Veterans whose PTSD improved less during treatment were more likely to use cannabis afterward | Research

The takeaway

Among 432 male veterans in residential PTSD treatment, less improvement in PTSD symptoms during treatment predicted greater cannabis use at 4-month follow-up, specifically avoidance/numbing and hyperarousal symptoms.

Read this if you are a veteran using cannabis and want to understand its relationship with PTSD symptom management.

Cannabis use specifically predicted by residual PTSD symptoms (not alcohol or opiates)

What the researchers found

Researchers tracked 432 male military veterans admitted to residential PTSD rehabilitation, examining whether treatment response predicted subsequent cannabis use.

Lower levels of PTSD symptom improvement between intake and discharge significantly predicted greater cannabis use frequency at 4-month follow-up, even after controlling for pre-treatment cannabis use and length of stay.

Specifically, less improvement in avoidance/numbing symptoms and hyperarousal symptoms drove this relationship. These are the PTSD symptom clusters most associated with emotional regulation difficulties.

Importantly, this relationship was specific to cannabis. The same pattern was not observed for alcohol or opiates, suggesting veterans may have been selectively using cannabis to manage residual PTSD symptoms.

Why it matters

The cannabis-specific finding suggested that veterans may have been self-medicating residual PTSD symptoms with cannabis, highlighting the need for both more effective PTSD treatments and integrated substance use management.

The numbers in context

432 male veterans, mean age 51. Lower PCL-M change scores predicted greater cannabis use at 4 months (p < .05). Effect was specific to cannabis, not alcohol or opiates. Avoidance/numbing and hyperarousal symptom clusters drove the relationship.

How the study worked

Prospective cohort study of 432 male military veterans (mean age 51 years) with primary PTSD diagnosis. PCL-M (PTSD Checklist-Military) scores at intake and discharge compared to substance use frequency at 4-month follow-up. Controlled for treatment duration and baseline substance use.

What this study cannot tell us

All-male veteran sample limits generalizability. Self-reported cannabis use. Observational design cannot prove cannabis was used specifically for PTSD symptom relief. No data on whether cannabis actually helped manage symptoms.

How to read the evidence

Prospective study with large sample, controlled analysis, and clinically meaningful follow-up period.

When this study was published

Published in 2011. Research on cannabis for PTSD has expanded significantly, including clinical trials.

The bigger picture

This study contributed to the growing evidence that cannabis use among veterans may represent self-medication for inadequately treated PTSD symptoms, informing the debate about medical cannabis for PTSD.

Questions still open

Does cannabis actually help veterans manage PTSD symptoms, or does it create additional problems? Would more effective PTSD treatments reduce subsequent cannabis use?

Common questions

Do veterans use cannabis for PTSD?

This study found that veterans whose PTSD symptoms improved less during treatment were more likely to use cannabis afterward, suggesting a self-medication pattern. This relationship was specific to cannabis and not seen with alcohol or opiates.

Which PTSD symptoms were linked to cannabis use?

Avoidance/numbing (emotional withdrawal, feeling detached) and hyperarousal (being on edge, sleep problems) were the symptom clusters that predicted post-treatment cannabis use.

Read the original research

Cannabis use among military veterans after residential treatment for posttraumatic stress disorder.

Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 25(3), 485-91

View on PubMed ↗Publisher’s paper ↗

Citation

Bonn-Miller, Marcel O; Vujanovic, Anka A; Drescher, Kent D. (2011). Cannabis use among military veterans after residential treatment for posttraumatic stress disorder.. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 25(3), 485-91. https://doi.org/10.1037/a0021945