I recently finished my residency in emergency medicine and began to practice in Pueblo, Colorado. I grew up there, and I was excited to return home. However, when I returned home, the Pueblo I once knew had drastically changed. Where there were once hardware stores, animal feed shops, and homes along dotted farms, I now found marijuana shops—and lots of them. As of January 2016, there were 424 retail marijuana stores in Colorado compared with 202 McDonald’s restaurants.1
These stores are not selling the marijuana I had seen in high school. Multiple different types of patients are coming into the emergency department with a variety of unexpected problems such as marijuana-induced psychosis, dependence, burn injuries, increased abuse of other drugs, increased homelessness and its associated problems, and self-medication with marijuana to treat their medical problems instead of seeking appropriate medical care.
I watched one of my colleagues and several security guards restrain a psychotic teenage girl who was reportedly “dabbing” (heating highly concentrated, solidified THC, which is inhaled). A short time later, a young adult male came in, having reportedly tried to hang himself three times. He stated that he had been smoking marijuana “all day, every day.” He was “seeing ghosts” that told him to kill himself. Not long after, a man presented in tears, saying that he had lost his job, was on the verge of losing his family, and needed help stopping the use of marijuana and didn’t know where go for help. Another colleague saw two young adult patients from a hash oil explosion that left them with very severe burns. I have certainly seen more cases of infective endocarditis from injection drug use than I expected in this once-quaint town.