In a Saskatchewan survey during COVID-19, suicidal ideation was most common among those with both problematic cannabis and alcohol use (25.8%), and younger adults (16-34) were most likely to experience all three problems together.
Mental health professionals and people interested in how substance use and suicidality intersect during crises
25.8% suicidal ideation in dual users
What the researchers found
Suicidal ideation prevalence was highest among dual substance users (25.8%) compared to alcohol-only (23.2%) or cannabis-only (18.7%) problematic use. Younger age (16-34), changes in other substance use, pre-existing mental health diagnoses, and low resilience were independent predictors. LGBTQIA2S+ identity and pandemic stress predicted problematic cannabis use specifically.
Why it matters
The pandemic highlighted the intersection of mental health and substance use crises. Understanding that these problems cluster together, especially in younger people and those with pre-existing conditions, can guide targeted intervention during future public health emergencies.
The numbers in context
666 respondents; 25.8% suicidal ideation among dual cannabis/alcohol problem users; 23.2% alcohol-only; 18.7% cannabis-only; 16-34 year-olds most likely to experience all three; LGBTQIA2S+ identity associated with problematic cannabis use
How the study worked
Cross-sectional analysis of 666 Saskatchewan residents aged 16+ from March 2022 data collection by MHCC-CCSA. Trivariate probit regression modeled the joint occurrence of suicidal ideation, problematic alcohol use, and problematic cannabis use simultaneously.
What this study cannot tell us
Cross-sectional design during a pandemic may not reflect typical patterns. Self-reported measures may underestimate substance problems and suicidality. Single Canadian province limits generalizability. Cannot establish causal relationships between variables.
How to read the evidence
Moderately sized survey with sophisticated joint modeling, but cross-sectional pandemic data limits generalizability
When this study was published
2023 study
The bigger picture
This study reinforces that suicidal ideation, alcohol problems, and cannabis problems frequently co-occur and share risk factors. Treating them as separate issues may miss the interconnected nature of these crises, especially during periods of societal stress.
Questions still open
- Did the pandemic create new co-occurrence patterns or amplify existing ones? Would integrated substance use and mental health interventions reduce all three outcomes? How do these patterns compare post-pandemic?
Common questions
Does using cannabis and alcohol together increase suicide risk?
Who was most at risk during the pandemic?
Read the original research
Prevalence and factors associated with suicidal ideation, cannabis, and alcohol use during the COVID-19 pandemic in Saskatchewan: findings from a joint-effect modeling.
BMC psychiatry, 23(1), 571
Citation
Adeyinka, Daniel A; Novik, Nuelle; Novotna, Gabriela; Bartram, Mary; Gabrys, Robert; Muhajarine, Nazeem. (2023). Prevalence and factors associated with suicidal ideation, cannabis, and alcohol use during the COVID-19 pandemic in Saskatchewan: findings from a joint-effect modeling.. BMC psychiatry, 23(1), 571. https://doi.org/10.1186/s12888-023-05051-w
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