Women who use cannabis regularly report more suicidal thoughts and psychological distress than male counterparts | Research

The takeaway

Among 43,466 Canadians, women who used cannabis regularly had significantly higher psychological distress and were more likely to report suicidal thoughts and attempts than men who used at the same frequency.

Women who use cannabis, clinicians, and researchers interested in sex differences in cannabis-related mental health outcomes.

Regular female cannabis users had significantly higher suicidal thoughts and distress than male peers

What the researchers found

Significant sex differences were found for cannabis use and suicidal thoughts/attempts and psychological distress, but not for major depressive episodes. Occasional female users (1-4x/month) had higher distress than male counterparts. Regular female users (>1x/week) had higher distress and more suicidal thoughts and attempts than regular male users.

Why it matters

Most cannabis research does not examine sex differences, yet this study shows the mental health associations differ significantly between men and women. This has direct implications for how cannabis risks are communicated and how clinicians screen for problems.

The numbers in context

43,466 Canadians surveyed. Occasional use (1-4x/month): women had higher psychological distress than men. Regular use (>1x/week): women had higher distress AND more suicidal thoughts/attempts. No sex difference for major depressive episodes.

How the study worked

Analysis of 2002 and 2012 Canadian Community Health Survey-Mental Health data (n=43,466), a nationally representative sample of Canadians aged 15+, using linear and binary logistic regressions with weighting and bootstrapping.

What this study cannot tell us

Cross-sectional design cannot determine whether cannabis causes worse mental health in women or whether women with worse mental health are more likely to use cannabis. Self-reported measures. Combining 2002 and 2012 data spans a period of changing cannabis attitudes.

How to read the evidence

Moderate: large nationally representative sample with appropriate statistical methods, but cross-sectional design.

When this study was published

Published in 2019, using 2002 and 2012 data.

The bigger picture

If women are more vulnerable to cannabis-associated emotional problems, current public health messaging that treats all users the same may be inadequate. Sex-specific risk communication and clinical screening approaches may be needed.

Questions still open

What biological or social factors explain the sex difference? Is the association specific to certain cannabis products or potencies? Would these sex differences persist in a clinical sample versus a population survey?

Common questions

Does cannabis affect women's mental health differently than men's?

This study found women who used cannabis regularly reported more psychological distress and suicidal thoughts than men using at the same frequency. The association was not found for major depression, suggesting a specific pattern rather than generally worse outcomes.

Should women be more careful with cannabis?

The data suggests being female may be a risk factor for cannabis-associated emotional problems at higher frequencies of use. The authors recommend incorporating sex as a factor in public health messaging and clinical screening.

Read the original research

Sex Differences in the Association Between Cannabis Use and Suicidal Ideation and Attempts, Depression, and Psychological Distress Among Canadians.

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 64(5), 345-350

View on PubMed ↗Publisher’s paper ↗

Citation

Halladay, Jillian E; Boyle, Michael H; Munn, Catharine; Jack, Susan M; Georgiades, Katholiki. (2019). Sex Differences in the Association Between Cannabis Use and Suicidal Ideation and Attempts, Depression, and Psychological Distress Among Canadians.. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 64(5), 345-350. https://doi.org/10.1177/0706743718804542