Cannabis Dependence Was Strongly Linked to Suicide Attempts in Iraq/Afghanistan Veterans

Among 319 Iraq/Afghanistan-era veterans, lifetime cannabis dependence was associated with nearly 8-fold increased odds of post-deployment suicide attempts, even after controlling for PTSD, depression, pain, and other substance use.

Adkisson, Kelsie et al.·Archives of suicide research : official journal of the International Academy for Suicide Research·2019·Moderate EvidenceRetrospective Cohort
RTHC-01897Retrospective CohortModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
N=319

What This Study Found

Lifetime cannabis dependence was significantly associated with post-deployment suicide attempts (AOR=7.963, p=.014) after controlling for pre-deployment suicide attempts, PTSD, depression, pain, non-cannabis substance use disorder, and gender. This is the first evidence that heavy cannabis use may be a unique risk factor for suicide in veterans.

Key Numbers

319 veterans studied. Cannabis dependence associated with AOR=7.963 for post-deployment suicide attempts (p=.014). Controlled for pre-deployment attempts, PTSD, depression, pain, other substance use, and gender.

How They Did This

Retrospective analysis of 319 veterans deployed to Iraq or Afghanistan. Structured clinical interviews and self-report questionnaires assessed cannabis dependence, suicide attempts, PTSD, depression, pain, and other substance use.

Why This Research Matters

Veteran suicide is a public health crisis. While some veterans use cannabis to self-medicate PTSD and pain, this study suggests cannabis dependence (not casual use) may independently increase suicide risk, complicating the risk-benefit calculation.

The Bigger Picture

This finding creates tension with the growing movement to provide veterans access to medical cannabis for PTSD. While cannabis may help some symptoms, this study suggests that heavy use progressing to dependence could increase suicide risk.

What This Study Doesn't Tell Us

Retrospective design with recall bias. Relatively small sample. Cannot determine causation. Cannabis dependence may be a marker for severity of underlying conditions. Self-selected veteran sample may not be representative.

Questions This Raises

  • ?Does cannabis dependence cause suicide risk or merely mark more severe mental health problems?
  • ?Would medical cannabis programs with monitoring prevent dependence and associated risks?
  • ?Is the risk specific to dependence or present at lower use levels?

Trust & Context

Key Stat:
Cannabis dependence was associated with 8-fold increased odds of suicide attempts (AOR=7.963), even after controlling for PTSD and depression.
Evidence Grade:
Moderate - controlled for key confounders including pre-deployment attempts, but retrospective design and relatively small sample.
Study Age:
Published in 2019.
Original Title:
Cannabis Use Disorder and Post-Deployment Suicide Attempts in Iraq/Afghanistan-Era Veterans.
Published In:
Archives of suicide research : official journal of the International Academy for Suicide Research, 23(4), 678-687 (2019)
Database ID:
RTHC-01897

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Does cannabis increase suicide risk in veterans?

This study found cannabis dependence (not casual use) was associated with nearly 8-fold increased odds of post-deployment suicide attempts, even after accounting for PTSD, depression, pain, and other substance use. However, the study cannot prove causation.

Should veterans with PTSD use cannabis?

This study raises a caution: while cannabis may help some PTSD symptoms, progressing to cannabis dependence was strongly associated with suicide risk. The authors suggest heavy cannabis use may be a unique risk factor that warrants monitoring.

Read More on RethinkTHC

Cite This Study

RTHC-01897·https://rethinkthc.com/research/RTHC-01897

APA

Adkisson, Kelsie; Cunningham, Katherine C; Dedert, Eric A; Dennis, Michelle F; Calhoun, Patrick S; Elbogen, Eric B; Beckham, Jean C; Kimbrel, Nathan A. (2019). Cannabis Use Disorder and Post-Deployment Suicide Attempts in Iraq/Afghanistan-Era Veterans.. Archives of suicide research : official journal of the International Academy for Suicide Research, 23(4), 678-687. https://doi.org/10.1080/13811118.2018.1488638

MLA

Adkisson, Kelsie, et al. "Cannabis Use Disorder and Post-Deployment Suicide Attempts in Iraq/Afghanistan-Era Veterans.." Archives of suicide research : official journal of the International Academy for Suicide Research, 2019. https://doi.org/10.1080/13811118.2018.1488638

RethinkTHC

RethinkTHC Research Database. "Cannabis Use Disorder and Post-Deployment Suicide Attempts i..." RTHC-01897. Retrieved from https://rethinkthc.com/research/adkisson-2019-cannabis-use-disorder-and

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.