Among 530 psychiatric inpatients, cannabis use was associated with lower suicidal intensity in females but not males, while increased cannabis use combined with low psychological flexibility predicted greater suicidal intensity in males.
Psychiatrists, suicide risk assessors, researchers studying sex differences in substance use and mental health.
Cannabis was linked to lower suicidal intensity in female but not male psychiatric inpatients
What the researchers found
Cannabis use was associated with lower suicidal ideation intensity for females (p=.026) but not males (p=.525). In males, increased cannabis use combined with lower psychological flexibility was associated with greater suicidal intensity (p=.049). 49.6% of the sample had attempted suicide, 34.3% had suicidal ideation, and 16% had no suicidality.
Why it matters
The sex-specific findings challenge one-size-fits-all assumptions about cannabis and suicide risk. The role of psychological flexibility as a mediator suggests that the mental health context in which cannabis is used may matter more than use itself.
The numbers in context
n=530; 49.6% prior suicide attempt; 34.3% suicidal ideation; 16% no suicidality; female cannabis-SII association p=.026; male cannabis x low flexibility p=.049.
How the study worked
Path analysis of 530 psychiatric inpatients aged 18+, using the Columbia-Suicide Severity Rating Scale and ASSIST for cannabis use. Model included moderating and mediating factors: psychiatric comorbidity, emotional regulation, psychological flexibility, and polygenic risk scores.
What this study cannot tell us
Cross-sectional design in a psychiatric inpatient sample, which may not generalize. Cannot determine causation. Path analysis results should be considered exploratory. Self-reported cannabis use.
How to read the evidence
Moderate: Meaningful sample size with sophisticated path analysis including genetic risk scores, but cross-sectional inpatient design limits generalizability.
When this study was published
Published in 2025.
The bigger picture
This adds to the complex picture of cannabis and suicide, where effects appear to depend on sex, comorbidities, and psychological factors rather than cannabis use alone.
Questions still open
- Why might cannabis use be associated with lower suicidal intensity in women but not men? Is psychological flexibility a targetable intervention for male cannabis users at suicide risk?
Common questions
Does this mean cannabis prevents suicide in women?
What is psychological flexibility?
Read the original research
The association between cannabis use and suicidal intensity in psychiatric inpatients.
The American journal on addictions, 34(5), 506-516
Citation
Oladunjoye, Adeolu Funso; Swann, Alan; Kosten, Thomas R; Patriquin, Michelle; Bigdeli, Tim; Barr, Peter; Wilkinson, Anna V; Harding, Mark J; Nielsen, David A; Graham, David P. (2025). The association between cannabis use and suicidal intensity in psychiatric inpatients.. The American journal on addictions, 34(5), 506-516. https://doi.org/10.1111/ajad.70047
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