25% of Medical Cannabis Patients Had Suicidal Thoughts at Treatment Entry, With Rates Declining Over 12 Months

At treatment entry, 25% of patients reported suicidal ideation. Those with SI had significantly higher depression scores (17.4 vs 11.3), lower well-being, and lower quality of life. After 3 months of cannabis-based medicinal product treatment, suicidal ideation significantly decreased. Over 12 months, depression scores dropped substantially in those with initial SI (17.7 to 10.3) and in other patients (11.1 to 7.0).

Prospective observational study of 3,781 patients at treatment entry, with follow-up data for 2,112 at 3 months and 777 at 12 months. Suicidal ideation and depression assessed using PHQ-9 items. Additional data on demographics and well-being.

Medical cannabis patients have high rates of mental health comorbidities, and suicidal ideation in this population is underrecognized. The finding that SI decreased with treatment is important, though the observational design means this could reflect regression to the mean or other factors.

This study highlights that medical cannabis patients are a psychologically vulnerable population. Whether cannabis treatment itself contributes to the improvement in suicidal ideation or whether other factors are responsible cannot be determined from this design.

Observational with no control group. Large dropout from 3,781 to 777 over 12 months introduces selection bias. Self-reported SI may be underreported. Cannot determine whether cannabis treatment caused improvement. PHQ-9 is a screening tool, not a diagnostic assessment.