PTSD Symptoms Predicted Declining Friend Support During Cannabis Cessation, Especially for Those Who Relapsed | Research

The takeaway

In 116 veterans with cannabis dependence attempting to quit, higher PTSD symptoms predicted declining friend-based social support over 6 months, but only among those who relapsed within the first month.

Veterans with PTSD who use cannabis and anyone interested in how mental health and substance use affect social relationships.

PTSD symptoms eroded friend support only in veterans who relapsed within the first month

What the researchers found

Researchers studied 116 veterans with cannabis dependence and PTSD symptoms who were attempting to quit cannabis use, tracking the relationship between PTSD and friend-based social support over 6 months.

Using a cross-lagged model, they found that earlier PTSD symptoms predicted later decreases in friend support, but the reverse was not significant. When the sample was split by relapse status, this negative effect of PTSD on future support was present only among veterans who relapsed in the first month after their quit attempt.

The findings suggest that substance use relapse may amplify the erosion of social support that PTSD can cause, creating a vicious cycle for those trying to quit.

Why it matters

Social support is important for both PTSD recovery and substance use cessation. This study identifies a pathway through which PTSD symptoms undermine the social resources that could help veterans maintain abstinence, with relapse further accelerating the loss of support.

The numbers in context

116 veterans studied over 6 months. PTSD symptoms significantly predicted declining friend support. This effect was present only in those who relapsed in the first month.

How the study worked

A longitudinal study following 116 veterans with cannabis dependence who initiated quit attempts. PTSD symptoms and friend-based social support were measured over 6 months. A cross-lagged autoregressive model was used to test bidirectional associations. Multigroup analysis compared those who relapsed within the first month to those who did not.

What this study cannot tell us

The relatively small sample (116 veterans) limited the multigroup analysis. Only friend-based (not family) support was measured. All participants were veterans, limiting generalizability. The study cannot determine whether cannabis relapse caused the loss of social support or whether declining support occurred for other reasons in the relapse group.

How to read the evidence

This is a small longitudinal study of 116 veterans. While the cross-lagged design provides directional evidence, the limited sample size and subgroup analysis make findings preliminary.

When this study was published

Published in 2016. Research on PTSD, cannabis use, and social support in veterans has continued.

The bigger picture

This study highlights the interconnected challenges facing veterans with co-occurring PTSD and cannabis dependence. The finding that relapse worsens the erosion of social support suggests that early relapse prevention is especially important, as losing social support makes subsequent quit attempts harder.

Questions still open

Would interventions that strengthen social support improve quit success rates in veterans with PTSD? Does the same pattern hold for other substances, or is it specific to cannabis?

Common questions

Why does PTSD affect friendships?

PTSD symptoms like emotional numbing, avoidance, irritability, and social withdrawal can strain relationships and make it harder to maintain friendships. This study found these symptoms predicted declining friend support, especially when combined with substance use relapse.

Does losing friends make it harder to quit cannabis?

The study suggests that relapsing and losing social support may create a negative cycle. Social support is a known protective factor for maintaining abstinence, so its loss could make future quit attempts more difficult. However, this specific causal pathway was not directly tested.

Read the original research

Longitudinal associations of friend-based social support and PTSD symptomatology during a cannabis cessation attempt.

Journal of anxiety disorders, 38, 62-7

View on PubMed ↗Publisher’s paper ↗

Citation

Carter, Sarah P; DiMauro, Jennifer; Renshaw, Keith D; Curby, Timothy W; Babson, Kimberly A; Bonn-Miller, Marcel O. (2016). Longitudinal associations of friend-based social support and PTSD symptomatology during a cannabis cessation attempt.. Journal of anxiety disorders, 38, 62-7. https://doi.org/10.1016/j.janxdis.2016.01.008