People with Cannabis Use Disorder Had 22 Times the Suicide Attempt Rate of the General Population

What the researchers found

The crude suicide attempt rate among people with cannabis use disorder was 2.5 per 1,000 person-years, over 22 times higher than the general population. Risk was higher in females, people with co-occurring alcohol use disorder, those with any psychiatric diagnosis, within one year of first treatment visit, and during the COVID-19 period.

Why it matters

The 22-fold higher suicide attempt rate underscores that cannabis use disorder is not a benign condition and is associated with serious mental health consequences. The elevated risk in the first year after initial clinical contact highlights a critical window for intervention.

The numbers in context

Suicide attempt rate: 2.5 per 1,000 person-years. Over 22 times higher than general population. Higher risk: females, co-occurring alcohol use disorder, any psychiatric diagnosis, within 1 year of first visit, during COVID-19 period. Data from Bologna metro area, 2009-2019.

How the study worked

Retrospective cohort study using electronic health records from Bologna, Italy, identifying individuals diagnosed with cannabis use disorder from 2009-2019 and tracking their emergency department visits for suicide attempts through the same period.

What this study cannot tell us

Observational study that cannot establish whether cannabis use disorder causes elevated suicide risk or both share common underlying factors (depression, trauma, other psychiatric conditions). ICD coding may not capture all cannabis use disorders. Single Italian metro area. Cannot distinguish between cannabis and concurrent substance use effects on suicide risk.

How to read the evidence

Moderate evidence from a population-based record linkage study with a 10-year follow-up period, though limited by the observational design and inability to control for all confounders.

When this study was published

2025 study analyzing health records from Bologna, Italy, 2009-2019.

The bigger picture

This study adds to the evidence that substance use disorders, including cannabis, are associated with significantly elevated suicide risk. Given the high prevalence of cannabis use globally, even a small proportion developing use disorder with elevated suicide risk represents a substantial public health burden.

Questions still open

• Is the suicide risk driven by the cannabis use disorder itself or by commonly co-occurring conditions? Would treating the cannabis use disorder reduce suicide risk? Are there specific clinical markers that identify which CUD patients are at highest suicide risk?

Common questions

Read the original research

Suicide Attempts in an Italian Population with Cannabis Use Disorders: Results of a Follow-Up Study.

Journal of psychoactive drugs, 57(1), 121-128

Citation

Pavarin, Raimondo Maria; Lia, Loredana; Tugnoli, Stefano; Caracciolo, Stefano. (2025). Suicide Attempts in an Italian Population with Cannabis Use Disorders: Results of a Follow-Up Study.. Journal of psychoactive drugs, 57(1), 121-128. https://doi.org/10.1080/02791072.2023.2287674

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