Cannabis use often co-occurs with suicidal thoughts and psychological distress — and more-so among women

The link between cannabis use and psychological distress is stronger for women than men, according to new research published in The Canadian Journal of Psychiatry. The findings indicate that the negative effects of cannabis use may be more pronounced for women.

“Regular cannabis use is much more common among individuals who have mental health disorders. Depression (the most common mental health disorder) and suicide have been consistently associated with cannabis use,” said study author Jillian Halladay of McMaster University.

“Given Canada recently legalized recreational cannabis nationally, we thought it was important to examine who might be at particular risk of both using cannabis and also experiencing depression or suicide.”

“There is evidence to suggest that females respond to substance use differently than males. While males may be more likely to use substances, females may experience more consequences from substance use. In regards to cannabis specifically, it is thought that the area of the brain that cannabis acts on develops and acts differently in females compared to males,” Halladay explained.

“We wanted to examine whether being female and using cannabis was associated with a greater likelihood of experiencing suicidal thoughts or attempts, depression, and psychological distress.”

For their study, Halladay and her colleagues analyzed data from 43,466 individuals who participated in the 2002 and 2012 Canadian Community Health Survey.

The researchers found that people who reported using cannabis occasionally or regularly tended to also report more major depressive episodes, suicidal thoughts and attempts, and psychological distress.

“Both males and females who used cannabis at least once a month were more likely to experience depression, psychological distress, and suicidal thoughts or attempts than those who did not use cannabis,” Halladay told PsyPost.

“This association was stronger for females compared to males when considering more frequent use of cannabis. For example, males who used cannabis more than once a week were 3 times as likely to experience suicidal thoughts or attempts compared to males who did not use cannabis while females who used more than once a week were 5 times as likely.”

The study includes some limitations. It is unclear whether cannabis use increases the risk of depression, psychological distress, and suicidal thoughts — or whether people who are depressed, distressed, and suicidal are more likely to use cannabis.

“Our data is cross-sectional (i.e. collected at one point in time), which means we can not determine causality or what came first. What we do know is that cannabis use often co-occurs alongside suicidal thoughts, depression and psychological distress, and more-so among females,” Halladay explained.

Previous research that reviewed 12 longitudinal studies, however, suggests that cannabis use is linked to poorer treatment outcomes in patients with anxiety and mood disorders.

“Cannabis is complicated,” Halladay added. “There are over 500 different compounds in cannabis that occur in various combinations. These different combinations of compounds are likely going to produce different effects in different people. Our findings are based on recreational cannabis use among Canadian adults aged 15 years or older in the general population over the past 20 years.”

The study, “Sex Differences in the Association Between Cannabis Use and Suicidal Ideation and Attempts, Depression, and Psychological Distress Among Canadians“, was authored by Jillian E. Halladay, Michael H. Boyle, Catharine Munn, Susan M. Jack, and Katholiki Georgiades.