From courtroom to clinic: How legal rulings shape cannabis use among adolescents and young adults in South Africa

BACKGROUND: Substance use, including cannabis (marijuana/dagga), is a major global public health concern. In South Africa, the Cannabis for Private Purposes Bill decriminalised, the use, possession, and cultivation of cannabis by adults in private for personal use, but it remains illegal for those under 18. This study aimed to determine the impact of the cannabis decriminalisation bill on treatment demand among South African adolescents and young adults for cannabis use. A secondary aim was to examine trends in cannabis-related admissions post-legislation. METHODS: We used retrospective, inpatient and outpatient treatment demand data to assess time trends for cannabis t admissions among South African adolescents aged ≤18 years and young adults aged 19-25 years for the period 2015 to 2023. Basic descriptive statistics and logistic regression were employed to assess changes in cannabis-related admissions over time (2015-2023), adjusting for various sociodemographic and treatment-specific variables. Adjusted odds ratios (ORs) were reported at a 95% confidence interval and significance p-value of