Cannabis use declined among most adolescents since the 1990s but not among those with suicidal thoughts
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.
Quick Facts
What This Study 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.
Key Numbers
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 They Did This
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.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- Cannabis use has not declined since the 1990s among adolescents with suicidal thoughts or attempts
- Evidence Grade:
- 32 years of nationally representative surveillance data with robust trend analysis, though repeated cross-sectional design cannot track individuals over time.
- Study Age:
- Published 2025, data from 1991-2023
- Original Title:
- Alcohol and Cannabis Use Trends Among Adolescents With and Without a History of Recent Suicidal Thoughts and Behavior: 1991-2023.
- Published In:
- The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 77(2), 300-307 (2025)
- Authors:
- Cheek, Shayna M, Grove, Jeremy L(4), Barnes, Sarah E, Goldston, David B
- Database ID:
- RTHC-06190
Evidence Hierarchy
Follows a group of people over time to track how outcomes develop.
What do these levels mean? →Frequently Asked 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 More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-06190APA
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
MLA
Cheek, Shayna M, et al. "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, 2025. https://doi.org/10.1016/j.jadohealth.2025.04.020
RethinkTHC
RethinkTHC Research Database. "Alcohol and Cannabis Use Trends Among Adolescents With and W..." RTHC-06190. Retrieved from https://rethinkthc.com/research/cheek-2025-alcohol-and-cannabis-use
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.