Sex-Specific Associations Between Cannabis Use, Suicidal Intent, and Suicidal Ideation Among Low-Income U.S. Veterans

This study investigates whether lifetime cannabis use is associated with lifetime prevalence of suicidal ideation and intent among low-income U.S. veterans and whether these associations vary by sex. Data were drawn from 1,004 veterans who participated in the National Veteran Homeless and Other Poverty Experiences (NV-HOPE) survey. Bivariate and multivariable analyses were used to examine relationships between cannabis use, sex, major depressive disorder (MDD), and suicidal intent and ideation, considering sociodemographic measures. Lifetime cannabis use, younger age, and MDD were significantly associated with lifetime suicidal ideation. The association between lifetime cannabis use and suicidal intent was stronger among males than females, while MDD was associated with nearly five times higher odds of suicidal intent. In addition, White veterans had significantly lower odds of suicidal intent compared to non-White veterans. Overall, lifetime cannabis use was associated with both lifetime suicidal ideation and suicidal intent, with sex-specific differences observed for suicidal intent. These results highlight the need to consider sex-specific, demographic, and clinical factors when developing strategies to reduce suicidal behavior in veterans.