Cannabinoid-related psychiatric hospitalizations increased nearly 5-fold in Germany over 18 years

Hospital admissions for cannabinoid-related mental disorders in Germany increased 4.8-fold between 2000 and 2018, with significant rises across intoxication, dependence, withdrawal, and psychotic disorders.

Gahr, Maximilian et al.·European journal of public health·2022·Moderate EvidenceRetrospective Cohort
RTHC-03856Retrospective CohortModerate Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

All categories of cannabinoid-related psychiatric hospitalizations increased significantly: intoxications, harmful use, dependence syndrome, withdrawal, psychotic disorders, and residual/late-onset psychotic disorders. The overall relative frequency increased 4.8-fold comparing 2000 and 2018. Meanwhile, alcohol dependence admissions remained stable and schizophrenia-spectrum admissions slightly decreased.

Key Numbers

4.8-fold increase in relative frequency from 2000 to 2018. All six subcategories showed statistically significant increases (p<0.001 for most). Schizophrenia admissions slightly decreased (p=0.008). Alcohol dependence unchanged (p=0.844).

How They Did This

Analysis of all inpatient hospital diagnoses in Germany from 2000-2018 using Federal Statistical Office (Destatis) data. Linear trend analysis of absolute and relative annual frequencies of ICD-10 cannabinoid-related diagnoses versus control diagnoses.

Why This Research Matters

The dramatic increase in cannabinoid-related psychiatric hospitalizations coincides with rising recreational use, synthetic cannabinoid availability, and increasing THC content in cannabis preparations.

The Bigger Picture

The divergence between increasing cannabinoid-related admissions and stable/decreasing alcohol and schizophrenia admissions suggests a specific cannabis-related public health trend rather than a general increase in psychiatric hospitalizations.

What This Study Doesn't Tell Us

Administrative data may reflect changes in diagnostic practices, awareness, or healthcare-seeking behavior rather than true incidence changes. Cannot link to individual-level cannabis use data.

Questions This Raises

  • ?How much of the increase is driven by synthetic cannabinoids versus natural cannabis?
  • ?Are rising THC concentrations a major contributing factor?

Trust & Context

Key Stat:
4.8-fold increase in cannabinoid-related psychiatric hospitalizations (2000-2018)
Evidence Grade:
Complete national hospital data providing a reliable trend, though administrative data cannot determine causation.
Study Age:
Published in 2022 with German hospital data from 2000-2018.
Original Title:
Incidence of inpatient cases with mental disorders due to use of cannabinoids in Germany: a nationwide evaluation.
Published In:
European journal of public health, 32(2), 239-245 (2022)
Database ID:
RTHC-03856

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Which types of cannabis-related mental disorders increased most?

All categories showed significant increases, including intoxication, harmful use, dependence, withdrawal, psychotic disorders, and residual/late-onset psychotic disorders.

Could this just reflect more people seeking help?

Partially possible, but the contrast with stable alcohol dependence admissions and slightly declining schizophrenia admissions over the same period suggests a real increase in cannabinoid-related psychiatric problems specifically.

Read More on RethinkTHC

Cite This Study

RTHC-03856·https://rethinkthc.com/research/RTHC-03856

APA

Gahr, Maximilian; Ziller, Julia; Keller, Ferdinand; Muche, Rainer; Preuss, Ulrich W; Schönfeldt-Lecuona, Carlos. (2022). Incidence of inpatient cases with mental disorders due to use of cannabinoids in Germany: a nationwide evaluation.. European journal of public health, 32(2), 239-245. https://doi.org/10.1093/eurpub/ckab207

MLA

Gahr, Maximilian, et al. "Incidence of inpatient cases with mental disorders due to use of cannabinoids in Germany: a nationwide evaluation.." European journal of public health, 2022. https://doi.org/10.1093/eurpub/ckab207

RethinkTHC

RethinkTHC Research Database. "Incidence of inpatient cases with mental disorders due to us..." RTHC-03856. Retrieved from https://rethinkthc.com/research/gahr-2022-incidence-of-inpatient-cases

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.