conception and design: K. Heard, C.O. Hoyte.Analysis and interpretation of the data: A.A. Monte, C.O. Hoyte.Drafting of the article: K. Heard, A.A. Monte.Critical revision of the article for important intellectual content: K. Heard, A.A. Monte, C.O. Hoyte.Final approval of the article: K. Heard, A.A. Monte, C.O. Hoyte.Administrative, technical, or logistic support: K. Heard.Collection and assembly of data: A.A. Monte.This article was published at Annals.org on 8 January 2019. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBrief Commentary: Cannabinoid Dosing for Chronic Pain Management Kevin F. Boehnke and Daniel J. Clauw Brief Commentary: Marijuana and Cardiovascular Disease—What Should We Tell Patients? Tina M. Kaufman , Sergio Fazio , and Michael D. Shapiro Brief Commentary: Advocating for Blunt Policy Jan K. Carney Brief Commentary: Treating Pain—The Cannabis Conundrum Chester B. Good , Natasha Parekh , Kavita Fischer , James Schuster , Chronis Manolis , and William Shrank Brief Commentary: Marijuana Use During Gestation and Lactation—Harmful Until Proved Safe Eli Y. Adashi Metrics Cited byUnintentional cannabis exposures in children pre- and post-legalization: A retrospective review from a Canadian paediatric hospitalAssessing the public health impacts of legalizing recreational cannabis use: the US experience 15 January 2019Volume 170, Issue 2Page: 124KeywordsCannabinoidsCannabisCannabis useChildrenDisclosureEmergency departmentHospitalizationsMarijuanaMedical conditionsPsychiatry and mental health ePublished: 8 January 2019 Issue Published: 15 January 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.108 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.006 | 0.005 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.005 | 0.002 |
| Research integrity | 0.038 | 0.041 |
| Insufficient payload (model declined to judge) | 0.011 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".