CUD Hospitalization Raises Early Death Risk

TOPLINE:

Hospitalization for cannabis use disorder (CUD) is associated with a nearly threefold higher risk for premature death compared with the general population, with risk particularly high for death by trauma, suicide, and opioid poisoning, a new study showed.

METHODOLOGY:

• A population-based retrospective cohort study included 11.6 million individuals aged 15-105 years from Ontario, Canada, between 2006 and 2021.
• Researchers compared overall and cause-specific mortality between nearly 107,000 individuals receiving incident hospital-based care for CUD and nearly 421,000 age- and sex-matched members of the general population or individuals receiving hospital-based care for other substance use disorders.
• The analysis was adjusted for comorbid mental health, substance use, and chronic health conditions.
• The median follow-up duration was 5 years.

TAKEAWAY:

• Individuals who received incident hospital-based care for CUD were nearly three times more likely to die within 5 years of care than those in the general population (3.5% vs 0.6%; adjusted hazard ratio [aHR], 2.8; 95% CI, 2.6-3.0).
• After adjusting for comorbidities, the group receiving hospital-based care for CUD showed an increased risk for mortality by suicide (aHR, 9.7; 95% CI, 6.0-15.6), trauma (aHR, 4.6; 95% CI, 3.6-5.8), or opioid poisoning (aHR, 5.0; 95% CI, 2.9-8.8) compared with the general population.
• Risk for lung cancer mortality was also notably elevated among individuals receiving hospital-based care for CUD (aHR, 3.8; 95% CI, 2.4-6.1) compared with the general population.
• Interestingly, there was a higher mortality risk for individuals receiving hospital-based care for consuming alcohol (aHR, 1.30), stimulants (aHR, 1.7), or opioids (aHR, 2.2;) than for CUD.

IN PRACTICE:

“Although CUD may not be directly responsible, our findings highlight a growing segment of the population who are at elevated risk of death and may benefit from preventive measures,” the investigators wrote.

Authors of an accompanying editorial, led by Laura J. Bierut, MD, Washington University School of Medicine, St. Louis, noted that “We must adopt a robust public health approach, similar to the successful strategies used to reduce tobacco consumption, to mitigate the harms associated with cannabis use. We need a nationwide public health campaign to address the dangers of cannabis use and cannabis use disorder.”

SOURCE:

The study was led by Daniel T. Myran, MD, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, and was published online on February 6 in JAMA Network Open.

LIMITATIONS:

The study considered only individuals seeking hospital-based care for CUD, representing a high-risk subpopulation, and the findings may not generalize to CUDs not requiring hospital-based care. The study also lacked detailed data on cannabis use patterns, including the frequency and type of cannabis used. Additionally, unmeasured confounding factors such as tobacco use, and risk-taking behaviors may have influenced the results.

DISCLOSURES:

The study was supported by the University of Ottawa site of ICES (formerly known as the Institute for Clinical Evaluative Sciences). Several investigators reported receiving grants and honoraria from various sources, including pharmaceutical companies; and one reported being an employee of Health Canada. Full details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.