Cannabis-Positive ER Tests in Israel Rose Modestly Despite Prescription Surge
Despite an exponential increase in cannabis prescriptions, cannabis-positive urine tests in Israeli ERs rose only modestly from 15.4% to 17.6% over eight years.
Quick Facts
What This Study Found
Among 20,022 urine toxicology tests from Israeli ER admissions (2016-2024), cannabis-positive results increased modestly from 15.4% to 17.6%. The most significant increase (16.6% to 22.4%) occurred in the 25-64 age group. Male sex, younger age, and Israeli-born status predicted positive results.
Key Numbers
20,022 urine tests analyzed. Cannabis-positive rate: 15.4% (2016) to 17.6% (2024). Ages 25-64: 16.6% to 22.4%. Male sex OR=1.5, age <25 OR=4.1, Israeli-born OR=1.3. Co-positive for opioids OR=1.4, MDMA OR=1.8.
How They Did This
Retrospective analysis of urine toxicology screening data from 20,022 emergency department admissions at a large Israeli tertiary medical center from 2016 to 2024.
Why This Research Matters
Israel has one of the world's largest medical cannabis programs. Tracking whether prescription expansion translates to increased ER presentations helps assess population-level impacts of medical access policies.
The Bigger Picture
The modest increase despite a prescription surge suggests that medical cannabis expansion does not necessarily lead to proportional increases in ER-presenting cannabis-related problems, a finding relevant to policy debates worldwide.
What This Study Doesn't Tell Us
Toxicology screens were ordered based on clinical suspicion, not universally, creating selection bias. No diagnostic information about why patients were in the ER. Cannot distinguish medical from recreational cannabis use. Single-center data.
Questions This Raises
- ?Why didn't the prescription surge produce a larger increase in positive tests?
- ?Are medical cannabis patients less likely to present to ERs?
- ?Does clinical suspicion-based screening miss many cannabis-positive patients?
Trust & Context
- Key Stat:
- Cannabis-positive ER tests: modest rise from 15.4% to 17.6% despite prescription surge
- Evidence Grade:
- Large single-center dataset spanning 8 years, but clinical suspicion-based testing creates significant selection bias.
- Study Age:
- 2025 study with data through June 2024 from an Israeli medical center.
- Original Title:
- Trends in urine screening positive for cannabis of emergency department admissions in Israel 2016-2024.
- Published In:
- Journal of cannabis research, 8(1), 14 (2025)
- Authors:
- Miron, Oren, Zeltser, David, Schreiber, Shaul(2), Adelson, Miriam, Peles, Einat
- Database ID:
- RTHC-07149
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Does medical cannabis expansion lead to more ER visits?
In Israel, where cannabis prescriptions surged over this period, cannabis-positive ER tests increased only modestly (15.4% to 17.6%), suggesting the relationship between medical access and emergency presentations is more nuanced than a simple increase.
Who tests positive for cannabis in Israeli ERs?
Young adults under 25 had the highest odds (4.1x), followed by males (1.5x) and Israeli-born individuals (1.3x). Those also positive for other substances like MDMA (1.8x) and opioids (1.4x) were more likely to test positive.
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Cite This Study
https://rethinkthc.com/research/RTHC-07149APA
Miron, Oren; Zeltser, David; Schreiber, Shaul; Adelson, Miriam; Peles, Einat. (2025). Trends in urine screening positive for cannabis of emergency department admissions in Israel 2016-2024.. Journal of cannabis research, 8(1), 14. https://doi.org/10.1186/s42238-025-00379-4
MLA
Miron, Oren, et al. "Trends in urine screening positive for cannabis of emergency department admissions in Israel 2016-2024.." Journal of cannabis research, 2025. https://doi.org/10.1186/s42238-025-00379-4
RethinkTHC
RethinkTHC Research Database. "Trends in urine screening positive for cannabis of emergency..." RTHC-07149. Retrieved from https://rethinkthc.com/research/miron-2025-trends-in-urine-screening
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.