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

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.