Cannabis Use Among Army Veterans Predicted Later Suicidal Thoughts
In a longitudinal study of 6,811 US Army veterans, cannabis use was among several substance use behaviors that predicted subsequent suicidal ideation and suicide planning, though not suicide attempts.
Quick Facts
What This Study Found
Cannabis use at baseline was significantly associated with subsequent suicidal ideation (AOR range: 1.42-2.60 across substance use measures) and suicide planning. Binge drinking, prescription drug abuse, illicit drug use, and alcohol use disorder showed similar associations. No substance use variable predicted suicide attempts as a main effect, though interactions with depression and sex were found.
Key Numbers
6,811 veterans/reservists; two survey waves; substance use variables associated with ideation (AOR 1.42-2.60) and planning; no main effects on attempts; interactions with sex and depression found for some substances; 1,527 had ideation at baseline
How They Did This
Longitudinal survey of 6,811 US Army veterans and deactivated reservists who completed surveys at two timepoints (2016-2018 and 2018-2019). Logistic regression adjusted for demographics and prior suicidality examined associations between substance use and subsequent suicidal behaviors.
Why This Research Matters
Veterans have elevated suicide rates, and understanding modifiable risk factors is critical. This study identifies substance use, including cannabis, as a prospective predictor of suicidal thoughts, providing potential screening and intervention targets.
The Bigger Picture
The finding that substance use predicts ideation and planning but not attempts suggests that substance use may increase suicidal thinking without necessarily being the factor that pushes someone to act. This has implications for how clinicians assess and intervene on suicide risk.
What This Study Doesn't Tell Us
Self-reported substance use and suicidality, survey-based study may miss those in acute crisis, Army-specific population may not generalize to all veterans, two-year follow-up may miss longer-term effects, attrition between waves
Questions This Raises
- ?Does treating cannabis use disorder reduce suicidal ideation in veterans?
- ?Are the associations driven by cannabis itself or by co-occurring conditions?
- ?Should cannabis use screening be integrated into veteran suicide risk assessment?
Trust & Context
- Key Stat:
- Cannabis use among veterans predicted 1.4-2.6x higher odds of subsequent suicidal ideation
- Evidence Grade:
- Large longitudinal study with prospective design controlling for prior suicidality; strong methodology but self-reported measures
- Study Age:
- Published 2025
- Original Title:
- Prospective associations of alcohol and drug misuse with suicidal behaviors among US Army soldiers who have left active service.
- Published In:
- Psychological medicine, 55, e119 (2025)
- Authors:
- Campbell-Sills, Laura, Sun, Xiaoying, Kessler, Ronald C(5), Ursano, Robert J, Jain, Sonia, Stein, Murray B
- Database ID:
- RTHC-06151
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked Questions
Does cannabis use increase suicide risk in veterans?
Cannabis use was associated with 1.4-2.6 times higher odds of subsequent suicidal thoughts and planning in this study of 6,811 Army veterans, though it did not predict actual suicide attempts as a standalone factor.
Is cannabis the only substance linked to veteran suicide risk?
No. Binge drinking, prescription drug abuse, illicit drug use, and alcohol use disorder showed similar associations with suicidal ideation. The relationship between substance use and suicide risk is broad, not cannabis-specific.
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Cite This Study
https://rethinkthc.com/research/RTHC-06151APA
Campbell-Sills, Laura; Sun, Xiaoying; Kessler, Ronald C; Ursano, Robert J; Jain, Sonia; Stein, Murray B. (2025). Prospective associations of alcohol and drug misuse with suicidal behaviors among US Army soldiers who have left active service.. Psychological medicine, 55, e119. https://doi.org/10.1017/S0033291725000947
MLA
Campbell-Sills, Laura, et al. "Prospective associations of alcohol and drug misuse with suicidal behaviors among US Army soldiers who have left active service.." Psychological medicine, 2025. https://doi.org/10.1017/S0033291725000947
RethinkTHC
RethinkTHC Research Database. "Prospective associations of alcohol and drug misuse with sui..." RTHC-06151. Retrieved from https://rethinkthc.com/research/campbell-sills-2025-prospective-associations-of-alcohol
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.