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

The takeaway

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.

Emergency physicians, pediatricians, public health officials tracking substance use trends, parents.

Cannabis ER visits: 17.9% to 35.3% (2018-2023)

What the researchers 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.

Why it 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 numbers in context

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 the study worked

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.

What this study cannot 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.

How to read the evidence

Strong: large multi-site EHR dataset (151,764 visits) with clear temporal trends, though single urban system limits generalizability.

When this study was published

2025 study (data from 2018-2023)

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.

Questions still open

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?

Common 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 the original research

Trends in substance use-related emergency department visits by youth, 2018-2023.

The American journal of emergency medicine, 92, 1-9

View on PubMed ↗Publisher’s paper ↗

Citation

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