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.
Medical cannabis policy analysts, emergency medicine researchers, Israeli health policymakers
Cannabis-positive ER tests: modest rise from 15.4% to 17.6% despite prescription surge
What the researchers 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.
Why it 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 numbers in context
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 the study worked
Retrospective analysis of urine toxicology screening data from 20,022 emergency department admissions at a large Israeli tertiary medical center from 2016 to 2024.
What this study cannot 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.
How to read the evidence
Large single-center dataset spanning 8 years, but clinical suspicion-based testing creates significant selection bias.
When this study was published
2025 study with data through June 2024 from an Israeli medical center.
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.
Questions still open
- 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?
Common questions
Does medical cannabis expansion lead to more ER visits?
Who tests positive for cannabis in Israeli ERs?
Read the original research
Trends in urine screening positive for cannabis of emergency department admissions in Israel 2016-2024.
Journal of cannabis research, 8(1), 14
Citation
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
Explore the wider topic
- Surviving 4/20 Sober: A Practical Survival Guide
- CBT for Cannabis Recovery: How Cognitive Behavioral Therapy Works
- The Cannabis Relapse Cycle: Quit, Feel Good, Get Complacent, Repeat
- Cold Turkey vs Tapering: Which Way to Quit Weed
- Dating Sober After Years of Being High: What Nobody Tells You
- Exercise as Medicine: Working Out After Quitting Weed
- Grieving Weed Itself: Mourning the Loss of a Companion
- How to Help Someone Quit Weed (When They're Not Ready)
- How to Quit Weed: A No-Judgment Step by Step Guide
- Journaling Through Weed Withdrawal: Why Writing Helps You Heal
- MA vs SMART Recovery vs Therapy: Comparing Your Options
- Meditation and Mindfulness for Weed Withdrawal
- Your Partner Still Smokes Weed: How to Navigate It
- Quitting Weed While Your Partner Still Smokes
- The Pink Cloud Effect: When Quitting Weed Feels Too Good
- How to Quit Smoking Weed Cold Turkey: What to Expect
- Quit Weed or Cut Back: Which Is Right for You?
- I Quit Weed and Regret It: An Honest Look at Non-Linear Recovery
- Quitting Weed in Your 20s: Career, Social Life, Starting Over
- Quitting Weed in Your 30s: It's Not Too Late
- Quitting Weed After 10+ Years of Daily Use: What to Expect
- Quitting Weed During a Life Crisis: Divorce, Job Loss, and Other Bad Timing
- Quitting Weed and Working Out: How Exercise Helps Recovery
- Quitting Weed After Loss: When Grief Comes Flooding Back
- Quitting Weed When It's Legal Everywhere
- Weed Withdrawal Success Stories: Real People Who Made It Through
- Quitting Weed Long Distance: When You Can't Remove Triggers
- I Relapsed on Weed. Now What? A Practical Reset Guide
- I Relapsed After Quitting Weed: What Now?
- Should I Quit Weed? A Decision Framework (Not a Lecture)
- Quitting Weed at Music Festivals and Concerts: A Sober Survival Guide
- Supplements That Actually Help with Weed Withdrawal (And Ones That Don't)
- How to Tell Your Friends You're Quitting Weed
- Relapse Prevention Plan for Cannabis: A CBT-Based Approach
- Why Weed Relapse Happens: The Science Behind Going Back
- Replacing the Ritual: What to Do When You Quit Weed
- How Cannabis Damaged My Relationships: Before and After
- Social Media Detox from Weed Content