National survey data from 2011-2017 found that adolescent marijuana use was associated with suicidal ideation and attempts at rates broadly comparable to tobacco and alcohol, with stronger associations for more frequent use.
Parents, school counselors, adolescent psychiatrists, and policymakers evaluating youth cannabis access.
Marijuana-suicide association comparable to tobacco, stable 2011-2017
What the researchers found
Marijuana was more strongly associated with suicide attempts than with suicidal ideation. More frequent marijuana use was associated with significantly greater risk. The association remained stable from 2011 to 2017 despite changing attitudes toward marijuana. Results were broadly comparable to tobacco, though frequent alcohol use had a significantly stronger association than other substances.
Why it matters
As marijuana legalization expanded between 2011 and 2017, the association between marijuana use and suicidality in teens remained unchanged, suggesting that normalization of marijuana use has not reduced this risk.
The numbers in context
Six years of national data (2011-2017). Marijuana more strongly associated with attempts than ideation. Dose-response: more frequent use = greater risk. Association stable over time despite changing attitudes. Comparable to tobacco; weaker than frequent alcohol.
How the study worked
Analysis of the National Youth Risk Behavior Survey (2011-2017). Logistic regression controlling for confounders estimated marginal prevalence ratios for the association between marijuana, tobacco, and alcohol use and suicidal ideation and attempts.
What this study cannot tell us
Cross-sectional data cannot establish causation. Self-reported substance use and suicidality. National survey may miss highest-risk youth. Cannot determine whether marijuana use preceded or followed suicidal thoughts. Confounders may not be fully controlled.
How to read the evidence
Large national survey with multiple years of data and appropriate statistical controls, but cross-sectional design limits causal inference.
When this study was published
Published in 2022, using 2011-2017 survey data.
The bigger picture
The finding that marijuana's association with suicidality is comparable to tobacco and alcohol challenges the perception that marijuana is a lower-risk substance for adolescent mental health.
Questions still open
- Does marijuana use cause suicidal ideation, or do suicidal teens self-medicate with marijuana? Would the association hold with more recent data from states with recreational legalization?
Common questions
Is marijuana linked to teen suicide?
Has changing attitudes toward marijuana affected this risk?
Read the original research
Marijuana Use Is Associated With Suicidal Ideation and Behavior Among US Adolescents at Rates Similar to Tobacco and Alcohol.
Archives of suicide research : official journal of the International Academy for Suicide Research, 26(2), 520-533
Citation
Kahn, Geoffrey D; Wilcox, Holly C. (2022). Marijuana Use Is Associated With Suicidal Ideation and Behavior Among US Adolescents at Rates Similar to Tobacco and Alcohol.. Archives of suicide research : official journal of the International Academy for Suicide Research, 26(2), 520-533. https://doi.org/10.1080/13811118.2020.1804025
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