Since New York legalized recreational cannabis, emergency rooms are treating thousands more people for endless vomiting, a racing heart and belief they are dying.
Cannabis-related ER visits statewide topped 135,000 in 2023, nearly double the cases from before legalization two years earlier.
No place has been hit harder than central New York, where ERs saw nearly 13,000 cannabis cases in 2023. That’s more than one ER visit for every 100 people — the highest rate in the state, according to health department data.
No adult deaths have been recorded in the area. But it’s scary enough to consume much-needed resources at the region’s overwhelmed and undersized ERs.
Children, while poisoned far less frequently than adults, face a much more dire situation. Some who accidentally ingest pot gummies stop breathing and need to be revived. They can stay at a hospital for weeks. None have died, according to the Upstate Poison Control Center, though some may face lingering effects from oxygen loss.
It’s undisputed that today’s cannabis is far stronger than what people consumed in the past. But society is also in the dark about why such symptoms exist. There’s little research on prolonged, high-concentration cannabis use. Often, a cannabis diagnosis can only be made by ruling out every other explanation.
It’s like pot roulette, especially for children and teens, who are most vulnerable to having lasting brain damage.
Dr. Jeff Lapoint, a former Upstate Medical University resident, likened marijuana to another mind-altering drug — alcohol.
But today’s marijuana isn’t like a normal drink, he said. It can resemble a beverage like Everclear that’s 95% alcohol, he said.
“It’s like if we were drinking beer for thousands of years and then one day we decriminalized that and said, ‘Here’s Everclear,’ ” he said.
In the early 2000s, someone coming to an ER for marijuana was nearly unheard of, said Dr. Deborah Mann, a veteran upstate ER doctor with training in addiction medicine.
Now she sees it multiple times a shift. Partially to blame, she said, are the daily high doses that people take now that it’s legal.
“It’s not the same marijuana that people smoked in their dorms in the ‘60s or ‘70s,” she said.
Legal cannabis products, called “dabs,” can contain up to 95% THC — the mind-altering component of cannabis — while stripping away the more medicinal CBD, experts say.
By comparison, an actual cannabis plant contains about 15% THC, manipulated up from about 4% in the 1990s.
In Central New York, cannabis ER visits have more than doubled since legalization, outpacing the state’s overall increase. State health department data shows there were 12,900 ER visits in 2023, up from 5,250 in 2020, a year before legalization. The region covers a population of about 1 million, spanning Onondaga to Tompkins counties.
Some of the high numbers might be because people outside the region (from the North Country, for example) are brought to major medical centers in Syracuse and Ithaca, state officials noted. But the region still remains an outlier compared to the region with Albany (2,754 cannabis ER visits with a population of 1.1 million) or Rochester and Buffalo (11,194 visits with a population of 2.04 million).
Most adults can use legal cannabis with little to no problem. But, like alcohol, some can’t.
And those are the people who end up in local ERs, experts say. They’re the ones who have smoked or eaten cannabis for years and believe they can do so safely.
Few – if any – have been treated at Syracuse chemical dependency clinics for marijuana addiction, providers say. And for them, cannabis is an emerging concern that still pales in comparison to the opioid crisis.
Experts also say cannabis is less dangerous than alcohol. While alcohol can cause a loss of gag reflex when vomiting, cannabis has no such effect on adults.
“There are very few studies that show you can die of a cannabis overdose,” said Dr. Ross Sullivan, the chief doctor at Helio Health, which treats substance abuse.
“Alcohol is way more dangerous, yet legal,” added Dr. Tolani Ajagbe, director of Crouse’s addiction treatment program.
Mike Golden, co-owner of Syracuse’s The Higher Calling THC, acknowledged that overconsumption can be a problem for some. But, he added, he’s seen more customers come into his shop noticeably drunk than those noticeably high.
“I think overconsumption can be a thing and is a thing for some people, just like drinking,” said Golden, a father of four who said he uses cannabis every night to soothe anxiety. “Usually, someone is trying to escape from something else that’s leading them to self-medicate.”
If customers return after having an adverse reaction like vomiting, Golden said, he tries to find another of his 600 or so cannabis products that might work better. He sells everything from mild, midday gummies to vapes with an 80% or 90% THC level.
“I think like everything, there’s balance,” Golden said.
The treatment doctors, not surprisingly, aren’t as sold on cannabis’ virtues.
“I think there should also be strong awareness programs to educate the public about the fact that marijuana being legal does not mean marijuana is safe,” Ajagbe said. “It still carries a high risk of addiction and remains a gateway drug to more harmful substances in susceptible populations.”
But the doctors agreed that cannabis should be legal. The vast majority of people use it responsibly, Sullivan said, adding that making it illegal didn’t stop people from using it.
The legalized market also brings more testing and tax revenue for research, Ajagbe said.