Cannabis use declined among most adolescents since the 1990s but not among those with suicidal thoughts | Research

The takeaway

While cannabis use dropped significantly among adolescents without suicidal histories over 32 years, it has not declined among those with recent suicidal ideation or attempts, especially females.

Adolescent mental health providers, school counselors, suicide prevention researchers

Cannabis use has not declined since the 1990s among adolescents with suicidal thoughts or attempts

What the researchers found

Cannabis use prevalence decreased since 1995 for adolescents with no STB history but showed no significant decline for those with recent suicidal ideation or attempts; female adolescents with suicide attempt history showed plateauing cannabis use since the 1990s.

Why it matters

The population-level success story of declining adolescent substance use does not extend to the most psychiatrically vulnerable youth, who may need targeted intervention.

The numbers in context

254,675 adolescents over 32 years (1991-2023); cannabis use declined significantly since 1995 for no-STB group; no significant decline for suicidal ideation or attempt groups; female suicide attempters showed cannabis use plateauing since the 1990s.

How the study worked

Joinpoint regression analysis of 32 years (1991-2023) of Youth Risk Behavior Surveillance System data; 254,675 adolescents in grades 9-12 stratified by STB history and gender.

What this study cannot tell us

Self-reported data; STB measured as recent (past 12 months) which may not capture full history; cannot determine if substance use preceded or followed suicidal thoughts; repeated cross-sections, not longitudinal individuals.

How to read the evidence

32 years of nationally representative surveillance data with robust trend analysis, though repeated cross-sectional design cannot track individuals over time.

When this study was published

Published 2025, data from 1991-2023

The bigger picture

This finding challenges the assumption that broad-based prevention efforts are reaching all youth equally, with suicidal adolescents representing a persistent high-risk group.

Questions still open

Why are suicidal adolescents resistant to the broader decline in substance use? Are they self-medicating? Would integrated substance use and suicide prevention programs be more effective?

Common questions

Has adolescent cannabis use declined?

For most adolescents, yes. But among those with recent suicidal thoughts or attempts, cannabis use has not significantly declined since the 1990s.

Were there gender differences?

Yes. Female adolescents with a recent suicide attempt showed particularly resistant patterns, with cannabis use plateauing since the 1990s.

Read the original research

Alcohol and Cannabis Use Trends Among Adolescents With and Without a History of Recent Suicidal Thoughts and Behavior: 1991-2023.

The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 77(2), 300-307

View on PubMed ↗Publisher’s paper ↗

Citation

Cheek, Shayna M; Grove, Jeremy L; Barnes, Sarah E; Goldston, David B. (2025). Alcohol and Cannabis Use Trends Among Adolescents With and Without a History of Recent Suicidal Thoughts and Behavior: 1991-2023.. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 77(2), 300-307. https://doi.org/10.1016/j.jadohealth.2025.04.020