Cannabis use appears to be associated with an increased risk of suicidal thoughts and actions in young adults, according to a study published Tuesday in JAMA Network Open. These risks were similar regardless of whether the young adults had major depression and were more pronounced in women than men.
“Suicide is a leading cause of death among young adults in the United States, and the findings of this study offer important information that may help us reduce this risk,” said lead study author Beth Han, M.D., Ph.D., M.P.H., of the National Institute on Drug Abuse (NIDA) in a news release.
Han and colleagues analyzed data collected from 281,650 adults aged 18 to 34 years who participated in the National Survey on Drug Use and Health between 2008 and 2019. As part of the survey, participants were asked about past-year major depressive episode and suicidal ideation, plan, and attempt. They were also asked about lifetime and past-year use of tobacco, alcohol, cannabis, and cocaine, as well as sociodemographic information (including age, sex, race/ethnicity, educational attainment, college/school enrollment, employment status, family income, marital status, and health insurance). The authors used DSM-IV criteria to estimate the prevalence of past-year alcohol, cannabis, and cocaine use disorders and major depressive episode.
Past-year suicidal ideation and plan along with daily cannabis use increased among all of the sociodemographic subgroups, with the exception of daily cannabis use among current high school students, the authors reported. Past-year suicide attempts also increased among most subgroups.
“Past-year [cannabis use disorder], daily cannabis use, and nondaily cannabis use were associated with a higher prevalence of past-year suicidal ideation, plan, and attempt in both sexes,” the authors wrote. For instance, among people without a major depressive episode, about 3% of those who did not use cannabis had suicidal ideation, compared with about 7% of those with nondaily cannabis use, about 9% of those with daily cannabis use, and 14% of those with a cannabis use disorder. Similarly, among people with depression, 35% of people who did not use cannabis had suicidal ideation, compared to 44% of those with nondaily cannabis use, 53% of those with daily cannabis use, and 50% of those with a cannabis use disorder. Women who used cannabis at any frequency were more likely to have suicidal ideation or report a suicide plan or attempt than men with the same frequency of cannabis use.
“While we cannot establish that cannabis use caused the increased suicidality we observed in this study, these associations warrant further research, especially given the great burden of suicide on young adults,” said NIDA Director Nora Volkow, M.D., who is a senior author on the study. “As we better understand the relationship between cannabis use, depression, and suicidality, clinicians will be able to provide better guidance and care to patients.”
For related information, see the Psychiatric News article “Cannabis Withdrawal Syndrome Affects Nearly Half of Those Who Quit” and the American Journal of Psychiatry article “U.S. Adults With Pain, a Group Increasingly Vulnerable to Nonmedical Cannabis Use and Cannabis Use Disorder: 2001–2002 and 2012–2013.”
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