Cannabis use linked to higher suicidal ideation among opioid use disorder patients

Among 2,335 patients with opioid use disorder, current cannabis use was associated with 41% higher odds of suicidal ideation over the past 30 days, even after adjusting for depression and anxiety.

Naji, Leen et al.·Journal of addiction medicine·2021·Moderate EvidenceCross-Sectional
RTHC-03373Cross SectionalModerate Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=2,335

What This Study Found

Current cannabis use was associated with suicidal ideation (OR 1.41, 95% CI 1.11-1.80, P = 0.005) in multivariable analysis. Male sex (OR 1.84), younger age (OR 1.02 per year), and more anxiety/depression symptoms (OR 1.16) also predicted suicidal ideation. 51% of OUD patients reported current cannabis use.

Key Numbers

2,335 OUD patients; 51% current cannabis use; cannabis-suicidal ideation OR 1.41; male sex OR 1.84; anxiety/depression OR 1.16

How They Did This

Cross-sectional multivariable logistic regression analysis of 2,335 participants with opioid use disorder from a large cohort. Self-reported current cannabis use and 30-day suicidal ideation were the primary variables.

Why This Research Matters

Patients with opioid use disorder are already at high suicide risk. Finding that concurrent cannabis use further increases suicidal ideation in this population is clinically important, especially as cannabis is sometimes promoted for harm reduction in opioid dependence.

The Bigger Picture

This creates a tension with studies showing cannabis may help reduce opioid use: if cannabis increases suicidal ideation in OUD patients, the harm reduction calculus becomes more complex.

What This Study Doesn't Tell Us

Cross-sectional design cannot determine causation. Self-reported cannabis use and suicidal ideation. Cannot control for all confounders. Direction of association unclear.

Questions This Raises

  • ?Does cannabis cause suicidal ideation in OUD patients, or do those with more severe mental health issues use both cannabis and have suicidal thoughts?
  • ?Would specific cannabinoid profiles (high CBD, low THC) have a different association?
  • ?Should OUD treatment programs screen for cannabis use as a suicide risk factor?

Trust & Context

Key Stat:
41% higher odds of suicidal ideation with cannabis use in OUD patients
Evidence Grade:
Large cohort with multivariable adjustment, though cross-sectional design limits causal inference.
Study Age:
Published in 2021.
Original Title:
The Role of Cannabis Use in Suicidal Ideation Among Patients With Opioid Use Disorder.
Published In:
Journal of addiction medicine, 15(5), 370-375 (2021)
Database ID:
RTHC-03373

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Does cannabis increase suicide risk in opioid-dependent people?

This study found an association between cannabis use and suicidal ideation in OUD patients, but cannot determine whether cannabis directly increases risk or whether shared underlying factors explain both.

How common was cannabis use among opioid patients?

Very common. 51% of the 2,335 OUD patients reported current cannabis use.

Read More on RethinkTHC

Cite This Study

RTHC-03373·https://rethinkthc.com/research/RTHC-03373

APA

Naji, Leen; Rosic, Tea; Sanger, Nitika; Dennis, Brittany; Worster, Andrew; Paul, James; Thabane, Lehana; Samaan, Zainab. (2021). The Role of Cannabis Use in Suicidal Ideation Among Patients With Opioid Use Disorder.. Journal of addiction medicine, 15(5), 370-375. https://doi.org/10.1097/ADM.0000000000000781

MLA

Naji, Leen, et al. "The Role of Cannabis Use in Suicidal Ideation Among Patients With Opioid Use Disorder.." Journal of addiction medicine, 2021. https://doi.org/10.1097/ADM.0000000000000781

RethinkTHC

RethinkTHC Research Database. "The Role of Cannabis Use in Suicidal Ideation Among Patients..." RTHC-03373. Retrieved from https://rethinkthc.com/research/naji-2021-the-role-of-cannabis

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.