Health Services/Policy
Association between legal access to cannabis and rates of suicide mortality among adults in the United States from 2012 to 2023 Mengni Jing* Mengni Jing Jing University of Michigan
Objective
Cannabis legalization is associated with higher rates of suicide among adolescents and increased self-harm among adult males. Little is known the impacts of increased legal access to cannabis through dispensaries on suicide mortality. In this study we examined the associations between legal access to cannabis through both medical and recreational cannabis dispensaries (MCD and RCD, respectively) and and adult suicide death rates in the United States from 2012 to 2023.
Method
We used monthly adult suicide deaths (N = 528,056) across the 50 states and the District of Columbia from the National Center for Health Statistics Mortality Data during 2012–2023, and linked these to state-month dispensary policy status. We fit Bayesian spatiotemporal models using integrated nested Laplace approximation (INLA) to account for temporal trends and spatial correlation, adjusting for state-level sociodemographic characteristics and other relevant policy statuses. Primary models used a 1-month lag for dispensary policy status, with sensitivity analyses using a 1-year lag.
Results
The average unadjusted monthly adult suicide rate was 1.26 per 100,000 population: 1.25 in state-months without legal dispensary access, 1.16 with MCD, and 1.45 with RCD. In fully adjusted INLA models with a 1-month lag, there was no evidence of an association between MCD and suicide rates (IRR = 1.01; 95% CrI: 0.99–1.03). RCD showed a small, borderline positive association with suicide rates (IRR = 1.02; 95% CrI: 1.00–1.04) compared with no legal dispensary access. Results were similar for the sensitivity analysis of the 1-year time lag of policy status.
Conclusion
Legal access to recreational cannabis dispensaries may be associated with increasing suicide rates among adults, whereas legal access to medical dispensaries was not. Further research should identify which adult subpopulations are most affected and clarify the mechanisms that may explain the relationship between legal cannabis dispensaries and suicide mortality.
