Between 2000 and 2024, more than 20,000 deaths recorded marijuana poisoning or a marijuana-related disorder as the underlying or contributing cause of death, illustrating how the health loss attributable to marijuana use is greater than many believe.
Every death certificate includes one underlying cause of death and up to twenty contributing causes of death. The Centers for Disease Control and Prevention (CDC), as well as the World Health Organization, defines the underlying cause of death as “the disease or injury which initiated the train of morbid events leading directly to death or the circumstances of the accident or violence which produced the fatal injury.” As for a contributing cause of death, the CDC explained that “any cause of death that is neither the direct, intervening, originating antecedent nor underlying is a contributory cause of death.” Death certificates are completed by medical professionals, such as physicians and medical examiners.
Overdoses
Drug overdoses (any one of ICD-10 codes X40–X44, X60–X64, X85, and Y10–Y14) can be recorded as the underlying or contributing cause of death. Poisoning from specific substances, such as heroin or marijuana, can be identified as a contributing cause of death.
In 2024, 881 deaths recorded a drug overdose as the underlying cause of death, alongside marijuana poisoning as a contributing cause of death (ICD-10 code T40.7), according to an analysis of the CDC’s WONDER database. Given that there were 79,384 drug overdose deaths that year, marijuana was implicated in approximately 1.1% of them. Between 2000 and 2024, 10,496 drug overdose deaths recorded marijuana poisoning as a contributing cause of death.
As the number of drug overdose deaths involving opioids (any one of ICD-10 codes T40.0–T40.4 and T40.6) increased 6-fold, the number involving marijuana increased 20-fold, though opioids accounted for more deaths overall. The annual number of marijuana-involved overdose deaths increased from 40 in 2000 to 881 in 2024, peaking at 1,161 in 2022. This trend followed the broader nationwide decline in drug overdose deaths from 107,941 in 2022 to 79,384 in 2024.
Of note, marijuana was determined by the certifying physician to have contributed to these deaths and was not merely used by the decedent prior to his or her death. It is also possible that more than one substance contributed to the overdose (e.g., the death certificate could list poisoning from cocaine and marijuana).
Additionally, 1,182 deaths in 2024 recorded a drug overdose as the underlying or contributing cause of death, with marijuana poisoning as a contributing cause of death. Among these deaths, the most common underlying causes of death were poisoning (888), car crashes (117), firearms (45), heart disease (43), drowning (18), suffocation (18), and falls (10). Causes of death with fewer than 10 deaths were suppressed.
More broadly, marijuana poisoning, alongside any cause of death, was cited as a contributing cause of death in 1,198 deaths in 2024. Between 2000 and 2024, 14,025 deaths recorded marijuana poisoning as a contributing cause of death.
| Year | Deaths that recorded a drug overdose as the underlying cause of death and marijuana poisoning as a contributing cause of death | Deaths that recorded a drug overdose as the underlying or contributing cause of death and marijuana poisoning as a contributing cause of death | Deaths in which marijuana poisoning was recorded as a contributing cause regardless of the underlying cause of death |
| 2000 | 40 | 60 | 61 |
| 2001 | 37 | 56 | 58 |
| 2002 | 50 | 69 | 70 |
| 2003 | 61 | 86 | 88 |
| 2004 | 99 | 122 | 122 |
| 2005 | 111 | 137 | 141 |
| 2006 | 131 | 161 | 162 |
| 2007 | 119 | 172 | 177 |
| 2008 | 114 | 164 | 169 |
| 2009 | 118 | 168 | 170 |
| 2010 | 185 | 257 | 261 |
| 2011 | 220 | 308 | 312 |
| 2012 | 231 | 340 | 343 |
| 2013 | 262 | 381 | 388 |
| 2014 | 287 | 417 | 421 |
| 2015 | 409 | 557 | 560 |
| 2016 | 526 | 709 | 717 |
| 2017 | 642 | 856 | 862 |
| 2018 | 758 | 1,027 | 1,036 |
| 2019 | 799 | 1,097 | 1,101 |
| 2020 | 1,028 | 1,294 | 1,302 |
| 2021 | 1,159 | 1,444 | 1,450 |
| 2022 | 1,161 | 1,412 | 1,419 |
| 2023 | 1,068 | 1,420 | 1,437 |
| 2024 | 881 | 1,182 | 1,198 |
| Total | 10,496 | 13,896 | 14,025 |
Mental and Behavioral Disorders due to the Use of Cannabinoids
Apart from deaths that recorded marijuana poisoning as a contributing cause of death, mental and behavioral disorders due to the use of cannabinoids (ICD-10 code F12) can be cited as the underlying or contributing cause of death. This category includes conditions such as withdrawal (F12.3), withdrawal with delirium (F12.4), psychotic disorder (F12.5), and amnesic syndrome (F12.6), among others. While poisoning is an acute outcome, these disorders may develop over an extended period of use.
Between 2000 and 2024, the number of deaths that recorded a marijuana-related disorder as the underlying cause of death increased from fewer than 10 to 35. Over this period, 247 deaths recorded a marijuana-related disorder as the underlying cause of death.
In 2024, 789 deaths recorded a marijuana-related disorder as a contributing cause of death, bringing the total that year to 824. Between 2000 and 2024, 7,881 deaths recorded a marijuana-related disorder as the underlying or contributing cause of death, rising 12-fold from 68 to 824
Among these 824 deaths in 2024, the most common underlying causes of death were poisoning (180), heart disease (134), car crashes (62), chronic lower respiratory diseases (57), firearms (46), diabetes mellitus (36), cancer (35), cerebrovascular diseases, including stroke (23), suffocation (18), essential (primary) hypertension and hypertensive renal disease (17), chronic liver disease and cirrhosis (14), and drowning (10).
| Year | Deaths that recorded a mental and behavioral disorder due to marijuana as the underlying cause of death | Deaths that recorded a mental and behavioral disorder due to marijuana as the underlying or contributing cause of death |
| 2000 | * | 68 |
| 2001 | * | 81 |
| 2002 | * | 72 |
| 2003 | * | 75 |
| 2004 | * | 97 |
| 2005 | * | 118 |
| 2006 | * | 117 |
| 2007 | * | 139 |
| 2008 | * | 136 |
| 2009 | * | 151 |
| 2010 | 0 | 116 |
| 2011 | * | 165 |
| 2012 | * | 193 |
| 2013 | * | 180 |
| 2014 | * | 218 |
| 2015 | 13 | 277 |
| 2016 | 10 | 387 |
| 2017 | 23 | 379 |
| 2018 | 13 | 479 |
| 2019 | 20 | 517 |
| 2020 | 21 | 595 |
| 2021 | 20 | 801 |
| 2022 | 19 | 806 |
| 2023 | 25 | 890 |
| 2024 | 35 | 824 |
| Total | 247 | 7,881 |
* = suppressed when the number was between 1–9.
Conclusion
In 2024, 1,918 deaths recorded marijuana poisoning, a marijuana-related disorder, or both as the underlying or contributing cause of death, up from 129 in 2000. Between 2000 and 2024, 20,985 deaths recorded at least one of these ICD-10 codes as the underlying or contributing cause of death.
However, the true number of marijuana-related deaths is even higher, given that this overview included only deaths that explicitly listed one of these conditions on the decedent’s death certificate. For example, if a car crash occurred in part because of marijuana, but a marijuana-related code was not listed on the death certificate, the death would not have been included in the tally. Additionally, it did not include deaths attributable to cannabinoid hyperemesis syndrome (R11.16), which was given an ICD-10 code in October 2025, or cannabinosis (J66.2).
Though only 25.8% of Americans aged 12 or older in 2024 believed that there was a great risk of harm associated with smoking marijuana once a week, thousands of deaths record a marijuana-related condition as the underlying or contributing cause of death each year. This trend will likely continue as the prevalence of marijuana use continues to increase.