https://www.infirmiere-canadienne.com/blogs/ic-contenu/2026/10/13/cannabis-augmentation-tendances-suicidaires
Considerations for practice as association identified between drug use and poor mental health
By Eh Sue Kaw
October 13, 2026
istockphoto.com/önder kanbur
Recent population-based and systematic review evidence suggests that frequent cannabis use, especially at a young age, is associated with adverse mental health outcomes, including depression, anxiety, suicidal ideation, suicide attempts, and earlier onset of psychosis.
Mental health nurses across Canada are encountering a concerning clinical pattern: increasing numbers of young adults presenting with suicide attempts, suicidal ideation, and complex psychiatric needs. Many of these presentations involve co-occurring substance use, most commonly cannabis, used either recreationally or as a coping strategy. While national data continue to evolve, emerging research and clinical observations suggest that this pattern warrants closer attention within nursing practice and suicide prevention efforts (Edalati et al., 2024; Cheek et al., 2025).
As a registered nurse working in an inpatient mental health and addictions unit, I encounter this pattern frequently in clinical practice. In a unit serving a community of approximately 75,000 people, the co-occurrence of cannabis use and suicidality among young adults has become increasingly visible. Many patients between the ages of 18 and 40 present with chronic suicidal ideation, repeated hospitalizations, and co-occurring substance use. A recurring theme is the use of cannabis as a primary coping strategy. While these observations are practice-based, they are consistent with emerging literature highlighting the complex relationship between substance use, mental health, and suicide risk (Edalati et al., 2024; Matheson et al., 2025).
Cannabis use and mental health: what the evidence shows
Cannabis is among the most widely used psychoactive substances globally. In Canada, accessibility and social acceptance have increased since legalization in 2018. While legalization aimed to reduce harms associated with illegal markets, more recent evidence suggests potential mental health risks for some populations, particularly young people (Bennett, 2025; Government of Canada, 2025).
Research has identified associations between cannabis use and mental health conditions such as anxiety and depression (Wadsworth et al., 2019). Depression, particularly when accompanied by suicidal ideation, is a major contributor to suicide-related mortality (Halladay et al., 2020). Broader substance use literature indicates that substance use disorders are associated with increased suicide risk and a greater likelihood of progression from suicidal thoughts to suicidal behaviour (Edalati et al., 2024). While these findings are not cannabis-specific, they provide important context for understanding potential pathways linking substance use and suicidality.
Recent population-based and systematic review evidence suggests that frequent cannabis use, especially at a young age, is associated with adverse mental health outcomes, including depression, anxiety, suicidal ideation, suicide attempts, and earlier onset of psychosis (Nosko et al., 2025; Sanz-Pérez et al., 2026). However, much of this evidence is derived from observational and cross-sectional studies, limiting the ability to determine causation. Longitudinal findings remain variable, and the direction of the relationship is likely influenced by pre-existing mental health conditions and other confounding factors (Matheson et al., 2025).
Risk appears to be higher among individuals with more frequent use, longer duration of use, and exposure to higher-potency cannabis products (Soboka et al., 2024). Some studies also report sex-based differences in the relationship between cannabis use and suicidality, although findings remain mixed and not yet fully understood (Halladay et al., 2019).
Overall, current evidence supports an association between cannabis use and adverse mental health outcomes; however, the nature and direction of this relationship remain complex and cannot be interpreted as causal (Matheson et al., 2025; Sanz-Pérez et al., 2026).
Cannabis as a coping strategy in clinical practice
In inpatient mental health settings, cannabis use is rarely described as purely recreational. Many individuals report using cannabis to manage anxiety, low mood, insomnia, trauma-related symptoms, or emotional distress. Kourgiantakis et al. (2025) found that some young adults who experienced a suicide attempt described cannabis use as either a coping strategy or part of their daily routine.
While some individuals report short-term symptom relief, reliance on cannabis as a primary coping strategy may reinforce avoidance-based coping and may be associated with worsening symptoms of anxiety and depression over time (Government of Canada, 2025). These relationships are not uniform and may vary depending on individual clinical profiles and social context.
In practice, many young adults presenting with suicidal ideation also report trauma histories, mood or anxiety disorders, social isolation, and structural stressors such as housing insecurity, financial strain, identity-related challenges, and lack of belonging. Cannabis use often compounds these vulnerabilities rather than addressing underlying causes (Edalati et al., 2024). This underscores the importance of comprehensive, trauma-informed assessment in nursing practice.
Cannabis, psychosis, and suicide risk
Another important consideration is the relationship between cannabis use and first-episode psychosis. Evidence suggests that early initiation (e.g., during adolescence) and frequent cannabis use are associated with an increased likelihood of psychosis among some individuals (Nosko et al., 2025; Spinazzola et al., 2025). Psychotic disorders are, in turn, associated with elevated suicide risk, particularly during early stages of illness and in periods of heightened distress (Myhre et al., 2025).
However, not all individuals who use cannabis will experience psychosis or suicidality. Individual risk is shaped by a range of biological, psychological, and social factors, and current evidence does not support a direct causal pathway.
Why nursing insight matters
Nurses are often among the first health-care professionals to observe emerging clinical patterns before they are fully reflected in population-level data. Direct-care nurses working with individuals experiencing substance use, mental illness, and suicidality are uniquely positioned to recognize how broader policy and social changes, such as cannabis legalization, may intersect with coping behaviours and mental health outcomes. These practice-based insights complement existing research and contribute to a more comprehensive understanding of patient needs, supporting evidence-informed and patient-centred care.
Implications for nursing practice
Nursing practice plays a central role in identifying and addressing the intersection of cannabis use and suicidality. Current Canadian mental health and nursing best practice guidelines support comprehensive, patient-centred approaches to assessment and intervention (Registered Nurses’ Association of Ontario, 2017).
Key nursing actions include:
- Conducting detailed assessments of cannabis use, including frequency, potency, duration, and reasons for use
- Exploring substance use within the context of coping, mental health symptoms, and social determinants of health
- Providing evidence-informed education on potential mental health risks associated with cannabis use (Government of Canada, 2025)
- Supporting the development of alternative coping strategies, including psychosocial and trauma-informed approaches
- Encouraging early intervention and facilitating access to mental health and addiction services
- Completing comprehensive suicide risk assessments using structured, patient-centred approaches
- Incorporating screening tools for individuals with co-occurring substance use and suicide risk
While research involving nursing observations and practice-based insights on cannabis use and suicidality remains limited, these recommendations are informed by clinical practice, national guidance, and interdisciplinary evidence.
Conclusion
Cannabis use cannot be identified as a cause of suicidal ideation or suicide attempts. However, current evidence, combined with nursing observations, suggests that frequent or early cannabis use may be associated with increased suicidality among some young people, particularly those with underlying mental health conditions and social vulnerabilities (Sanz-Pérez et al., 2026; Myhre et al., 2025).
While clearly acknowledging the limitations of existing evidence, recognizing this association is essential for nursing assessment, patient education, and suicide prevention efforts within mental health care.
References
Bennett, J. (2025). St. Joe’s researchers explore changes in cannabis use since legalization. Mental Health & Addiction.
https://research.stjoes.ca/communications/news/~1953-St-Joe-s-Researchers-Explore-Changes-in-Cannabis-Use-Since-Legalization
Cheek, S. M., Grove, J. L., Barnes, S. E., & Goldston, D. B. (2025). Alcohol and cannabis use trends among adolescents with and without a history of suicidal thoughts and behavior: 1991–2023. Journal of Adolescent Health, 77(2), 300–307. https://doi.org/10.1016/j.jadohealth.2025.04.020
Edalati, H., Bate, E., Rewari, N., Seymour, L., & Bauer, J. (2024). Intersections of substance use and suicide: Evidence and key take-aways. Canadian Centre on Substance Use and Addiction. https://www.ccsa.ca/sites/default/files/2024-02/Intersections-of-Substance-Use-and-Suicide-Evidence-and-Key-Take-Aways.pdf
Government of Canada. (2025). Cannabis and mental health.
https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/health-effects/mental-health.html
Halladay, J. E., Boyle, M. H., Munn, C., & Georgiades, K. (2019). Sex differences in the association between cannabis use and suicidal ideation and attempts, depression, and psychological distress among Canadians. The Canadian Journal of Psychiatry, 64(5). https://doi.org/10.1177/0706743718804542
Halladay, J. E., Munn, C., Boyle, M., Jack, S. M., & Georgiades, K. (2020). Temporal changes in the cross-sectional associations between cannabis use, suicidal ideation, and depression in a nationally representative sample of Canadian adults. The Canadian Journal of Psychiatry, 65(2), 115–123. https://doi.org/10.1177/0706743719854071
Kourgiantakis, T., Cooper, D., Craig, S., Lee, E., Jones, J., Lau, C. K. Y., Tousignant, R., Singer, J., Johnstone, M., & Zaheer, J. (2025). Suicide among youth and young adults in Canada: Bereaved parents’ perspectives on systems of care. International Journal of Mental Health Systems, 19(26). https://doi.org/10.1186/s13033-025-00680-y
Matheson, J., MacKillop, J., Sloan, M. E., Sanches, M., Saini, H., Haines-Saah, R., Hassan, A., Buckley, L., Porath, A., Hendershot, C. S., & Le Foll, B. (2025). Associations between cannabis use and mental health in patients accessing treatment for substance use disorders: An exploratory cross-sectional study. Substance Use & Misuse. https://doi.org/10.1080/10826084.2025.2519419
Myhre, M. Ø., Rognli, E. B., Walby, F. A., Bramness, J. G., & Mehlum, L. (2025). The annual trend of suicide rates in patients with cannabis use disorder: A national registry study. Social Psychiatry and Psychiatric Epidemiology. https://doi.org/10.1007/s00127-024-02781-4
Nosko, L., Crocker, C. E., & Tibbo, P. G. (2025). Cannabis use in adolescence and young adulthood and its effects on brain structure and function: A scoping review. Frontiers in Psychiatry, 16. https://doi.org/10.3389/fpsyt.2025.1644105
Registered Nurses’ Association of Ontario. (2017). Assessment and care of adults at risk for suicidal ideation and behaviour (2nd ed.).
https://rnao.ca/bpg/guidelines/assessment-and-care-adults-risk-suicidal-ideation-and-behaviour
Sanz-Pérez, A., Serrano, D. R., Fraguas-Sánchez, A. I., Pardo, M. C., Ruiz Sánchez de León, J. M., Estupiñá, F. J., Pérez, T., & González-Burgos, E. (2026). Growing concerns: A systematic review and meta-analysis of cannabis use and mental health risks in youth. Addictive Behaviors, 172, 108528. https://doi.org/10.1016/j.addbeh.2025.108528
Soboka, M., Stewart, S. H., Tibbo, P., & Wang, J. (2024). Substance use and risk of suicide among adults who sought mental health and addiction specialty services through a centralised intake process in Nova Scotia: A cross-sectional study. BMJ Open, 14(10). https://doi.org/10.1136/bmjopen-2024-086487
Spinazzola, E., Degen, H., Austin-Zimmerman, I., Trotta, G., Chesney, E., Li, Z., Alameda, L., Leung, B. M., Lang, Y., Quattrone, A., Castrignano, E., Wolff, K., Murray, R., Freeman, T. P., & Di Forti, M. (2025). Are reasons for first using cannabis associated with subsequent cannabis consumption (standard THC units) and psychopathology? BMJ Mental Health, 28(1). https://doi.org/10.1136/bmjment-2025-301810
Wadsworth, E., Leos-Toro, C., & Hammond, D. (2019). Mental health and medical cannabis use among youth and young adults in Canada. Substance Use & Misuse, 55(4), 582–589. https://doi.org/10.1080/10826084.2019.1691594
Eh Sue Kaw, RN, works in inpatient mental health and addictions unit, Sault Area Hospital, Sault Ste. Marie, Ontario, with clinical interests in suicide prevention, substance use, and nursing-led mental health education.
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