Cannabis drove the largest increase in substance-related visits to children's hospitals

From 2016-2021, substance-related visits increased 47.9% across all demographics. Cannabis accounted for 52.2% of visits and had 82.4% growth (p<0.001). Hispanic youth had the greatest demographic growth (63.3%). During the pandemic, publicly insured, female, non-Hispanic Black, and Hispanic youth exceeded predicted visit numbers.

Cross-sectional analysis of the Pediatric Health Information System database covering substance-related visits by youth ages 12-21 at children's hospitals from 2016-2021. ICD-10 codes identified visits for substance use, dependence, or overdoses. Time series analysis predicted pandemic-era expected visits.

Cannabis-related visits to children's hospitals growing at 82% far outpaces other substances and represents a significant and growing burden on pediatric healthcare. The disproportionate impact on minoritized youth adds an equity dimension.

The concentration of pandemic-era increases among publicly insured and minoritized youth suggests the pandemic amplified existing health disparities in adolescent substance use, with cannabis as the primary driver of the overall trend.

Children's hospital data may not capture youth seen in adult facilities or community settings. ICD-10 coding practices vary. Cannot determine whether increases reflect more use, more severe use, or changes in healthcare-seeking behavior. Hospital-level data, not population-based.