Cannabis use disorder linked to suicidal ideation in rural Maryland ER visits

Among rural Maryland ER patients, cannabis use disorder was associated with a 2.7-fold higher likelihood of suicidal ideation, though depression carried a far stronger association.

Ahuja, Manik et al.·Chronic stress (Thousand Oaks·2024·Moderate EvidenceCross-Sectional
RTHC-05069Cross SectionalModerate Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Cannabis use disorder was positively associated with suicidal ideation in rural Maryland emergency department visits (OR 2.67, 95% CI 1.37-5.18), though its association was smaller than that of major depressive disorder (OR 79.3), alcohol use disorder (OR 6.87), or opioid use disorder (OR 5.39).

Key Numbers

Cannabis use disorder OR for suicidal ideation: 2.67 (95% CI 1.37-5.18). Opioid use disorder: OR 5.39 (95% CI 3.63-7.99). Alcohol use disorder: OR 6.87 (95% CI 4.97-9.51). Major depressive disorder: OR 79.30 (95% CI 51.91-121.15).

How They Did This

Researchers analyzed Maryland HCUP State Emergency Department Database discharge data, using logistic regression to assess associations between ICD-10 coded substance use disorders and suicidal ideation, controlling for income, race, age, and gender.

Why This Research Matters

Rural communities face disproportionate burdens of substance use and suicide, with fewer mental health resources. Understanding which substance use disorders carry the strongest associations with suicidal ideation could help target limited rural prevention resources.

The Bigger Picture

This study places cannabis use disorder within the broader landscape of rural mental health crises. While cannabis carries the smallest association with suicidal ideation among the substances studied, the co-occurrence of multiple substance use disorders and depression in rural populations suggests compounding risk.

What This Study Doesn't Tell Us

Cross-sectional ER data cannot establish causation or determine the direction of the association. Rural Maryland may not represent other rural regions. ICD-10 coding may undercount cannabis use disorder. The study could not assess severity or frequency of use.

Questions This Raises

  • ?Does the association between cannabis use disorder and suicidal ideation differ by frequency or method of use?
  • ?How does cannabis interact with co-occurring depression to affect suicide risk in rural populations?

Trust & Context

Key Stat:
OR 2.67 for suicidal ideation
Evidence Grade:
Cross-sectional emergency department data with statistical controls, but cannot establish causation and limited to one state.
Study Age:
2024 study using Maryland HCUP emergency department data
Original Title:
Substance Use Disorder and Suicidal Ideation in Rural Maryland.
Published In:
Chronic stress (Thousand Oaks, Calif.), 8, 24705470241268483 (2024)
Database ID:
RTHC-05069

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Was cannabis the biggest risk factor for suicidal ideation?

No. Depression had by far the strongest association (OR 79.3), followed by alcohol use disorder (OR 6.87) and opioid use disorder (OR 5.39). Cannabis use disorder had the smallest association (OR 2.67) among the conditions studied.

Does this prove cannabis causes suicidal thoughts?

No. This cross-sectional study found an association, not a causal link. People with suicidal ideation may be more likely to use cannabis, or shared factors like trauma may drive both.

Read More on RethinkTHC

Cite This Study

RTHC-05069·https://rethinkthc.com/research/RTHC-05069

APA

Ahuja, Manik; Jain, Monika; Mamudu, Hadii; Al Ksir, Kawther; Sathiyaseelan, Thiveya; Zare, Shahin; Went, Nils; Fernandopulle, Praveen; Schuver, Trisha; Pons, Amanda; Dooley, McKenzie; Nwanecki, Chisom; Dahal, Kajol. (2024). Substance Use Disorder and Suicidal Ideation in Rural Maryland.. Chronic stress (Thousand Oaks, Calif.), 8, 24705470241268483. https://doi.org/10.1177/24705470241268483

MLA

Ahuja, Manik, et al. "Substance Use Disorder and Suicidal Ideation in Rural Maryland.." Chronic stress (Thousand Oaks, 2024. https://doi.org/10.1177/24705470241268483

RethinkTHC

RethinkTHC Research Database. "Substance Use Disorder and Suicidal Ideation in Rural Maryla..." RTHC-05069. Retrieved from https://rethinkthc.com/research/ahuja-2024-substance-use-disorder-and

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.