J Stud Alcohol Drugs. 2026 Apr 17. doi: 10.15288/jsad.25-00481. Online ahead of print.
ABSTRACT
OBJECTIVE: Amid rising cannabis use, declining perceived harm, and policy liberalization over the past 15 years, we examined whether the association between cannabis use disorder (CUD) and past-year suicidal ideation among U.S. adults changed from 2014-2023 and varied by sex, age, and race/ethnicity.
METHOD: Using data from 415,861 adults in the 2014-2023 National Surveys on Drug Use and Health, we examined temporal association change between past-year suicidal ideation and CUD (≥2 of 9 harmonized DSM-5 criteria). Logistic regression models, adjusted for demographic, social, clinical, and geographic covariates, tested whether survey year moderated the CUD-suicidal ideation association overall and in strata by sex, age, and race/ethnicity.
RESULTS: Adults with cannabis use disorder had 57% higher odds of past-year suicidal ideation than those without (OR, 1.57; 95% CI, 1.44-1.72) across years. Joint Wald tests showed no evidence that the association changed over time overall (p = 0.12) nor within strata defined by sex or age. Although the joint interaction test suggested some variation among Hispanic respondents (p = 0.01), no individual year-specific interaction terms remained statistically significant after Bonferroni correction.
CONCLUSIONS: Adults with CUD had higher odds of suicidal ideation but, contrary to expectations, the strength of this association remained stable from 2014-2023 and did not differ significantly across sex, age, or racial/ethnic groups despite widespread legalization, increased potency, and shifting norms.
PMID:41995600 | DOI:10.15288/jsad.25-00481
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