People who need hospital-based care for cannabis use disorder at a greater risk for death

Key takeaways:

• People, especially younger adults, who needed hospital-based care for cannabis use disorder had a higher risk for death.
• Cannabis use disorder may cause death from its links to several disorders and diseases.

Individuals who required hospital-based care for cannabis use disorder faced nearly three times the risk for premature death, results from a cohort analysis published in JAMA Network Open showed.

Study findings also revealed an even greater risk for certain types of death, such as suicide or opioid poisoning, among those who received hospital-based care for cannabis use disorder.

According to the CDC, about three in 10 people who use cannabis have cannabis use disorder.

Daniel T. Myran, MD, MPH, CCFP, FRCPC, a family physician and researcher at the University of Ottawa in Canada, and colleagues noted that evidence on links between mortality and cannabis use disorder remains limited “despite large increases over time in patterns of cannabis use that are associated with CUDs, including daily use and high potency use.”

In the retrospective cohort study, the researchers examined all people aged 15 to 105 years who lived in Ontario, Canada, between 2006 and 2021 (n = 11,622,571). They subsequently compared overall and cause-specific mortality among people in the general population and those with hospital-based care for cannabis use disorder who were matched based on age and sex.

Myran and colleagues also compared the mortality outcomes of hospital-based cannabis use disorder care with those of other substance use disorders.

Overall, 3.5% of people who received hospital-based care for cannabis use disorder died within 5 years vs. 0.6% of their matched counterparts from the general population.

The researchers reported that, after adjusting for comorbid conditions, people with hospital-based cannabis use disorder care had a greater risk for death compared with the general population (adjusted HR = 2.79; 95% CI, 2.62-2.97).

Those with hospital-based cannabis use disorder care had an increased risk for all types of mortality and faced a particularly greater risk for death from:

• suicide (aHR = 9.7; 95% CI, 6.04-15.57);
• opioid poisoning (aHR = 5.03; 95% CI, 2.86-8.84);
• other drug poisoning (aHR = 4.56; 95% CI, 3.11-6.68);
• trauma (aHR = 4.55; 95% CI, 3.55-5.82); and
• lung cancer (aHR = 4.56; 95% CI, 3.11-6.68).

Men and women of all ages had a higher death risk, but the relative increases in risk appeared greatest among those aged 25 to 44 years — for instance, women in that age range had a 5.91-fold increased risk for death (95% CI, 3.55-9.85).

Compared with those who had hospital-based care for cannabis use disorder, individuals with hospital-based care for opioids (aHR = 2.19; 95% CI, 2.1-2.27), alcohol (aHR = 1.3; 95% CI, 1.26-1.34) and stimulants (aHR = 1.69; 95% CI, 1.62-1.75) had a higher for death within 5 years.

Myran and colleagues explained that cannabis use disorder may raise mortality risk through its development or worsening of several different chronic diseases and mental health disorders, such as CVD, bipolar disorder, schizophrenia, cancer and chronic respiratory diseases.

Additionally, “exposure to and intoxication from [tetrahydrocannabinol] has previously been associated with an increased risk of death by trauma, including motor vehicle collisions, violence and death by suicide,” they wrote.

The researchers identified a couple of analysis limitations. The results may not be generally applicable to cases of cannabis use disorder that do not require hospital-based care, while the researchers could not access data on outpatient care for cannabis use disorder.

The findings “highlight the importance of cannabis as a public health concern, especially in young strata of the population and in light of growing interest in cannabis legalization and market commercialization,” Myran and colleagues concluded.

References:

• Cannabis facts and stats. Available at: https://www.cdc.gov/cannabis/data-research/facts-stats/index.html. Accessed Feb. 19, 2025.
• Myran D, et al. JAMA Netw Open. 2025;doi:10.1001/jamanetworkopen.2024.57852.