Cannabis (marijuana) and suicidal ideation

A previous post discussed cannabis (marijuana) use and Memory and academic performance and symptoms of depression and anxiety from cannabis withdrawal.

This post talks about a study looking at cannabis use and suicidal ideation.

What was the study (1)?

Dr Han and colleagues looked at data from 281 650 adult participants in the 2008-2019 National Surveys of Drug Use and Health data.

What were some study results (1)?

  • Past-year Cannabis use disorder, daily cannabis use, and nondaily cannabis use were associated with a higher prevalence of past-year suicidal ideation, plan, and attempt in both sexes (eg, among individuals without Major depressive episode.)
  • The prevalence of suicidal ideation for those with vs without Cannabis use disorder was 13.9% vs 3.5% among women and 9.9% vs 3.0% among men; P < .001).
  • Suicide plan among those with Cannabis use disorder and major depressive episode was 52% higher for women [23.7%] than men [15.6%]; P < .001).

What are some caveats?

  • This is just one study and further research is needed.
  • While this study shows correlation between cannabis and suicidal ideation among those with depression, but does not show direct cause and effect.
  • Future research is needed to examine this increase in suicidality and to determine whether it is due to cannabis use or other overlapping risk factors.
  • According to this study, cannabis use can be concerning for suicidal ideation for those with and without major depressive disorder.

Additional information 

Treatment Facilities in the Columbus, Ohio area:

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Han B, Compton WM, Einstein EB, Volkow ND. Associations of Suicidality Trends With Cannabis Use as a Function of Sex and Depression Status. JAMA Netw Open. 2021;4(6):e2113025. doi:10.1001/jamanetworkopen.2021.13025

Marijuana (Cannabis) withdrawal and mental health

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

During times of stress people may become vulnerable to using cannabis as a way to cope.

Previous posts have discussed the negative impact of cannabis on memory, cognitive performance, and PTSD.

Cannabis withdrawal can cause and worsen a variety of mental health symptoms.

It is important become aware of this connection for mental health.

What are some symptoms of cannabis withdrawal syndrome (CWS)?

CWS involves 3 or more of the following symptoms within 7 days of reduced cannabis use (1):

  • Anxiety
  • Depression
  • Changes in sleep
  • Irritability, anger, or aggression
  • Appetite or weight disturbance
  • Restlessness
  • Somatic symptoms, such as headaches, sweating, nausea, vomiting, or abdominal pain.

How common is cannabis withdrawal syndrome?

A meta-analysis(2) of 47 studies including 23,518 participants, found that the prevalence of cannabis withdrawal syndrome was found to be 47% (2).

What are some factors that were associated with higher cannabis withdrawal syndrome (2)?

Researchers (2) found that Daily cannabis use, concurrent tobacco use, and use of other substances was associated with higher CWS (2).

Other thoughts:

  • It bears repeating that daily users were more likely to have cannabis withdrawal syndrome.
  • Some people may report cannabis use helping with anxiety, depression, or insomnia when it may just be masking the withdrawal symptoms caused by previous cannabis use.
  • Research shows an association between cannabis use and several medical, cognitive, functional, and psychosocial problems(3).
  • Short-term risks of cannabis use include impaired short-term memory motor dis-coordination, altered judgment, paranoia, and psychosis (4).
  • Some long-term effects of cannabis use include addiction, altered brain development, poor educational outcomes, cognitive impairment, diminished quality of life, increased risk psychotic disorders, injuries, motor vehicle collisions, and suicide (4,5).
  • Further research is needed on cannabis and mental health.

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Resources for mental health support can be found here.

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association Publishing; 2013.
  2. Bahji A, Stephenson C, Tyo R, Hawken ER, Seitz DP. Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of Cannabinoids: A Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3(4):e202370. doi:10.1001/jamanetworkopen.2020.2370.
  3. Crean  RD , Tapert SF , Minassian  A , Macdonald  K , Crane  NA , Mason  BJ .  Effects of chronic, heavy cannabis use on executive functions.   J Addict Med. 2011;5(1):9-15. doi:1097/ADM.0b013e31820cdd57
  4. Volkow  ND , Baler RD , Compton  WM , Weiss  SRB .  Adverse health effects of marijuana use.   N Engl J Med. 2014;370(23):2219-2227. doi:1056/NEJMra1402309
  5. Carvalho  AF , Stubbs B , Vancampfort  D ,  et al.  Cannabis use and suicide attempts among 86,254 adolescents aged 12-15 years from 21 low- and middle-income countries.   Eur Psychiatry. 2019;56:8-13. doi:1016/j.eurpsy.2018.10.006

Cannabis Might Worsen Memory and Stopping It Might Improve It

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

As of 2016, about 37 million individuals in the United States reported using cannabis / marijuana in the last year (1).

This is projected to increase in the future as many states move to legalize medicinal and or recreational cannabis or marijuana use.

As with many things like excessive junk food, excessive alcohol, tobacco, etc. being legal does NOT ALWAYS mean being  healthy.

For example, a recent study looked at cannabis and false memories (2), while another study looked at memory changes after stopping cannabis (3).

What was the first study? (2)

  • 23 healthy people aged 18 to 29 with and without tetrahydrocannabinol (THC).
  • They were asked to learn material while sober.
  • 2 days later, researchers compared memory recall among those who had used cannabis vs those who had not 2 hours before the test.

What were the study results of the first study (2)

In the first study, subjects who used cannabis 2 hours prior to the test were more likely to have false recognition of words and pictures that had not been presented during the sober study session (2).

What does this mean?

This small study suggests that cannabis use might impact academic performance (2), though further study is needed.

What was the second study (3)?

  • 88 individuals (Average age 21 years) who used cannabis at least weekly were randomized to 30 days of abstinence or to a control group, abstinence confirmed through biochemical testing (3).
  • Participants underwent cognitive testing at baseline and then weekly for 4 weeks.

What were the results of the second study? (3)

This 4 week study showed that improvements in memory started at week 1 and continued improvement through week 4. (3)

What does this mean?

  • This small study implies stopping cannabis may improve memory; and further longer, larger studies are underway (3).
  • Subjects used cannabis atleast weekly, and it is unclear if there is a difference in benefit among heavy vs light users.
  • These studies suggest that Cannabis or Marijuana may impact your ability to remember, and may cause false recall during tests; as well as memory improvement after stopping cannabis use.  A previous post showed that cannabis may increase alcohol intake (4).

How else is cannabis impacting you?

What are some useful resources regarding cannabis?

Drug treatment group at OSU Office of Student Life Counseling and Consultation Service.

Treatment Facilities in the Columbus, Ohio area:

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Center for Behavioral Health Statistics and Quality, 2016 National Survey on Drug Use and Health: Detailed Tables, Substance Abuse and Mental Health Services Administration, Rockville 2017.  http://www.samhsa.gov
  2. Doss MK et al. Δ9-Tetrahydrocannibinol at retrieval drives false recollection of neutral and emotional memories. Biol Psychiatry 2018 May 9; [e-pub]. (https://doi.org/10.1016/j.biopsych.2018.04.020) .
  3.  Schuster RM, Gilman J, Schoenfeld D, et al. One month of cannabis abstinence in adolescents and young adults is associated with improved memory. J Clin Psychiatry. 2018;79(6):17m11977 .
  4. https://u.osu.edu/emotionalfitness/2017/02/08/study-impact-of-cannabis-on-alcohol/