CUD symptom, median age at first cannabis use coincided with the median age at first SI (18 years) in cannabis users and only preceded first suicide attempt by a year. Hence, cannabis involvement likely occurred contemporaneously. Finally, as stated by the disinhibition theory, cannabis intoxication prior to an attempt could also directly lead to an increased risk of suicide attempt. Related studies (Borges et al., 2000; Conner et al., 2007) allude to the possible role of facets of disinhibited behavior as mediators. While we did not assess substance-induced disinhibition or trait level aggression in our study, the inclusion of conduct disorder (which encompasses both facets to some degree) did not attenuate the association. In addition, only 56 individuals (13.7% of attempters) indicated that their suicide attempt was related to co-occurring drug use. A more likely alternative is that both cannabis involvement and STBs are influenced by and related to a common set of risk and protective influences and that any observed association is due to these confounding effects (Price et al., 2009).
