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Research finds an association between cannabis use and both perpetrating violence and being a victim of violence, but it does not show that cannabis use alone causes violence. A 2026 systematic review found different pooled associations across study designs and populations. Its results are averages from studies with varied measures and substantial limitations—not a prediction of what any individual cannabis user will do.
What did the latest review find?
Trotta and colleagues’ systematic review and meta-analysis, published online in Psychological Medicine on September 24, 2026, combined 63 peer-reviewed studies involving 265,079 people. The authors searched MEDLINE, EMBASE, and PsycINFO for studies published through November 2024, so the review’s publication year should not be read as meaning it includes evidence collected through all of 2026. Read the review in Psychological Medicine.
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The review reported pooled odds ratios (ORs). An OR compares the odds of an outcome between groups; it is not an absolute probability, and it does not by itself show that cannabis caused the outcome. The estimates below refer to different populations, study designs, or outcomes, so they should not be treated as interchangeable.
| Outcome and evidence group | Pooled estimate | What it describes |
|---|---|---|
| Violence perpetration, general-population studies | OR 2.05 (95% CI 1.74–2.41) | Higher odds of a measured perpetration outcome among cannabis users than the comparison group in the included studies. |
| Violence perpetration, psychiatric-patient studies | OR 2.49 (95% CI 1.72–3.61) | An estimate from psychiatric samples; it should not be generalized to all cannabis users. |
| Violence perpetration, longitudinal studies | OR 1.17 (95% CI 1.07–1.28) | An association in studies that followed participants over time. |
| Violence perpetration, cross-sectional studies | OR 2.37 (95% CI 1.66–3.40) | An association measured at a point in time, which cannot establish which came first. |
| Violence victimization, general-population studies | OR 1.49 (95% CI 1.38–1.60) | Higher odds of being a victim of a measured form of violence; victimization is distinct from perpetration. |
All estimates in the table are from Trotta et al. (2026). The confidence intervals (CIs) show the statistical uncertainty around each pooled estimate; they do not account for every limitation in the underlying studies. In particular, an OR of 2.05 does not mean a person using cannabis is “twice as likely” to commit violence in everyday terms: the absolute likelihood depends on the outcome and the people being compared.
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Does the association show that cannabis causes violence?
No. An association means that cannabis use and a violence-related outcome appeared together more often than in comparison groups. It does not establish that cannabis exposure itself produced the outcome. The longitudinal studies provide evidence that cannabis use preceded some later measured outcomes, but following people over time does not remove confounding or prove cause and effect.
The difference between the review’s cross-sectional and longitudinal pooled estimates matters. Cross-sectional studies measure exposure and outcome at roughly the same time, making the direction of the relationship difficult to determine. Longitudinal studies can establish sequence more clearly, but other differences between participants may still account for some or all of an association. The 2020 youth-focused meta-analysis also cautioned that reverse causation could affect longitudinal findings: earlier violence or circumstances linked to violence may precede or influence cannabis use. See the 2020 meta-analysis of cannabis use and physical violence in youths.
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A 2022 scoping review likewise characterized the evidence as correlational and variable across populations. Read the 2022 scoping review. Together, these reviews support describing a relationship in the observed data, not assigning a single cause.
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The studies do not all measure the same exposure, population, or outcome. Those differences affect what a pooled estimate can mean.
- Study design: Cross-sectional, retrospective, and longitudinal studies differ in whether they can establish timing and how vulnerable their findings are to bias.
- Population: General-population estimates and psychiatric-sample estimates describe different groups; a clinical-sample result is not a population-wide risk estimate.
- Outcome: Studies may measure physical, sexual, psychological, or intimate-partner violence, or use criminal-conviction records. Perpetration and victimization are separate outcomes.
- Cannabis exposure: A measure of any, recent, or lifetime use says less than a measure of frequency, duration, cumulative exposure, dose, or THC/CBD composition.
- Measurement and adjustment: Self-reports and administrative records capture different things. Studies also vary in whether they measure and account for alcohol, other drugs, and relevant social or personal factors.
In the 2026 review, exposure was often recorded as recent or lifetime use without enough detail to compare intensity or potency robustly. The authors also found substantial heterogeneity across studies, and some eligible studies could not be included in the quantitative synthesis because their published data did not allow an effect size to be calculated.
Study quality varied as well: the review rated 13 included studies good, 45 fair, and 5 poor. Those ratings are a reason to interpret the pooled numbers cautiously, not a way to determine whether any one person will be violent. The review also noted possible reporting, publication, and language bias.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What might explain the association?
The review discusses several possible, potentially interacting pathways. They are explanations researchers consider, not established proof of a direct causal mechanism.
- Cognitive and behavioral effects: Changes in attention, executive functioning, inhibition, and problem-solving could affect behavior in some situations.
- Mood and emotional regulation: Effects on mood or regulation of emotion may contribute to conflict or affect how a person responds to it.
- Other experiences and traits: The review discusses possible roles for paranoia and irritability during withdrawal, as well as impulsivity and antisocial traits.
- Social and environmental context: Socioeconomic circumstances, exposure to violent settings, and other substance use may shape both cannabis use and violence-related outcomes.
As Trotta and colleagues put it in their 2026 discussion, “The available evidence therefore suggests that the association between cannabis use and violence is likely to reflect multiple interacting pathways rather than a single direct causal mechanism.” A 2020 focused review also called for longitudinal research that addresses confounding, including other substance use. Read the focused review in Frontiers in Psychiatry.
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What is still unknown?
The current evidence does not establish the size of any causal effect, whether a causal relationship differs by dose or potency, or which mechanisms account for the observed associations. It also does not establish whether reducing cannabis use reduces violent behavior.
Trotta and colleagues call for prospective longitudinal studies that measure frequency, cumulative exposure, and THC/CBD composition more fully, and for studies testing whether cannabis-reduction interventions change violence outcomes. Better measurement would help distinguish the timing and intensity of use, the kinds of violence being assessed, and the role of other influences.
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