Abstract

Increasing numbers of older adults use cannabis and cannabis-derived products that can have adverse effects. This study examined management site and level of healthcare services for older adult poison control center cases involving cannabis products. Using the American Association of Poison Control Centers’ (PCC) National Poison Data System, 2016–2019, we extracted the 3109 cases aged 50+ for which cannabis was the only or primary substance. Multinomial logistic regression models were fit to examine associations between specific cannabis forms and management/care site (on site [mostly at home], at a healthcare facility [HCF], or no follow-up due to referral refusal or leaving against medical advice) and level of healthcare services for cases managed at a HCF. The results show that between 2016 and 2019, PCC cannabis cases involving older adults increased twofold, largely due to cases of cannabidiol, edibles, and concentrated extracts. Plant form and synthetic cannabinoid cases declined substantially. Compared to plant forms, synthetic cannabinoid cases had 4.22 (95% CI = 2.59–6.89) greater odds of being managed at, rather than outside, a HCF and 2.17 (1.42–3.31) greater odds of critical care unit admission. Although e-cigarette cases, compared to plant form cases, had lower odds of being managed at a HCF, HCF-managed e-cigarette cases had 3.43 greater odds (95% CI = 1.08–10.88) of critical care unit admission. Synthetic cannabinoid cases also had 1.86 (95% CI = 1.03–3.35) greater odds of no follow-up, and the presence of a secondary substance was also a significant factor. Stricter regulations for listing chemical ingredients and providing safety guidelines are needed for cannabis-derived products.

 抽象的

越来越多的老年人使用大麻和大麻衍生产品，这些产品可能会产生不利影响。这项研究调查了涉及大麻产品的老年人毒物控制中心案件的管理地点和医疗服务水平。使用美国中毒控制中心协会 (PCC) 2016-2019 年国家中毒数据系统，我们提取了 3109 例 50 岁以上以大麻为唯一或主要物质的病例。多项逻辑回归模型适合检查特定大麻形式和管理/护理地点之间的关联（现场[主要是在家里]、在医疗机构[HCF]，或者由于拒绝转诊或不遵守医疗建议而没有后续行动） HCF 管理的病例的医疗保健服务水平。结果显示，2016 年至 2019 年间，涉及老年人的 PCC 大麻案件增加了一倍，主要原因是大麻二酚、食用食品和浓缩提取物案件。植物形态和合成大麻素病例大幅下降。与植物形式相比，合成大麻素病例在 HCF 内而非外部接受治疗的几率高 4.22 (95% CI = 2.59–6.89)，进入重症监护病房的几率高 2.17 (1.42–3.31)。尽管与植物形式病例相比，电子烟病例在 HCF 进行管理的几率较低，但 HCF 管理的电子烟病例入住重症监护病房的几率要高出 3.43（95% CI = 1.08–10.88）。合成大麻素病例没有随访的几率也高出 1.86 (95% CI = 1.03–3.35)，并且次要物质的存在也是一个重要因素。大麻衍生产品需要更严格的法规来列出化学成分并提供安全指南。