Increase in cannabis-specific hospital admissions after partial legalization in Germany: A nationwide time-series analysis

SUMMARY: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.