Veterans with PTSD who use cannabis frequently have more depression, anxiety, and suicidal thoughts

In a nationally representative survey of 608 US veterans with PTSD symptoms, those who used cannabis more than weekly were 3-4 times more likely to screen positive for depression, anxiety, and suicidal ideation.

Hill, Melanie L et al.·Journal of traumatic stress·2022·Strong EvidenceCross-Sectional
RTHC-03913Cross SectionalStrong Evidence2022RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Strong Evidence
Sample
N=608

What This Study Found

Veterans with PTSD who used cannabis more than weekly were significantly more likely to screen positive for depression (OR 3.4-3.8), anxiety, and suicidal ideation compared to non-users. They scored lower on cognitive functioning, were 8-12 times more likely to use avoidance coping strategies, and were no more likely to seek mental health treatment despite worse symptoms.

Key Numbers

N=608 veterans with PTSD. Frequent users had ORs of 3.4-3.8 for depression/anxiety/suicidal ideation vs. non-users. Avoidance coping ORs of 8.2-12.2. Substance use coping OR of 4.4. Cognitive functioning effect sizes: d=0.25 vs. non-users, d=0.71 vs. infrequent users.

How They Did This

Analysis of the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative survey. Focused on 608 veterans with current subthreshold or full PTSD who reported on past-6-month cannabis use, psychiatric symptoms, functioning, and coping strategies.

Why This Research Matters

Many veterans with PTSD use cannabis for symptom relief, but this large representative survey found that frequent use was associated with worse psychiatric outcomes and avoidance coping, not better functioning.

The Bigger Picture

The finding that frequent cannabis-using veterans were not more likely to engage in mental health treatment despite having more severe symptoms suggests cannabis may function as a substitute for, rather than complement to, professional care.

What This Study Doesn't Tell Us

Cross-sectional design cannot determine whether cannabis use caused worse outcomes or whether veterans with worse symptoms were more likely to use cannabis. Self-reported data. Cannabis potency and composition not measured.

Questions This Raises

  • ?Does cannabis use prevent veterans from seeking treatment they need?
  • ?Would controlled therapeutic cannabis use produce different outcomes than self-directed frequent use?

Trust & Context

Key Stat:
3-4x higher rates of depression and suicidal ideation in frequent users
Evidence Grade:
Large, nationally representative veteran survey with robust statistical analysis, but cross-sectional design limits causal inference.
Study Age:
Published in 2022, using 2019-2020 survey data.
Original Title:
Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: Psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms.
Published In:
Journal of traumatic stress, 35(4), 1154-1166 (2022)
Database ID:
RTHC-03913

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

Does cannabis help veterans with PTSD?

In this nationally representative survey, veterans with PTSD who used cannabis frequently had worse psychiatric symptoms, lower cognitive functioning, and more avoidance coping than those who used less or not at all.

Are veterans who use cannabis less likely to get mental health treatment?

Despite having more severe symptoms, veterans who used cannabis frequently were no more likely to engage in mental health treatment than those who did not use cannabis.

Read More on RethinkTHC

Cite This Study

RTHC-03913·https://rethinkthc.com/research/RTHC-03913

APA

Hill, Melanie L; Loflin, Mallory; Nichter, Brandon; Na, Peter J; Herzog, Sarah; Norman, Sonya B; Pietrzak, Robert H. (2022). Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: Psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms.. Journal of traumatic stress, 35(4), 1154-1166. https://doi.org/10.1002/jts.22823

MLA

Hill, Melanie L, et al. "Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: Psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms.." Journal of traumatic stress, 2022. https://doi.org/10.1002/jts.22823

RethinkTHC

RethinkTHC Research Database. "Cannabis use among U.S. military veterans with subthreshold ..." RTHC-03913. Retrieved from https://rethinkthc.com/research/hill-2022-cannabis-use-among-us

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.