Starting cannabis before age 15 was associated with 4 times higher odds of suicide attempt | Research

The takeaway

Among 15,238 US adults, early cannabis initiation (age 14 or younger) was associated with 3.3 times higher odds of suicidal ideation and 4.4 times higher odds of suicide attempt compared to non-users.

Suicide prevention researchers, adolescent medicine providers, school counselors, and parents.

4.4x higher odds of suicide attempt with cannabis initiation before age 15

What the researchers found

Early cannabis use (age 14 or younger) was associated with higher risks of suicide ideation (AOR 3.32) and attempt (AOR 4.38) than later initiation (AOR 2.15 and 2.56 respectively). The differences between early and late initiation were statistically significant for both outcomes.

Why it matters

The dose-response relationship between earlier cannabis initiation and suicide risk suggests that delaying cannabis exposure during adolescent brain development may be an important prevention target.

The numbers in context

Sample: 15,238. Suicide ideation: 12.5%. Suicide attempt: 4.2%. Early initiation ideation AOR: 3.32 (95% CI 2.75-3.80). Late initiation ideation AOR: 2.15. Early attempt AOR: 4.38 (95% CI 3.48-5.52). Late attempt AOR: 2.56.

How the study worked

Cross-sectional analysis of the Collaborative Psychiatric Epidemiology Surveys (2001-2003, N=15,238). Logistic regression examined associations between early (14 or younger) vs. later (over 14) cannabis initiation and lifetime suicide ideation and attempt, controlling for cigarette use, demographics, and other factors.

What this study cannot tell us

Cross-sectional design cannot establish causation. Retrospective recall of initiation age. Data from 2001-2003 may not reflect current cannabis landscape. Cannot control for all confounders (mental health history, trauma).

How to read the evidence

Large national sample with appropriate controls, but cross-sectional design and retrospective recall limit causal inference.

When this study was published

Published in 2022 using survey data from 2001-2003.

The bigger picture

While the study cannot prove cannabis causes suicidal behavior, the strong association with early initiation, independent of other substance use and demographics, warrants attention in youth prevention programs.

Questions still open

Does early cannabis exposure disrupt neurodevelopmental processes that protect against suicidal behavior? Would the associations change with more recent data reflecting higher-potency cannabis?

Common questions

Is early cannabis use linked to suicide risk?

In this large study, starting cannabis before age 15 was associated with 4.4 times higher odds of suicide attempt and 3.3 times higher odds of suicidal ideation, significantly higher than later initiation.

Does starting later reduce the risk?

Later initiation (after age 14) was still associated with elevated risk (2.6x for attempt), but significantly less than early initiation (4.4x for attempt).

Read the original research

Early Age of Cannabis Initiation and Its Association With Suicidal Behaviors.

Substance abuse : research and treatment, 16, 11782218221116731

View on PubMed ↗Publisher’s paper ↗

Citation

Ahuja, Manik; Awasthi, Manul; Gim, Suzanna; Records, Kathie; Cimilluca, Johanna; Al-Ksir, Kawther; Tremblay, Johnathan; Doshi, Riddhi P; Sathiyasaleen, Thiveya; Fernandopulle, Praveen. (2022). Early Age of Cannabis Initiation and Its Association With Suicidal Behaviors.. Substance abuse : research and treatment, 16, 11782218221116731. https://doi.org/10.1177/11782218221116731