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A 2026 systematic review found that cannabis use was associated with higher odds of both perpetrating violence and experiencing it as a victim. The findings do not show that cannabis causes violence, and the association was substantially smaller in longitudinal studies than in cross-sectional ones.
What the review found
Published online in Psychological Medicine on 24 September 2026, the review by Giulia Trotta and colleagues combined 63 peer-reviewed studies involving 265,079 participants. The authors searched MEDLINE, EMBASE, and PsycINFO through November 2024 and used random-effects models to synthesize results. It was a review of existing evidence, not a new experiment. Read the journal article.
The authors examined violent perpetration and victimization. A secondary account describes the violence definition as including physical, sexual, and psychological violence against another person, whether within or outside a relationship; where studies measured multiple forms, the most serious was selected. SciTechDaily’s report provides that definition.
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An odds ratio (OR) compares the odds of an outcome between groups; it is not a percentage-point increase or an individual’s probability. A 95% confidence interval (CI) expresses the range of estimates compatible with the study data under the statistical model. These pooled estimates describe associations across studies, not what will happen to any particular person.
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| Question or subgroup | Pooled odds ratio (95% CI) | What it measures |
| General population | 2.05 (1.74–2.41) | Violent perpetration associated with cannabis use |
| Psychiatric patients | 2.49 (1.72–3.61) | Violent perpetration associated with cannabis use |
| Longitudinal studies | 1.17 (1.07–1.28) | Violent perpetration association in studies following participants over time |
| Cross-sectional studies | 2.37 (1.66–3.40) | Violent perpetration association in studies measuring exposure and outcome at a point in time |
| General-population samples | 3.75 (2.54–5.53) | Violence resulting in criminal conviction |
| Psychiatric samples | 4.21 (2.86–6.22) | Violence resulting in criminal conviction |
| Victimization | 1.49 (1.38–1.60) | Odds of experiencing violence as a victim |
All figures are pooled results reported by Trotta and colleagues. The conviction estimates came from relatively few studies, so they warrant particular caution. Subgroup analyses also found a more pronounced victimization association among female than male participants; the review summary does not provide subgroup estimates here.
Why association is not proof of cause
The review does not establish that cannabis itself causes violence. The contrast by study design is important: the pooled association was smaller in longitudinal studies than in cross-sectional studies. Cross-sectional results cannot establish which came first, while even a longitudinal association can reflect other influences rather than a direct causal effect.
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Alcohol or other drug use and difficult social circumstances may contribute to both cannabis use and violence, complicating interpretation. The underlying studies also often did not measure cannabis quantity or frequency. Much of the evidence predates widespread high-potency cannabis, so the pooled estimates cannot reliably answer whether risk differs by dose, pattern of use, or potency.
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- They indicate a population-level association: pooled studies found higher odds of both perpetration and victimization among people who used cannabis.
- They do not predict individual behavior: odds ratios are not absolute risks, and the review does not show that a cannabis user will commit violence or become a victim.
- They do not settle the role of use patterns: limited measurement of frequency, quantity, and potency prevents reliable conclusions about specific products or levels of use.
- Conviction is a distinct outcome: it captures violence resulting in criminal conviction, not all violence, and those pooled estimates rest on relatively few studies.
Implications for care and public-health communication
The journal abstract identifies routine assessment of cannabis use among psychiatric patients as a possible intervention target. That is an implication proposed by the authors, not an intervention tested by the review. The secondary report also says the researchers believe violence should be included in public-health messaging about cannabis. Neither implication changes the central limitation: the pooled associations do not establish causation.
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