— Review of data shows cause for alarm
by Libby Stuyt, MD
Research data linking marijuana use to people with suicidal ideation, attempts, and completed suicides are steadily increasing.
Many states, including Colorado, have made post-traumatic stress disorder (PTSD) an approved condition for medical marijuana. As a psychiatrist having treated many people with PTSD, I know that marijuana is not the answer, similarly to why benzodiazepines or alcohol are not the answer to treat PTSD.
A study of 3,233 veterans found that cannabis use disorder (CUD) was significantly associated with both current suicidal ideation and lifetime suicide attempts compared to veterans with no lifetime history of CUD. The significance persisted even after adjusting for sex, PTSD, depression, alcohol use disorder, non-cannabis drug use disorder, history of childhood sexual abuse, and combat exposure.
Colorado’s rate for veteran suicides is significantly higher than the national rate. There were 217 veteran suicide deaths in Colorado in 2019 – an all-time high and a 25% increase over 2018.
Colorado has seen a gradual increase in suicides, from 795 people in 2004 to 1,242 people in 2018 – a trend mirroring increased commercialization of marijuana there.
Even more alarming is the correlation with marijuana and suicide found among adolescents. A large systematic review and meta-analysis found that suicidal ideation and suicide attempts were significantly higher in adolescent cannabis users than in non-users.
“Many states, including Colorado, have made post-traumatic stress disorder (PTSD) an approved condition for medical marijuana. As a psychiatrist having treated many people with PTSD, I know that marijuana is not the answer, similarly to why benzodiazepines or alcohol are not the answer to treat PTSD.”
– Dr. Libby Stuyt
In Colorado, marijuana is the most common drug found in toxicology of teens who die by suicide – even greater than alcohol. There has been a significant increase in the number of teen suicides in Colorado in the last 5 years, up to 80 in 2019, along with a significant increase in the number with marijuana found in their system.
A much larger recent study found recreational cannabis laws permitting dispensaries and lacking dose-related restrictions were associated with significant increases in assaults among people younger than 21 years and increases in self-harm for men ages 21 to 39 years, compared with states with no medical or recreational cannabis laws.
There is increasing research demonstrating that regular use of marijuana with THC greater than 10% can result in development of psychotic symptoms. Cannabis-induced psychosis can become permanent.
Multiple studies link cannabis use with psychotic disorders and an increasing risk of violence. This can include violence toward one’s self as well as others. A study of 1,136 patients discharged from acute psychiatric facilities found cannabis a moderate predictor of subsequent violent behavior – even more so than alcohol or cocaine.
Cannabis use can cause or exacerbate psychotic symptoms such as delusions; alter a person’s sense of reality by causing perceptual distortions; cause a person to feel anxious, panicky, and paranoid about their surroundings and others; impair executive functioning, creating problems with impulse control and decision-making; and cannabis withdrawal can cause people to feel irritable, restless, and anxious. It is logical that any of these could contribute to suicidal thoughts in someone whose mood is dysregulated by cannabis.
Libby Stuyt, MD, is an addiction psychiatrist in Colorado.