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James Donaldson on Mental Health – Cannabis Use Increases Depressive and Suicidal Thinking
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New studies raise concerns about cannabis use, especially for young users.
Teens and drugs
By Mark S. Gold
Key points
There’s a strong relationship between cannabis use and suicidal thinking only partly explained by depression.
Cannabis may be taken for depression but could make depression worse when more successful treatments exist.
Genetic moderators and developmental vulnerabilities may clarify those most at risk for suicidal behaviors.
Cannabis use has become increasingly normalized in the United States, and at least half the states have “medical marijuana” laws. This reversed criminalization, but rather than following FDA-like testing and approval, cannabis was suddenly “a medicine.” Access to cannabis or its intoxicant THC has never been greater. Adolescents may not legally purchase cannabis; however, their access has increased.
Cannabis is largely unstudied or has failed rigorous medication trials, so its impact on mental health is mostly unknown. However, new findings indicate distressing results, causing experts to call for a reassessment of the risks and benefits of cannabis, as nearly 30% of users develop cannabis use disorder (CUD). For adolescent users, risks for addiction are twice that of adults, and after four years, 1 in 5 adolescents develop problematic use. Disturbingly, new studies suggest elevated cannabis risks for depression and suicidal thoughts and behaviors, especially in adolescents and young adults.
A Self-Medication Tragedy
A CDC study of 16,000 adolescents 13-18 years old found the most common reasons for marijuana/THC use were: to feel calm or relaxed (73%), have fun/experiment (50%), sleep better (44%), forget problems/ memories (44%), and alleviate anxiety or depression (40%). In contrast, a cohort of adults reported these primary uses: stressmanagement (58%), anxiety relief (36%), and headache/pain relief (~11%) and self-medication reasons; others used the drug “to feel well” (83%) or “forget life’s problems” (20.6%). A new article in Drug and Alcohol Dependence delves into the relationships between cannabis use, depression, and suicidal behaviors. After adjusting for depression, adolescent cannabis use was significantly associated with increased risks for thinking about suicide and more than double the risk for suicide attempts. Among adolescents, cannabis use was linked to a 1.85 times higher likelihood of attempting suicide.
Depression may contribute to the relationship between cannabis use and suicidality, but doesn’t fully explain it, suggesting cannabis use poses independent risks for suicidal thoughts and behaviors. Cannabis may act as a catalyst, accelerating depressive processes.
Cannabis for Teens Should Be Considered Dangerous Until Proven Safe
Even FDA-approved medication use is a concern in young people. In contrast to adult FDA trials, pediatric trials are very closely monitored due to stricter ethical considerations. Pediatric trials include enhanced monitoring for suicidality, given increased risks of suicidal thoughts and behaviors in younger populations—a concern that led to the FDA’s black box warning on all antidepressants for individuals under age 25. (And as noted earlier, there were no successful adult or adolescent drug trials of cannabis for depression.)
Additionally, pediatric drug studies that occur monitor potential effects on growth and neurodevelopment. Informed consent processes are complex, requiring parental consent along with age-appropriate assents from children/adolescents. Long-term follow-up is often more critical in pediatric studies to assess the impact of the drug over time on physical and psychological development. But none of this research was performed with cannabis.
Corroborating Studies on Cannabis and Depression
Recent high-quality studies reinforce findings that cannabis use during adolescence can predict increases in depressive symptoms and suicidal ideation. Gobbi et?al. in JAMA Psychiatryreported a strong association of cannabis use in adolescence to risks for depression, anxiety, and suicidality in young adulthood. For example, cannabis use in adolescence was associated with an increased risk for major depression and suicidal ideation (about 1.5 times greater). Much worse, adolescent cannabis was associated with suicide attempts in young adulthood (3.4X greater).
A longitudinal study of 2,000+ Norwegians from adolescence into their late 20s found frequent adolescent cannabis use (?11 times/year) correlated with nearly a three times greater risk for suicide attempts in adulthood. In a 21-year study in New Zealand of individuals ages 14-21 years later followed up, cannabis use frequency and psychosocial outcomes were linked to depression, suicidal ideation, and suicide attempts. Frequent adolescent cannabis use (weekly or more) predicted higher risks of later suicidal ideation and attempts. Cannabis use was also significantly associated with increased suicidal thoughts after adjustments for other factors, such as other substance use.
#James Donaldson notes: Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes. Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use. Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.#http://bit.ly/JamesMentalHealthArticle Find out more about the work I do on my 501c3 non-profit foundation website www.yourgiftoflife.org Order your copy of James Donaldson’s latest book, #CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy
Adolescent Cannabis Use and Future Depression and Suicidality
Some researchers examined the association between cannabis use in adolescence and later adult depression, suicidality, and anxiety disorders. In a cohort of young adults (n = 591) from Zurich, Switzerland, subjects ages 19/20 were asked about past cannabis use in adolescence. In this study, adolescent cannabis use was associated with adult depression and suicidality. Younger age at first cannabis use and more frequent use in adolescence related to a particularly increased risk for adult depression.
A study in Frontiers in Public Health found cannabis use associated with higher risks of major depressive disorder, as well as suicidality. Another study demonstrated that adolescents with cannabis use disorder (CUD) symptoms were more severely ill than adults, suggesting a developmental vulnerability. Experts concluded youth cannabis use likely fuels depression and suicide in young people.
Adolescent users had a persistently higher severity of cannabis use disorder symptoms compared to adults. The earlier the use, the more severe the patterns. Cannabis targets the brain to change thoughts, moods, and behavior. Although it does not produce overdoses, it can lead to schizophrenia, accidents, depression, and suicide. As Harvard Professor Bertha Madras said in May 2024. “This is not a war on drugs. It’s a defence of the human brain at every possible age from in?utero to old?age.”?
Summary
Multiple recent studies have presented convincing evidence supporting likely causal pathways from youth cannabis use to depression and suicidal outcomes in adolescence and adulthood. Trauma or minority stress and self-medication heighten vulnerability, making cannabis a perceived treatment or coping mechanism in the absence of FDA-approved treatments, psychological support, or treatment.
Depressed patients should be assessed for cannabis use as a possible additional risk factor for suicidal behavior. Also, cannabis users in turn should be assessed for depression and suicidal behaviors. Lastly, future cohort studies should track the onset timing of cannabis use, depressive symptoms, and suicidal behaviors.
Teens and drugs
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James Donaldson is a Washington State University graduate (’79). After an outstanding basketball career with WSU, he went on to play professional basketball in the NBA with the Seattle Supersonics, San Diego/L.A. Clippers, Dallas Mavericks, New York Knicks, and Utah Jazz. He also played for several teams in the European Leagues in Spain, Italy, and Greece, and he toured with The Harlem Globetrotters to wrap up his career. James was an NBA All-Star in 1988 while playing center for the Dallas Mavericks. In 2006, James was inducted into the Pac-10 Sports Hall of Fame and also the Washington State University Athletic Hall of Fame. In 2010, James was elected as a board member for the NBA Retired Players Association.
James frequently conducts speaking engagements (motivational, inspirational, educational) for organizations, schools, and youth groups.
In 2010, James was the recipient of the NBA Legends of Basketball ABC Award, awarded for outstanding contributions in Athletics–Business–Community.
He believes in being a role model for success and professionalism to the scores of young people to whom he devotes so much of his time. He currently serves on several boards and committees and is a member of many organizations.
James believes in developing relationships that create a “Win-Win” environment for everyone involved, and in being the best he can be!
For more information about James Donaldson or to request he speak at your event, contact him at:
James Donaldson is the author of “Standing Above The Crowd” and “Celebrating Your Gift of Life” and founder of the Your Gift of Life Foundation which focuses on mental health awareness and suicide prevention, especially pertaining to our school aged children and men.
If you’re interested in having James come and speak to your group of young adults, business entrepreneurs, aspiring political and community leaders, and athletic teams, please contact him at jamesd@yourgiftoflife.org and or leave a personal message for him at 1-800-745-3161. Keep up with him and read about how he is reaching out and making a difference in the lives of so many around the world at www.yourgiftoflife.org
