Cannabis leads youth hospitalizations, but gender differences demand attention

Adverse outcomes, including hospitalization, associated with psychoactive substance use among children and adolescents, remain an important public health issue. This study aimed to assess psychoactive substance-related hospital admissions among minors in France. A national cohort study was conducted using data from the French Hospital Discharge Database. Hospitalizations of individuals aged 11-17 years between 2016 and 2022 were extracted using the International Classification of Diseases 10th Revision (ICD-10) codes (F11-F19 except F17; T40-T43). A descriptive analysis was performed, followed by a gender-specific analysis. During the study, 9520 psychoactive substance use-related hospital stays were recorded for 8031 subjects. At the time of entry, the median age was 16 (interquartile range [IQR]: 15-17) years; 52.6% were male. Hospitalizations were primarily associated with cannabis intoxication (44.2%), misuse of benzodiazepines as well as other sedative drugs (28.8%), and multidrug use (11.6%). Overall hospitalization decreased between 2016 and 2022 (incidence rate ratio [IRR] = 0.98; 95% CI, 0.97-1.00; P = 0.019), particularly among males (IRR = 0.97; 95% confidence interval [CI], 0.93-1.00; P = 0.043). Cannabis-related admissions were more frequent in males (55.5% versus 31.6%) whereas psychotropic medication misuse was more commonly reported in females (42.4% versus 16.6%; P <0.001). Despite an overall decline in psychoactive substance-related hospital stays, the proportion of females increased markedly over the study period. A strong gender contrast was observed in the main substances involved, supporting the need for tailored prevention strategies. Raising awareness among young people and their families about the risks of non-medical substance use and psychotropic medications is essential to anticipate and prevent related harms.