Youth Cannabis-Related ER Visits Nearly Doubled From 2018 to 2023

Cannabis-related ER visits among youth aged 12-21 nearly doubled from 17.9% to 35.3% of all substance-related visits between 2018 and 2023, with increases across all age groups.

Renny, Madeline H et al.·The American journal of emergency medicine·2025·Strong EvidenceRetrospective Cohort
RTHC-07468Retrospective CohortStrong Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Strong Evidence
Sample
Not reported

What This Study Found

Among 151,764 ED visits for 12-21 year olds, substance use accounted for 3.0% overall but increased from 2.8% to 3.4% (p<0.001). Cannabis visits nearly doubled from 17.9% to 35.3% of substance visits, with increases across all age groups. Female visits increased from 43.4% to 52.4%. Visits by 12-14 and 15-17 year olds also increased significantly. 19% of patients had a substance-related revisit within one year.

Key Numbers

151,764 total ED visits. 3.0% substance-related. Cannabis visits: 17.9% to 35.3% (2018-2023). Female proportion: 43.4% to 52.4%. 19% had substance revisit within 1 year. Significant increases in 12-14 and 15-17 year olds.

How They Did This

Retrospective EHR review from six EDs in an urban healthcare system. Identified 12-21 year old patients with substance use-related visits (2018-2023) using ICD-10 codes. Logistic regression assessed characteristics associated with visits, hospital admissions, and revisits.

Why This Research Matters

The near-doubling of cannabis-related ER visits among youth during a period of expanding legalization and product availability is a clear public health signal. The increase among 12-14 year olds is particularly concerning, as is the finding that nearly one in five had a repeat visit within a year.

The Bigger Picture

While cannabis-related ER visits are rising, alcohol remains the most common substance (53.4%). The shift toward cannabis may reflect increased availability of edibles and concentrated products that can cause more intense acute reactions, or greater willingness to report cannabis use as legal stigma decreases.

What This Study Doesn't Tell Us

Single urban healthcare system. ICD-10 coding may misclassify or undercount substance visits. Cannot determine severity of cannabis-related presentations. Rising visits may partly reflect increased coding for cannabis rather than true increases. Does not distinguish intentional from accidental exposure.

Questions This Raises

  • ?Are cannabis ER visits driven by higher-potency products or by accidental pediatric exposures?
  • ?Would ED-based intervention reduce the 19% revisit rate?
  • ?Are the trends similar in rural healthcare systems?

Trust & Context

Key Stat:
Cannabis ER visits: 17.9% to 35.3% (2018-2023)
Evidence Grade:
Strong: large multi-site EHR dataset (151,764 visits) with clear temporal trends, though single urban system limits generalizability.
Study Age:
2025 study (data from 2018-2023)
Original Title:
Trends in substance use-related emergency department visits by youth, 2018-2023.
Published In:
The American journal of emergency medicine, 92, 1-9 (2025)
Database ID:
RTHC-07468

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

Are more young people going to the ER for cannabis?

Yes. Cannabis-related ER visits among 12-21 year olds nearly doubled from 17.9% to 35.3% of all substance visits between 2018 and 2023, with increases seen even among 12-14 year olds.

Do cannabis ER visits lead to repeat visits?

19% of youth with a substance-related ER visit had another substance-related visit within one year, suggesting a need for intervention at the first visit to prevent recurrence.

Read More on RethinkTHC

Cite This Study

RTHC-07468·https://rethinkthc.com/research/RTHC-07468

APA

Renny, Madeline H; Stecher, Yago; Vargas-Torres, Carmen; Zebrowski, Alexis M; Merchant, Roland C. (2025). Trends in substance use-related emergency department visits by youth, 2018-2023.. The American journal of emergency medicine, 92, 1-9. https://doi.org/10.1016/j.ajem.2025.02.035

MLA

Renny, Madeline H, et al. "Trends in substance use-related emergency department visits by youth, 2018-2023.." The American journal of emergency medicine, 2025. https://doi.org/10.1016/j.ajem.2025.02.035

RethinkTHC

RethinkTHC Research Database. "Trends in substance use-related emergency department visits ..." RTHC-07468. Retrieved from https://rethinkthc.com/research/renny-2025-trends-in-substance-userelated

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.