Substance Use
Trends in the association between cannabis use disorder and suicidal ideation in the United States, 2014–2023 Tosin Oyetunji* Tosin Oyetunji Oyetunji Oyetunji Oyetunji Department of Public Health, University of California, Merced; Merced, CA USA
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. 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 CUD (≥2 of 9 harmonized DSM-5 criteria) and suicidal ideation. 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. 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. Adjusted models including interaction terms for CUD and survey year showed elevated odds in certain years, such as 2016 (OR, 1.71; 95% CI, 1.23–2.36). Among males, similar elevations occurred in 2016 (OR, 2.11; 95% CI, 1.34–3.30) and 2021 (OR, 1.77; 95% CI, 1.12–2.80). However, none of these interactions reached Bonferroni-adjusted statistical significance. Results suggested that the strength of the association between cannabis use disorder and suicidal ideation 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. Additional research is needed to examine longitudinal CUD-suicidal ideation associations, and to incorporate potency-specific exposure (THC concentration, product type, concentrate use) measurements to clarify potential dose-response relationships.