Seattle — Cannabis may be legal in Washington, but clinicians say the health fallout landing in exam rooms and emergency departments is getting harder to ignore. A new University of Washington survey of doctors, nurses and other providers across the state finds many are seeing a steady stream of serious cannabis-related problems and feel they are playing catch-up on how to handle them.
In a 20-question survey of 388 health care providers, roughly one-third said they see cannabis-related cases at least two to three times a month. The problems they flagged most often include repeated bouts of severe vomiting, escalating anxiety, signs of addiction and, in some patients, full-blown psychosis.
What the survey measured
The study, published online March 30, 2026, gathered 388 valid responses from clinicians who mostly work in hospitals and primary care clinics. According to the paper in Substance Use & Addiction, 35% of respondents reported seeing cannabis-related adverse events two to three times per month. Seventy percent said they had treated severe cyclic vomiting, and 53% reported psychoses or hallucinations they attributed to cannabis use.
Clinicians say they lack training and tools
Even with those numbers, many clinicians told researchers they feel only moderately prepared to manage cannabis-related problems. In coverage from UW Medicine Newsroom, about two-thirds of respondents said they had slight or no knowledge of how cannabis interacts with other medications. Nearly three-quarters said they want more training on how to screen for cannabis use and manage complications when they appear. While 90% agreed that screening and intervening are important parts of patient care, only about 39% reported that they routinely screen all patients for cannabis use.
Researchers point to potency and availability
Lead author Beatriz Carlini summed up the mood among providers this way: “Healthcare providers are noticing, and concerned about, cannabis adverse events.” Carlini and her co-authors note that the products people are using today are far stronger than the joints many older users remember, and they connect that jump in potency to the acute problems clinicians keep seeing.
The reporting and interviews around the study point to high potency and easy availability as central to those worries. Local coverage, as summarized by KING5 and UW Medicine, underscores that many frontline providers feel like the legal market has sprinted ahead while clinical guidance lags behind.
Potency and ER visits: a local view
Public radio reports and other local stories have linked high-potency products with more emergency visits and worrying symptoms, particularly among younger patients and people who already have mental health diagnoses. Coverage from KUOW notes that the research team is urging clearer warning labels for people with psychotic disorders and stronger clinical guidance for frontline providers, with the goal of cutting down on avoidable ER trips. The idea is to give clinicians concrete steps for triage and referral instead of leaving them to improvise in the moment.
What providers say would help
In the survey, many clinicians said they would be far more likely to screen and intervene if health systems gave them practical tools to work with. Respondents pointed to a wish list that includes formal clinical guidelines, validated screening tools and clear referral pathways to specialists.
A summary from the UW Addictions, Drug & Alcohol Institute (ADAI) recommends expanding training and creating straightforward workflows that primary care teams can actually use in busy clinics. Researchers also call for better data sharing between systems and long-term monitoring so health organizations can track cannabis-related trends over time instead of relying on scattered anecdotes.
The study was funded in part by the Washington State Legislature and is available online with supporting data stored in public repositories, part of a broader push to keep tabs on cannabis-related harms as the legal market evolves. For clinicians and policymakers, the message is blunt: providers are seeing measurable harms tied to cannabis use, they want better tools to respond and building that capacity will take real investment in training, protocols and referral options.
The full paper is available in Substance Use & Addiction, and the dataset can be accessed through Dryad.
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