Coping With Cannabis

Cannabis use is common among individuals with post-traumatic stress disorder (PTSD), but evidence of its impact on psychiatric symptoms and functioning is mixed. To clarify this issue, researchers at the University of California explored cannabis use among 608 US military veterans with subthreshold or threshold PTSD – specifically investigating psychiatric comorbidities, functioning, and strategies for coping with PTSD symptoms (1).

Using data from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative survey of US military veterans, the researchers found that veterans with PTSD who used cannabis more than weekly were at greater risk of major depressive disorder, generalized anxiety disorder, and suicidal ideation compared with veterans who used cannabis less than weekly or not at all. The former group also scored lower in cognitive functioning tests and were more likely to use avoidance strategies to cope with PTSD symptoms. Notably, these findings remained significant even when accounting for sociodemographic, military, and clinical variables, including current PTSD symptom severity and other substance use.

The researchers were particularly concerned by the finding that veterans who used cannabis frequently were twice as likely to report current suicide ideation, as previous studies have found cannabis use disorder is strongly linked to high-severity suicidal behavior, such as suicidal planning (2). Overall, despite more psychiatric and functional problems, veterans who used cannabis frequently were less likely to engage in mental health treatment. 

However, the researchers acknowledge some limitations with their work. It is unclear whether frequent cannabis use causes psychiatric and functioning difficulties, or rather if such difficulties lead veterans to use cannabis more frequently. The sample is also predominantly white and male, with a mean age of 55 years, which potentially limits generalization of the findings. 

Further studies are required to test prospective associations between cannabis use and co-occurring problems among veterans with PTSD symptoms. The research team also calls for new interventions to promote engagement and retention in mental health treatment for veterans.

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