German legalization linked to more cannabis-related hospital care

Increase in Cannabis-Specific Hospital Admissions After Partial Legalization in Germany: A Nationwide Time-Series Analysis.

Deutsches Arzteblatt international • • Observational • Highly Relevant
🤖

AI Summary

This nationwide German time-series analysis examined hospital admissions before and after the April 2024 changes that legalized adult possession and cultivation of non-medical cannabis and liberalized medical-cannabis rules. After the law changed, cannabis-specific admissions initially increased by 5.6% overall and then remained stable. The initial increase was larger among minors, at 14.9%, although their admission rate subsequently declined slightly each week.

Among adults, admissions for acute cannabis intoxication and poisoning rose immediately by 37.1%, while hospitalizations for cannabis-induced psychosis increased by 16.4% and then remained stable. The study shows an association between the legal changes and increased cannabis-related hospital use; it does not establish that legalization itself caused every admission. The authors suggest that greater use of highly potent medical cannabis may be one possible explanation, but this was not proven by the analysis. For users, the findings underline the importance of avoiding excessive doses and seeking help after severe intoxication or psychotic symptoms.

💡 Key Findings

1
After the April 2024 legal changes, cannabis-specific hospital admissions initially rose by 5.6% overall and then remained stable.
High
80%
2
Among adults, admissions for acute cannabis poisoning increased immediately by 37.1%, followed by a slight, non-significant decline.
High
80%
3
Adult hospitalizations for cannabis-induced psychosis rose immediately by 16.4% and remained stable afterward.
High
80%
4
Among minors, cannabis-specific admissions initially increased by 14.9%, then declined slightly each week.
High
80%
5
The study found an association—not proof of causation—between the legal changes and increased hospital admissions; the authors suggest highly potent medical cannabis as one possible explanation.
Good
70%

📄 Original Abstract

In April 2024, the possession and cultivation of non-medical cannabis for adults were legalized in Germany, and the regulation of cannabis for medical purposes was liberalized. We studied whether the rate of hospital admissions with cannabis-specific diagnoses has risen since then. The number of inpatient admissions each week from January 2022 to September 2025 was ascertained from DRG and PEPP statistics. The primary endpoint was the rate of admissions with a cannabis-specific ICD-10 main diagnosis (F12.0-F12.9; T40.7) as a proportion of all admissions, determined separately for minors and adults. Secondary endpoints for adults were the admission rates for acute intoxication and poisoning (F12.0; T40.7) and for cannabis-induced psychosis (F12.5) as a percentage of all admissions. Immediate and gradual changes after the modification in the law were examined with time-series analyses. After 1 April 2024, the rate of hospital admissions with a cannabis-specific diagnosis initially rose by 5.6% (risk ratio (RR) = 1.056) and remained stable thereafter (RR = 1.000). Among minors, an initial immediate rise of 14.9% (RR = 1.149) was followed by a decline of 0.4% (RR = 0.996) per week. Among adults, cases of acute cannabis poisoning saw an immediate rise of 37.1% (RR = 1.371), followed by a slight, non-significant, gradual decline (RR = 0.998). The hospitalization rate of cannabis-induced psychosis among adults rose immediately by 16.4% (RR = 1.164) and remained stable thereafter (RR = 1.000). The change in cannabis laws in Germany was followed by a rise in cannabis-specific hospital admissions, particularly among adults, mainly because of acute intoxication and cannabis-induced psychosis. The reason may be increased consumption of highly potent medical cannabis.

Explore More Research

Stay informed about the latest cannabis science.

Your stash, decoded.