Cannabis Detected in 21% of U.S. Overdose Deaths
/By Pat Anson
A new study by the CDC seems likely to revive an old debate about cannabis: Can you overdose on cannabis?
The study, published in the CDC’s Morbidity and Mortality Weekly Report (MMWR), looked at U.S. overdoses from 2021 to 2025 and found that cannabis was “detected” in 43,880 deaths. That’s over one in five overdoses (21%).
It’s an alarming statistic, and also misleading because it doesn’t tell us the cause of those deaths – only that cannabis was detected in a toxicology test after someone died.
A deeper reading of the study shows that cannabis was listed as causing death (i.e., involved) in 0.8% of drug deaths and was the only drug involved in 0.004% of them. That represents just nine deaths over a five year period.
Most of the cannabis-related deaths also involved more risky substances, such as illicit fentanyl (73.5%) and stimulants like cocaine or methamphetamine (60.4%).
“This evidence indicates that overdose deaths caused by cannabis are rare, and detection of cannabis among overdose deaths is primarily indicative of polysubstance use,” wrote lead author Lauren Tanz, ScD, Senior Scientist of Overdose Prevention in the National Center for Injury Prevention and Control.
“Because cannabinoids are rarely implicated in the cause of death, cannabinoid screening and confirmatory testing is not universally conducted. Thus, the identification of cannabis use among overdose deaths is likely underestimated.”
The CDC study is in line with previous ones, which found that the risk of death due to cannabis poisoning is “negligible.” Unlike opioids, cannabis doesn’t cause respiratory depression, which can stop people from breathing.
But even the caveat of a cannabis overdose being “rare” is a bridge too far for cannabis advocates.
“Since it is well understood and acknowledged that cannabinoids are incapable of causing overdose death, and since the DEA continues to acknowledge even now that "no deaths from overdose of marijuana have been reported,” it seems irresponsible for the authors to put this statement out there at face value,” said Paul Armentano, Deputy Director of NORML, which advocates for marijuana legalization.
Armentano says the nine fatal overdoses in which cannabis was the only drug detected could be laboratory coding errors. Or some untested substance or health condition may have played a role.
“Perhaps it’s also possible that a person suffered cardiac arrest following cannabis use and this death was miscoded as an overdose involving cannabis. Again, neither I nor anyone else have any idea because this report is presented without any details necessary to give it any sort of probative value whatsoever,” Armentano said in an email.
A cannabis overdose may be rare or unlikely, but you can become impaired by consuming too much cannabis, which increases the risk of an accident or a traumatic physical injury. Regular consumption can also contribute to cannabis use disorder (CUD), cognitive decline, mental health problems, or lung disorders if cannabis is smoked or vaped.
With the potency and availability of cannabis increasing, it’s not surprising that CUD rates are also rising. A recent study by the National Institute of Drug Abuse (NIDA) estimates that 19.4 million Americans have CUD, or about 7.3% of all adults.
Increasingly, those adults tend to be older. The steepest increases in CUD occurred among adults aged 35 to 49 years and males 50 or older.
While CUD rates are going up, the number of Americans abusing alcohol has stabilized and is going down for some age groups, such as adults aged 21 to 34 years – the prime drinking age for earlier generations.
“This divergence may reflect behavioral and cultural shift – including increasing cannabis preference over alcohol – and declines in binge or heavy drinking,” wrote senior author Nora Volkow, MD, NIDA’s Director. “Findings repudiate conventional assumptions that cannabis carries a low addiction risk and that most young adults with CUD have mild symptoms.”
In the end, the biggest risk from cannabis isn’t the “negligible” or “rare” risk of an overdose – it’s the risk of dying from something else.
A recent JAMA study found that 3.5% of patients receiving hospital-based care for CUD in Canada died within five years — a rate 6 times higher than the general population. CUD patients had an elevated risk of dying from suicide, trauma, opioid poisoning, and lung cancer.
