Cannabis hospitalisations up 49% in a decade — women drove the surge

A decade of Victorian hospital data has been analysed by Monash University’s Addiction Research Centre, and the numbers are specific enough to change how a GP thinks about the next consultation where cannabis might be relevant. The study, published in the journal Addiction, found cannabis-related hospital admissions in Victoria rose 49% between July 2013 and June 2023 — nearly 40,000 separations in total. More than 1,500 required intensive care.

The number that will matter most for anyone in general practice treating women: admissions among women and girls rose 75% over the same period, compared with 35% among men. The gap is not small. It is a signal.

Psychotic disorder was the most common principal diagnosis, accounting for 40% of admissions. Admissions peaked in 2020–21 — the pandemic years, the lockdown years — and have not returned to pre-2020 levels. Lead author Myfanwy Graham from Monash Addiction Research Centre notes the findings point to significant strain on the healthcare system.

What the data can and can’t tell us

Associate Professor Vicki Kotsirilos, who in 2018 became Australia’s first GP authorised to prescribe medicinal cannabis, offered important methodological context: this study cannot identify whether the hospitalisations were driven by medicinal or illicit cannabis. It cannot exclude polypharmacy — many patients presenting to hospital use more than one substance. It does not control for socioeconomic or other confounders.

This matters. The both-and framing: the data is real, and it has real limits. A 49% rise in cannabis-related admissions is a signal that should change clinical behaviour. It is not proof that medicinal cannabis is causing hospitalisation, and using it to reject all therapeutic use of cannabinoids is not the right conclusion. What it does establish is that cannabis — however obtained, whatever the source — is reaching people in ways that produce serious harm, and that harm is disproportionately falling on women.

The gender signal is the story

The 75% rise in admissions among women is not explained in this study, but it sits alongside other trends that are not hard to link.

Cannabis use among women in their thirties and forties has increased substantially over the past decade. Drivers include growing social normalisation, and its use as a self-management tool for anxiety, insomnia, and chronic pain — conditions that are disproportionately prevalent in women, and particularly in women who have not found adequate responses in the conventional medical system. The woman who is exhausted, dismissed, looking for anything that helps sleep or quiets the noise — she is precisely the demographic this data is flagging.

Medicinal cannabis is also increasingly prescribed to this population. Kotsirilos’s caution about attributing these admissions to medicinal prescriptions is valid. Her separate caution — that GPs should be “extremely cautious” prescribing high-dose THC, using it only as a last resort after evidence-based treatments have failed — is equally important, and it applies in both directions: to new prescriptions, and to the informal, over-the-counter, social-media-facilitated use that is happening without any prescription at all.

Psychosis is not a fringe outcome. It is the leading diagnosis in these admissions. And it is not limited to young men — the traditional teaching anchor for cannabis-psychosis risk. The data now shows women are catching up at a rate that warrants explicit clinical attention.

2 cents

Three things worth doing this week:

Normalise the question. Asking “do you use cannabis?” belongs alongside questions about alcohol, tobacco, and other substances. It is not a judgement — it is a clinical history. A patient who has been using cannabis to manage insomnia or anxiety, and who has never been asked, may not know it is relevant to disclose. Kotsirilos recommends raising it specifically when patients present with mental health, behavioural, or social issues.

Name the psychosis risk directly — and specifically for women. The common patient narrative around cannabis is that it is “natural,” that it helps, that it is not the hard stuff. The psychosis data is a counterweight that the patient deserves to hear. Something like: “There’s new Victorian data showing cannabis-related hospitalisations for mental health have risen nearly 50% in a decade, and the biggest increase is in women — I want to make sure you know that risk.” That takes 15 seconds and it is clinically important.

Refer early. For any patient where there is concern — escalating use, mental health symptoms, a desire to reduce but difficulty doing so — referral to a psychologist familiar with substance use, or to an addiction-skilled GP, is appropriate. The RACGP’s position is clear: when not confident in this area, refer. That is not failure; it is appropriate scope management.

Medicinal cannabis has a role. The data says the population using it, alongside those using illicit cannabis, is producing hospitalisation numbers that general practice cannot ignore. The clinical response is not panic — it is a better-quality conversation at the point of care, where most of this can be intercepted.

Verdict: yes — the gender signal in this data is new and specific, the psychosis rate is not marginal, and the GP response is straightforward.

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Sources cited

1. Concern over cannabis-related hospitalisation spike — RACGP newsGP
2. Cannabis-related hospital admissions in Victoria, 2013–2023 — Addiction