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JAMA Netw Open. 2021;4(6):e2113025. doi:10.1001/jamanetworkopen.2021.13025

Key Points

  • Question  Are there associations between cannabis use and suicidality trends in young adults, and do they vary as a function of sex and depression?
  • Findings  This survey study examined 281 650 adult participants in the 2008-2019 National Surveys of Drug Use and Health data and found associations of past-year cannabis use disorder, daily cannabis use, and nondaily cannabis use with higher prevalence of past-year suicidal ideation, plan, and attempt in both sexes, but significantly more in women.
  • Meaning  In this study, cannabis use was associated with higher prevalence of suicidal ideation, plan, and attempt among US young adults with or without depression, and the risks were greater for women than men.


Importance  During the past decade, cannabis use among US adults has increased markedly, with a parallel increase in suicidality (ideation, plan, attempt, and death). However, associations between cannabis use and suicidality among young adults are poorly understood.

Objective  To determine whether cannabis use and cannabis use disorder (CUD) are associated with a higher prevalence of suicidality among young adults with or without depression and to assess whether these associations vary by sex.

Design, Setting, and Participants  This survey study examined data from 281 650 adults aged 18 to 34 years who participated in the National Surveys on Drug Use and Health. Data were collected from January 1, 2008, to December 31, 2019.

Exposures  Prevalence of past-year daily or near-daily cannabis use (≥300 days in the past year), CUD, and major depressive episode (MDE). Past-year CUD and MDE were based on DSM-IV diagnostic criteria.

Main Outcomes and Measures  Past-year suicidal ideation, plan, and attempt.

Conclusions and Relevance  From 2008 to 2019, suicidal ideation, plan, and attempt increased 40% to 60% over increases ascribed to cannabis use and MDE. Future research is needed to examine this increase in suicidality and to determine whether it is due to cannabis use or overlapping risk factors.

For complete paper

International Academy on the Science and Impact of Cannabis





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