Among veterans diagnosed with cannabis use disorder, 79% also had a mental health disorder and 77% had another substance use disorder, with comorbid veterans using significantly more mental health services.
VA clinicians, veterans, addiction treatment planners
79% had comorbid mental health; 77% had comorbid substance use disorders
What the researchers found
Of veterans with CUD (2010-2016), 79.1% had a comorbid mental health disorder and 76.8% had another substance use disorder. Veterans with CUD plus a mental health disorder used more individual psychotherapy than those with CUD alone. CUD was rarely an isolated diagnosis.
Why it matters
CUD among veterans is almost never a standalone condition. Effective treatment requires addressing co-occurring disorders, and integrated treatment models may be more appropriate than treating CUD in isolation.
The numbers in context
79.1% comorbid mental health disorder; 76.8% comorbid substance use disorder. Veterans with CUD + mental health disorder used more individual psychotherapy than CUD alone.
How the study worked
Retrospective analysis of national Veterans Health Administration administrative and clinical records from 2010-2016 examining comorbidity rates and mental health service utilization among veterans with CUD diagnoses.
What this study cannot tell us
Administrative data may have coding biases; CUD diagnoses in the VA may be underreported due to stigma and federal prohibition; cannot determine temporal ordering of diagnoses.
How to read the evidence
Large national VA dataset with complete administrative records, though subject to coding limitations.
When this study was published
Published in 2020.
The bigger picture
The VHA, as the largest US healthcare provider, is uniquely positioned to integrate CUD screening and treatment into existing mental health services rather than treating it separately.
Questions still open
- Would integrated CUD + mental health treatment improve outcomes? Is CUD being adequately screened for in VA mental health settings?
Common questions
Why do so many veterans with CUD have other disorders?
What does this mean for treatment?
Read the original research
Cannabis use disorder among veterans: Comorbidity and mental health treatment utilization.
Journal of substance abuse treatment, 109, 46-49
Citation
Ecker, Anthony H; Lang, Brent; Hogan, Julianna; Cucciare, Michael A; Lindsay, Jan. (2020). Cannabis use disorder among veterans: Comorbidity and mental health treatment utilization.. Journal of substance abuse treatment, 109, 46-49. https://doi.org/10.1016/j.jsat.2019.11.003
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