Cannabis use, mental health and suicide attempts among adolescents in Puerto Rico

Abstract Cannabis is the most widely used illicit substance worldwide, with recent reports estimating an 11.6% annual prevalence of use in North America. Mental health, suicidal ideation, suicide attempts and completed suicides, has been the focus of several studies exploring its association with frequent cannabis use. The purpose of this study is to evaluate the association between cannabis use, mental health symptoms and suicide attempts among adolescent students in Puerto Rico. Consulta Juvenil X is a monitoring program that aims to study the prevalence of substance use, mental health and violent behavior as well as the risk factors associated with those practices. The survey was conducted during the 2018-20 academic year. The study utilizes a self-administered questionnaire. The sample included 4,668 (54%) females and 3,977 (46%) males. Half of the sample was between seventh and ninth grade with a median age of 15 years old. The majority of the sample was recruited from the public school system in Puerto Rico (70.3%). The prevalence of marihuana use in the public and private schools participating in the study was 9.4% and the suicide attempts was 7.6%. Multiple logistic regression analyses revealed that students who use marihuana during the last year were significantly more likely to report depressive and anxiety symptoms after controlling for sociodemographic variables. Moreover, adolescents who use marihuana were significantly more likely to report suicide attempts after controlling for depression symptoms (OR = 3.07; 95%CI: 2.53-3.72). Findings of this study suggest that adolescents who report marihuana use seem to be at higher risk for mental health problems and suicide attempts. Understanding who is most likely to report marihuana use is important in developing interventions to prevent mental health problems and suicidal behaviors. Key messages • Findings of this study suggest that adolescents who report marihuana use seem to be at higher risk for mental health problems and suicide attempts. • Understanding who is most likely to report marihuana use is important in developing interventions to prevent mental health problems and suicidal behaviors.