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Study breakdown

South African Veterans Had High PTSD Rates, With Cannabis Use Specifically Linked to PTSD

Cross SectionalPreliminary evidence
The takeaway

Among South African border war veterans, 33% met criteria for PTSD, and current cannabis use was the only substance significantly associated with PTSD diagnosis, despite high overall resilience levels.

Read this if you are a veteran using cannabis and wonder about its relationship to PTSD.

33% PTSD prevalence with cannabis as the only substance significantly linked

What the researchers found

Of 54 responding veterans who served in the South African border war (1975-1988), 33% met criteria for PTSD. Despite this high rate, 94% showed normal to above-normal levels of resilience on the Connor Davidson Resilience Scale. PTSD was significantly associated with combat exposure.

Among substance use variables examined, only current cannabis use was significantly linked to PTSD (p=0.044). Alcohol and other substance use did not show significant associations. The resilience scores showed no association with PTSD severity, suggesting these may be independent dimensions.

Why it matters

This was one of the first studies examining PTSD in South African border war veterans, a conflict whose psychological impact has received little attention. The specific link between cannabis use and PTSD, rather than alcohol or other substances, aligns with research from other militaries suggesting cannabis may be used specifically to cope with PTSD symptoms.

The numbers in context

54 respondents from 109 reachable veterans. 33% PTSD prevalence. 94% showed normal or above-normal resilience. Cannabis use significantly linked to PTSD (p=.044). Combat exposure significantly linked to PTSD (p=.012).

How the study worked

Cross-sectional study using anonymous internet-based questionnaire. From 1,527 former high school students (1975-1988), 109 were reachable and 54 responded (49.5% response rate). IES-R assessed PTSD, CD-RISC measured resilience. Chi-square and regression analysis used.

What this study cannot tell us

Very small sample (54 respondents) from a hard-to-reach population. Low response rate (49.5%) introduces selection bias. Internet-based recruitment may exclude veterans without internet access. Cross-sectional design cannot determine whether cannabis use preceded or followed PTSD.

How to read the evidence

Very small cross-sectional study; preliminary evidence from an understudied population.

When this study was published

Published in 2013. Research on cannabis and PTSD in veterans has expanded globally.

The bigger picture

The coexistence of high PTSD rates and high resilience levels is noteworthy. These veterans are coping effectively in many life domains despite carrying the burden of PTSD. The cannabis-PTSD link adds to the international evidence that veterans may self-medicate PTSD symptoms with cannabis specifically.

Questions still open

  • Are South African veterans using cannabis specifically to manage PTSD symptoms? Would these veterans benefit from PTSD treatment combined with substance use support? Does the high resilience despite PTSD translate to better treatment outcomes?

Common questions

Why is cannabis specifically linked to PTSD in veterans?
While this study cannot explain causation, the specific cannabis-PTSD link (while alcohol showed no association) is consistent with research suggesting veterans may use cannabis to manage PTSD-specific symptoms like hyperarousal, nightmares, and anxiety. Cannabis's effects on the endocannabinoid system, which regulates fear and stress responses, may make it particularly appealing for PTSD symptom management.
Can someone have PTSD and still be resilient?
Yes. This study found that 94% of veterans showed normal or above-normal resilience despite 33% having PTSD. Resilience and PTSD appear to be independent dimensions. A veteran can function well in many areas of life while still carrying PTSD symptoms. High resilience may help them cope with but does not eliminate PTSD.

Read the original research

Post traumatic stress disorder and resilience in veterans who served in the South African border war.

African journal of psychiatry, 16(6)

Citation

Connell, M A; Omole, O; Subramaney, U; Olorunju, S. (2013). Post traumatic stress disorder and resilience in veterans who served in the South African border war.. African journal of psychiatry, 16(6). https://doi.org/10.4314/ajpsy.v16i6.55

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