Pot Tourists in Colorado Are Getting Too High and Ending Up in the ER

Maureen Dowd isn't the only visitor to Colorado to partake in a little too much of a marijuana edible since the state legalized weed in 2012.

"Sitting in my hotel room in Denver, I nibbled off the end and then, when nothing happened, nibbled some more," The New York Times columnist famously wrote after biting off more of a marijuana-laced candy bar than she should have in 2014."I was panting and paranoid, sure that when the room-service waiter knocked and I didn't answer, he'd call the police and have me arrested for being unable to handle my candy."

According to a study that was released in the New England Journal of Medicine today, the number of out-of-state tourists who ended up in the emergency room with pot-related symptoms doubled from 2013 to 2014, while the number of visits by locals remained about the same.

The doctors who authored the study said they believed local residents were more aware of the dosage and potential side effects of marijuana edibles thanks in part to educational campaigns run by the state's public health department and in part because they have edibles at their disposal all the time.

"I think when you're doing a leisure trip for pleasure, you're more likely to use something less moderately, or binge on something, so I think that's part of it as well," said Howard Kim, a professor in emergency medicine at Northwestern University and a coauthor of the study.

He compared the overindulgence of pot tourists to "high schoolers bingeing on alcohol, they aren't use to the effects and might not be ready for them. Once you're of legal age, it's not as enticing because it's around all the time."

Related: Inside America's Billion-Dollar Weed Business: The Grass Is Greener

The patients showing up in Colorado's hospitals generally complained of three ailments, he said: psychiatric issues, particularly anxiety or agitation or brief psychosis; cardiovascular issues such as high blood pressure and a fast heart rate; and gastrointestinal issues such as nausea or vomiting. The tourist-patients accounted for 168 of every 10,000 ER visits in 2014, compared to 112 visits out of every 10,000 for locals, according to the study.

None of the symptoms are difficult to treat, he said. Patients are usually given fluids, anti-anxiety medications if they need them, and anti-nausea medicines and sent on their way.

"I think a lot of visitors aren't really aware of the difference between inhaled or smoke products and ingested marijuana products," he said. "And that's a big problem there, people eat a pot brownie or a cookie and think they should feel something immediately, and then when they don't, they take another one or two, then when they kick in a few hours later they really feel it."

The state's public health department is now looking at ways to help educate visitors about potential side-effects and dosage at the point-of-sale retail locations, Kim said. He said he did not think the increase in tourist ER visits contributed significantly to public health costs, given that the number was still relatively low, but that it did highlight the need for better education for those traveling to Colorado to give marijuana a try in the future.