Written by Shannon Markus
Spoon Feed
People with cannabis use disorder were more likely to die from suicide, trauma, and drug poisoning and had a higher overall risk of death, which challenges the popular belief that it’s is a harmless recreational drug.
Not so chill after all… the deadly side of cannabis use
Cannabis use disorder (CUD) – a.k.a. “marijuana addiction” – is a chronic, relapsing condition with persistent cannabis use despite significant negative consequences. This retrospective cohort study used a matched analysis of 527,972 individuals with hospital-based CUD, comparing them to the general population (>11 million!) in Ontario. Mortality risks were adjusted for sociodemographics and comorbidities. Patients with CUD had a significantly higher risk of all-cause mortality (aHR 2.79, 95%CI 2.62-2.97).
For these inpatients, ICD-10 codes related to cannabis intoxication, poisoning, harmful use, dependence, withdrawal, cannabis-induced psychosis, and amnesia. These patients had a significantly higher risk of death, especially ages 25 to 44 (6-fold increased risk of death), largely from suicide, trauma, and overdose deaths from opioids, alcohol, and other drugs. Cannabis use, especially frequent and high-potency use, may increase the risk of death via trauma, cardiovascular events, respiratory disease, and mental health disorders. While CUD patients had a lower risk of death compared to those with opioid or stimulant use disorder, this highlights the growing concern of cannabis as a public health issue, particularly in light of legalization and increasing cannabis use, especially in younger populations. Limitations of the study include a focus on hospital-based care (thus excluding those who don’t seek treatment) and a lack of detailed data on cannabis use patterns.
How will this change my practice?
Cannabis, the third most commonly used drug after alcohol and nicotine, is increasing in use and is already linked to a higher risk of psychosis, schizophrenia, self-harm, suicide, and fatal MVCs. This study adds to the growing concern that this drug isn’t so benign after all. This (along with other recent studies) is shifting my perspective on the potential harms of cannabis and its role as a public health threat and will influence how I approach conversations with cannabis users both in and outside of the hospital.
Editor’s note: Also, if you haven’t seen Dr. Amal Mattu’s video on Emergency Cardiology from this year, he covers how cannabis use is a significant risk factor for coronary artery disease. ~Clay Smith
Source
Cannabis Use Disorder Emergency Department Visits and Hospitalizations and 5-Year Mortality. JAMA Netw Open. 2025 Feb 3;8(2):e2457852. doi: 10.1001/jamanetworkopen.2024.57852. Erratum in: JAMA Netw Open. 2025 Mar 3;8(3):e255061. doi: 10.1001/jamanetworkopen.2025.5061. PMID: 39913138
