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Document Type

Review

Abstract

Objective: Suicide is a leading cause of death for U.S. adolescents, while cannabis is the most used illicit substance. With changing legalization and perceptions of harm, this review aimed to organize and overview the evidence on the association between cannabis use and suicidality (ideation, planning, and attempts) among U.S. high school students.

Methods: A comprehensive search of PubMed, PsycINFO, and Scopus databases was conducted to identify relevant studies. This scoping review allowed an analysis of the findings of 37 articles. The article consisted of cross-sectional surveys, prospective cohort studies, and meta-analyses, that examined the link between cannabis use and suicidality in U.S. high-school-aged populations.

Results: The evidence consistently shows that cannabis use is associated with a significantly elevated risk for suicidality. Meta-analyses reported that cannabis users had more than double the odds of a suicide attempt and a 1.5-to-2.0-fold increased odds of suicidal ideation compared to non-users. This association remained significant even after statistically controlling for depression. Stronger associations were identified among females, adolescents engaging in polysubstance use, and those using cannabis at school.

Conclusions: The convergence of findings establishes cannabis use as a consistent correlate and potential independent risk factor for adolescent suicidality. These findings underscore the need for targeted prevention strategies for at-risk youth and highlight the importance of future longitudinal research to further clarify the causal pathways and inform effective public health interventions.

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