Cannabis-attributable hospitalizations rose 120% and ER visits rose 113% in Canada over 13 years, with psychosis and youth intoxication driving much of the increase.
People interested in the population-level health effects of cannabis legalization, particularly parents and public health advocates.
120% increase in cannabis-related hospitalizations over 13 years
What the researchers found
Between 2007 and 2020, cannabis-attributable inpatient hospitalizations increased from 6.4 to 14.0 per 100,000, while ER visits rose from 52.1 to 111.0 per 100,000. Neuropsychiatric conditions, especially psychotic disorders and acute intoxication in children and youth, accounted for a large share of the increase.
Why it matters
This study provides the most comprehensive Canadian tracking of cannabis-related hospital burden over a period spanning pre- and post-legalization. The sharp rise in youth intoxication cases and psychosis-related hospitalizations highlights specific areas where public health attention may be needed.
The numbers in context
Hospitalizations: 6.4 to 14.0 per 100,000 (120% increase). ER visits: 52.1 to 111.0 per 100,000 (113% increase, with a 12% drop in 2020 likely due to COVID). Key drivers: psychotic disorder hospitalizations and acute intoxication ER visits among children and youth.
How the study worked
Researchers used record-level hospital discharge data with ICD-10 codes across all Canadian provinces and territories from fiscal years 2006/07 to 2020/21. Cannabis-attributable fractions were calculated using prevalence estimates from national surveys combined with relative risk estimates from the literature.
What this study cannot tell us
Cannabis-attributable fractions rely on published relative risk estimates that may not perfectly reflect the Canadian population. The 2020 data is confounded by COVID-19 effects on both cannabis use patterns and hospital access. The study cannot distinguish between effects of legalization versus broader trends in cannabis use.
How to read the evidence
National-level hospital discharge data covering all Canadian provinces and territories over 13 years provides strong population-level evidence, though attributable fraction calculations introduce some estimation uncertainty.
When this study was published
Published in 2025 with data through 2020.
The bigger picture
Canada legalized recreational cannabis nationally in 2018, making this dataset uniquely valuable for tracking population-level health impacts of legalization. The 2020 dip in ER visits coincided with COVID-19 pandemic effects on healthcare access.
Questions still open
- Are post-2020 trends continuing to climb, or did legalization-era increases plateau? What specific factors are driving pediatric intoxication cases, and are child-resistant packaging laws making a difference?
Common questions
Did cannabis legalization in 2018 cause the increase?
Why did ER visits drop in 2020?
Read the original research
Trends in cannabis-attributable hospitalizations and emergency department visits: data from the Canadian Substance Use Costs and Harms Study (2007-2020).
Health promotion and chronic disease prevention in Canada : research, policy and practice, 45(6), 265-276
Citation
Malam, Raadiya; MacDonald-Spracklin, Rachael; Biggar, Emily; Sherk, Adam; Ziv, Anat; Gabrys, Robert; Wood, Shea; Young, Matthew M; Giwa, Aisha; Sondagar, Chandni; Zhao, Jinhui; Kent, Pamela; Stockwell, Tim. (2025). Trends in cannabis-attributable hospitalizations and emergency department visits: data from the Canadian Substance Use Costs and Harms Study (2007-2020).. Health promotion and chronic disease prevention in Canada : research, policy and practice, 45(6), 265-276. https://doi.org/10.24095/hpcdp.45.6.01