In an emergency room, the question asked to adolescents is not always what parents imagine: alcohol, medicine, cannabis, other product? In the United States, a large analysis presented by WashU Medicine looked at these emergency room visits and hospitalizations coded as substance-related.
The signal is clear, but it needs to be read carefully: in young American patients seen for an acute substance-related episode, cannabis appears more often than alcoholaccording to the university press release. This does not mean that cannabis is always the direct cause of referral to hospital, nor that these figures apply to French emergencies.
What does this American study really change?
The study, conducted at the Washington University School of Medicine in St. Louis, is based on large American health insurance databases, including commercial insurance and Medicaid, between January 2016 and December 2023. In other words, it does not describe all visits to the emergency room of the general population, but acute care files coded as linked to a substance.
The researchers still analyzed more than 1.3 million people aged 16 to 64, for more than 5 million consultations. The substances tracked included alcohol, cannabis, opioids and stimulants. The interest of this work is to compare ages: adolescents do not present the same profile as older adults.
Why is cannabis so popular among young people?
Among 16-18 year olds who have had a trip to the emergency room or hospitalization linked to a substance, 84% had at least one encounter involving cannabis. At the other end, this proportion was 19% among those aged 55-64. Among 19-24 year olds, the press release reports the most marked increase in the share of encounters involving cannabis over the period studied, without giving a comparable absolute percentage in its verified elements.
Alcohol follows another gradient. In the population studied, 33% of adolescents had an alcohol-related encounter, compared to 70% of 55-64 year olds. The message is therefore not that alcohol has disappeared from emergency rooms, but that cannabis occupies a particularly visible place in the files of the youngest
when a substance problem is coded.
The nuance is crucial: a substance can appear in the list of diagnoses without being the main reason for admission. Researchers also report that nearly half of cannabis-related encounters involved at least one other substance. And when the analysis was limited to hospitalizations where cannabis was the main reason, the trend decreased among adolescents.
The press release also mentions hospitalizations associated with psychosis or severe vomiting in the youngest. Here again, be careful: these are associations in hospital records, not proof that cannabis alone explains each situation. The risks seem to depend in particular on age, frequency, dosage, context and individual vulnerabilities, as also recalled by French sources on cannabis in adolescence and the risk of psychotic disorders.
What can we remember from this in France?
These American figures do not allow us to say that cannabis is ahead of alcohol in French emergencies. The healthcare system, available products, coding practices and consumption levels are not the same. In France, recent surveys tend to describe a drop in cannabis use among adolescents, even if alcohol remains very common at 17 years of age: Public Health France recalled that in 2022, 81% of young people of this age had already experimented with alcohol and 30% with cannabis.
The American study is nevertheless useful for families and caregivers: it reminds us that cannabis should not be trivialized among adolescents and young adults. The brain continues to mature until early adulthood, and the psychological, educational, family or social effects of repeated consumption deserve to be taken seriously. On this point, the recent French context of alcohol and cannabis consumption among French adolescents also calls for avoiding shortcuts.
If consumption becomes difficult to control, is accompanied by anxiety, repeated vomiting, family tensions, school absences or unusual withdrawal, the challenge is not to look for a single culprit, but to open up support. In France, a young person can be referred to a Young Consumer Consultation, a CSAPA or Drugs Info Service, with or without their parents depending on the situation.