Veterans who used cannabis had substantially higher rates of psychiatric conditions and suicidality

Among 3,157 veterans, those with lifetime cannabis use disorder had 1.6 to 2.7 times higher odds of PTSD, mood disorders, anxiety, and suicidal ideation compared to cannabis users without CUD.

Hill, Melanie L et al.·Journal of affective disorders·2021·Strong EvidenceCross-Sectional
RTHC-03201Cross SectionalStrong Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Strong Evidence
Sample
N=3,157

What This Study Found

Compared to veterans who never used cannabis, those with any lifetime use had elevated odds (ORs 1.5-8.3) of current and lifetime PTSD, mood disorders, anxiety disorders, substance use disorders, suicidal ideation, suicide attempts, and mental health treatment use. Veterans with CUD had even higher odds (ORs 1.6-2.7) of these conditions compared to cannabis users without CUD.

Key Numbers

3,157 veterans. Cannabis users vs. never-users: ORs 1.5-8.3 for psychiatric conditions and suicidality. CUD vs. non-CUD cannabis users: ORs 1.6-2.7 for PTSD, mood disorders, anxiety, nicotine and alcohol dependence, and suicidal ideation.

How They Did This

Cross-sectional analysis of 3,157 veterans ages 21-96 from the National Health and Resilience in Veterans Study (NHRVS). Cannabis use and CUD assessed using the Mini International Neuropsychiatric Interview. Compared three groups: never-users, cannabis users without CUD, and those with lifetime CUD.

Why This Research Matters

This study quantifies the psychiatric burden associated with cannabis use among veterans at a granular level, distinguishing between any use and disordered use. The graded relationship (more psychiatric burden with CUD than use alone) suggests dose-response dynamics.

The Bigger Picture

The cross-sectional design leaves open whether cannabis use worsens psychiatric conditions, whether veterans with psychiatric conditions are more drawn to cannabis, or both. The high rates of treatment utilization among cannabis users suggest they are seeking help, which creates opportunities for screening and intervention.

What This Study Doesn't Tell Us

Cross-sectional design prevents causal inference. Self-reported cannabis use. Cannot determine temporal ordering of cannabis use and psychiatric conditions. Veteran population may not generalize to civilians.

Questions This Raises

  • ?Does cannabis use precede or follow psychiatric conditions in veterans?
  • ?Would targeted CUD treatment reduce psychiatric symptom burden?
  • ?How does the psychiatric profile of veteran cannabis users differ from civilian users?

Trust & Context

Key Stat:
CUD veterans had 1.6-2.7x higher psychiatric burden than cannabis users without CUD
Evidence Grade:
Large nationally representative veteran sample with validated diagnostic interview. Limited by cross-sectional design.
Study Age:
2021 study from the National Health and Resilience in Veterans Study.
Original Title:
Burden of cannabis use and disorder in the U.S. veteran population: Psychiatric comorbidity, suicidality, and service utilization.
Published In:
Journal of affective disorders, 278, 528-535 (2021)
Database ID:
RTHC-03201

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Did cannabis use disorder carry more risk than casual cannabis use?

Yes. Veterans with CUD had significantly higher odds of PTSD, mood disorders, anxiety, and suicidal ideation compared to veterans who used cannabis but never developed CUD.

Were cannabis-using veterans getting treatment?

Yes. Cannabis users had elevated rates of both current and lifetime mental health treatment utilization compared to never-users, suggesting they were actively seeking care.

Read More on RethinkTHC

Cite This Study

RTHC-03201·https://rethinkthc.com/research/RTHC-03201

APA

Hill, Melanie L; Nichter, Brandon M; Norman, Sonya B; Loflin, Mallory; Pietrzak, Robert H. (2021). Burden of cannabis use and disorder in the U.S. veteran population: Psychiatric comorbidity, suicidality, and service utilization.. Journal of affective disorders, 278, 528-535. https://doi.org/10.1016/j.jad.2020.09.099

MLA

Hill, Melanie L, et al. "Burden of cannabis use and disorder in the U.S. veteran population: Psychiatric comorbidity, suicidality, and service utilization.." Journal of affective disorders, 2021. https://doi.org/10.1016/j.jad.2020.09.099

RethinkTHC

RethinkTHC Research Database. "Burden of cannabis use and disorder in the U.S. veteran popu..." RTHC-03201. Retrieved from https://rethinkthc.com/research/hill-2021-burden-of-cannabis-use

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.