BACKGROUND AND PURPOSE:

• The use of cannabis and suicide rates among US adults have both increased over the past decade, but whether an association exists between the two is not well understood
• Han et al. (JAMA Network Open, 2021) assessed whether cannabis use and cannabis use disorder (CUD) are associated with a higher prevalence of suicidality among young adults

METHODS:

• Survey study
• Population
  • US adults aged 18 to 34 years who participated in the National Surveys on Drug Use and Health, between 2008 and 2019
• Exposures
  • Prevalence of past-year daily or near daily cannabis use (≥300 days in the past year)
  • CUD | Based on DSM-IV diagnostic criteria
  • Major depressive episode (MDE) | Based on DSM-IV diagnostic criteria
• Primary outcome
  • Past year suicidal ideation, plan, and attempt

RESULTS:

• 281,650 adults
• In all examined sociodemographic subgroups, over the past decade, there was an increase in
  • Past-year suicidal ideation and plan
  • Daily cannabis use (except among current high-school students)
  • Past-year suicide attempt
• After controlling for MDE, CUD, cannabis use status, and potential confounding factors, the adjusted prevalence of suicidal ideation, plan, and attempt increased 1.4 to 1.6 times from the 2008-2009 to 2018-2019 periods
  • Suicidal ideation: Adjusted risk ratio (aRR) 1.4 (95% CI, 1.3 to 1.5)
  • Suicide plan: aRR 1.6 (95% CI, 1.5 to 1.9)
  • Suicide attempt: aRR 1.4 (95% CI, 1.2 to 1.7)
• Past-year CUD, daily cannabis use, and nondaily cannabis use were associated with a higher prevalence of past-year suicidal ideation, plan, and attempt in both sexes (P<0.001)
  • Suicidal ideation among women without MDE
    • With CUD: 13.9%
    • Without CUD: 3.5%
  • Suicidal ideation among men without MDE
    • With CUD: 9.9%
    • Without CUD: 3.0%
• Past-year CUD, daily cannabis use, and nondaily cannabis use were more often associated with suicidal behavior in women
  • Suicide plan among those with MDE (P<0.001)
    • Women with CUD: 23.7%
    • Men with CUD: 15.6%

CONCLUSION:

• Between 2008 and 2019, suicidal behaviors in US young adults increased, both among cannabis daily-users and those with CUD, but also among non-users
  • There are likely other factors influencing the upward suicidality trend
• Cannabis use and depression may be associated with suicidal behavior
• Limitations include
  • Suicidal behavior may be underreported for multiple reasons including self-reporting
  • Data on anxiety and impulse-control disorders were not available
• The authors state

The results of this survey study indicate that CUD, daily cannabis use, and even nondaily cannabis use are associated with the risks of suicidal ideation, plan, and attempt in both young adult men and women, but significantly more so in women than men

Learn More – Primary Sources:

Associations of Suicidality Trends With Cannabis Use as a Function of Sex and Depression Status

Related ObG Topics: