Analyzing NSDUH data from 2008-2020, marijuana addiction was among four substance addictions (with alcohol, pain relievers, and cocaine) that reliably predicted suicidal ideation, planning, and attempt across all survey years.
Crisis intervention clinicians and suicide risk assessors; addiction treatment providers integrating mental health screening.
Cannabis addiction: stable predictor of suicidality across 12 years
What the researchers found
Addictions to alcohol, pain relievers, marijuana, and cocaine were stable and reliable predictors of all three STB outcomes (ideation, planning, attempt) across 12 years. Cocaine was the exception, showing instability for suicide attempt prediction. The selected four-substance model had greater predictive accuracy than demographic factors alone or the remaining seven substances. Alcohol addiction alone had comparable predictive accuracy to all other ten addictions combined.
Why it matters
Identifying which substance addictions most reliably predict suicidality helps prioritize clinical screening. Cannabis addiction being among the four most stable predictors elevates its importance in suicide risk assessment, alongside the better-recognized risks of alcohol and opioids.
The numbers in context
NSDUH 2008-2020 data. 11 substance addictions tested. 4 stable predictors: alcohol, pain relievers, marijuana, cocaine. Selected model outperformed demographics-only and non-selected substances models. Alcohol alone matched predictive power of other 10 substances combined.
How the study worked
Analysis of National Survey on Drug Use and Health (NSDUH) data from 2008-2020 examining eleven substance addictions as predictors of suicidal thoughts and behaviors. Stability of predictions tested across multiple survey years.
What this study cannot tell us
Cross-sectional survey data collected annually; cannot determine temporal ordering. Self-reported substance use and suicidality. "Addiction" defined by survey criteria, not clinical diagnosis. Association does not prove causation.
How to read the evidence
Very large nationally representative dataset spanning 12 years with stability testing, though cross-sectional design limits causal claims.
When this study was published
2024 study
The bigger picture
The stability of marijuana addiction as a suicidality predictor across 12 years of data, spanning periods of changing legalization and social norms, suggests this is a robust clinical relationship that should inform suicide risk assessment protocols.
Questions still open
- Does treating cannabis addiction reduce suicidal risk? Is the association driven by the addiction itself or by the underlying conditions that lead to both cannabis addiction and suicidality?
Common questions
Does cannabis cause suicidal thoughts?
How does cannabis compare to alcohol as a suicide risk factor?
Read the original research
Substance addictions and suicidal thoughts and behaviors: Evidence from a multi-wave epidemiological study.
Psychiatry research, 334, 115821
Citation
Giugovaz, Angela; Grassi, Michele; Marchetti, Igor. (2024). Substance addictions and suicidal thoughts and behaviors: Evidence from a multi-wave epidemiological study.. Psychiatry research, 334, 115821. https://doi.org/10.1016/j.psychres.2024.115821
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