Young adults, men, and sexual minorities had highest risk of co-occurring suicidality and cannabis use disorder

Men had twice the odds of co-occurring suicidal ideation and CUD (AOR=2.06). All older age groups had far lower odds than emerging adults (AORs 0.06-0.39). Black/African American adults had 4 times higher odds of co-occurring CUD and suicide attempts (AOR=4.05). Bisexual adults had over 3 times higher odds of co-occurring ideation and CUD (AOR=3.16). Native adults had over twice the odds (AOR=2.16).

Combined five years (2015-2019) of NSDUH data. Multinomial logistic regressions tested demographic differences in odds of suicidality only, CUD only, and co-occurring CUD and suicidality. Controlled for survey year, major depressive episode, and other substance use disorders.

Knowing which demographic groups carry the highest risk of co-occurring CUD and suicidality allows for targeted screening and prevention. The intersection of substance use and suicide risk is particularly dangerous, and certain groups are bearing a disproportionate burden.

The racial and sexual orientation disparities identified here likely reflect structural factors including discrimination, reduced access to mental healthcare, and minority stress. Addressing co-occurring CUD and suicidality requires culturally responsive approaches that account for these intersecting vulnerabilities.

Cross-sectional design. Self-reported CUD screening, not clinical diagnosis. Cannot determine temporal ordering. Some subgroup analyses may be underpowered. NSDUH excludes institutionalized and homeless populations.