Cannabis Use Disorder and Mortality Risk: A Matched Cohort Study from a Colorado Health System
In brief
Cannabis use disorder linked to 52% higher mortality in Colorado cohort
Among 100,140 people followed for a median of 7.7 years, those diagnosed with cannabis use disorder had a 52% higher adjusted risk of death than matched people without the diagnosis. Risks were also higher for injury-related deaths, drug overdose, accidents and cancer, but this observational study cannot show that cannabis use disorder caused the excess deaths.
- Journal
- Journal of general internal medicine (Q1)
- Published
- 28 September 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Anh P Nguyen, Komal J Narwaney, Jason A Lyons, Morgan A Ford, Claudia A Steiner
- PMID
- 42806222
- DOI
- 10.1007/s11606-026-10845-1
Why clinicians should know about it
- Picked for Internal Medicine (paper of the day, 2 October 2026): CUD associated mortality risk in Colorado health system cohort
Abstract
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.