Journal of general internal medicine · 2026
Cannabis Use Disorder and Mortality Risk: A Matched Cohort Study from a Colorado Health System.
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Nguyen Anh P, Narwaney Komal J, Lyons Jason A, Ford Morgan A, Steiner Claudia A
Аннотация
BACKGROUND: Cannabis use disorder (CUD) is an underrecognized consequence of cannabis use, and evidence on mortality risk and leading causes of death among individuals with CUD remains limited.
OBJECTIVE: To characterize all-cause and cause-specific mortality following CUD diagnosis and compare mortality risk between individuals with and without CUD.
DESIGN, SETTING, AND PARTICIPANTS: This matched cohort study consisted of 100,140 individuals aged 12 years or older from a Colorado health system between 2006 and 2024, including 16,693 with a CUD diagnosis and 83,447 individuals without CUD, with follow-up through June 2024.
MAIN MEASURES: Primary outcomes were all-cause mortality, injury-related mortality, and illness-related mortality identified from state vital records. Secondary outcomes included deaths from drug overdose, self-harm, accidents, cancer, cardiovascular diseases, and respiratory diseases. Cox proportional hazards regressions estimated adjusted hazard ratios (HRs) and 95% CIs.
KEY RESULTS: Over a median follow-up of 7.7 years, 1,197 (7.2%) individuals with CUD died. Compared to matched individuals, those with CUD had higher crude rates of all-cause mortality (899.5 vs. 374.6 per 100,000 person-years), injury-related mortality (295.3 vs 62.5 per 100,000 person-years), and illness-related mortality (604.2 vs. 312.1 per 100,000 person-years). In adjusted analyses, CUD was associated with increased risk of all-cause mortality (HR 1.52; 95% CI, 1.30-1.77), injury-related mortality (HR 1.91; 95% CI, 1.37-2.67), and illness-related mortality (HR 1.40; 95% CI 1.17-1.67). Among leading causes, CUD was associated with elevated mortality risk from drug overdose (HR 2.59; 95% CI, 1.30-5.19), accidents (HR 1.96; 95% CI, 1.01-3.80), and cancer (HR 1.71; 95% CI, 1.20-2.46), but not self-harm (HR 1.18; 95% CI 0.62-2.24), cardiovascular diseases (HR 1.25; 95% CI 0.87-1.81), or respiratory diseases (HR 1.29; 95% CI, 0.73-2.25).
CONCLUSIONS: CUD may serve as a marker of increased all-cause, injury-related, and illness-related mortality risk. Comprehensive prevention strategies are needed to address elevated mortality risk in individuals with CUD.
OBJECTIVE: To characterize all-cause and cause-specific mortality following CUD diagnosis and compare mortality risk between individuals with and without CUD.
DESIGN, SETTING, AND PARTICIPANTS: This matched cohort study consisted of 100,140 individuals aged 12 years or older from a Colorado health system between 2006 and 2024, including 16,693 with a CUD diagnosis and 83,447 individuals without CUD, with follow-up through June 2024.
MAIN MEASURES: Primary outcomes were all-cause mortality, injury-related mortality, and illness-related mortality identified from state vital records. Secondary outcomes included deaths from drug overdose, self-harm, accidents, cancer, cardiovascular diseases, and respiratory diseases. Cox proportional hazards regressions estimated adjusted hazard ratios (HRs) and 95% CIs.
KEY RESULTS: Over a median follow-up of 7.7 years, 1,197 (7.2%) individuals with CUD died. Compared to matched individuals, those with CUD had higher crude rates of all-cause mortality (899.5 vs. 374.6 per 100,000 person-years), injury-related mortality (295.3 vs 62.5 per 100,000 person-years), and illness-related mortality (604.2 vs. 312.1 per 100,000 person-years). In adjusted analyses, CUD was associated with increased risk of all-cause mortality (HR 1.52; 95% CI, 1.30-1.77), injury-related mortality (HR 1.91; 95% CI, 1.37-2.67), and illness-related mortality (HR 1.40; 95% CI 1.17-1.67). Among leading causes, CUD was associated with elevated mortality risk from drug overdose (HR 2.59; 95% CI, 1.30-5.19), accidents (HR 1.96; 95% CI, 1.01-3.80), and cancer (HR 1.71; 95% CI, 1.20-2.46), but not self-harm (HR 1.18; 95% CI 0.62-2.24), cardiovascular diseases (HR 1.25; 95% CI 0.87-1.81), or respiratory diseases (HR 1.29; 95% CI, 0.73-2.25).
CONCLUSIONS: CUD may serve as a marker of increased all-cause, injury-related, and illness-related mortality risk. Comprehensive prevention strategies are needed to address elevated mortality risk in individuals with CUD.