Substance use patterns predicted worse PTSD and depression trajectories after trauma exposure

Among 1,618 recently trauma-exposed civilians, people who already used cannabis or alcohol heavily had worse PTSD and depression symptoms at baseline, with symptoms peaking around 8 weeks before declining.

Hinojosa, Cecilia A et al.·Psychological medicine·2024·Strong EvidenceObservational
RTHC-05378ObservationalStrong Evidence2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Strong Evidence
Sample
N=1,618

What This Study Found

Using latent class mixture modeling, researchers identified three trajectory classes for both alcohol and cannabis use: low, high, and increasing use. High cannabis users had significantly worse PTSD and depression symptoms at baseline compared to low users. All groups showed symptom increases peaking at week 8 followed by decline at week 12.

Key Numbers

1,618 participants (1,037 female); three trajectory classes per substance (low, high, increasing use); PTSD and depression symptoms peaked at week 8 across groups; symptoms declined by week 12

How They Did This

Longitudinal study of 1,618 trauma-exposed civilians (1,037 female) recruited from emergency departments. Self-reported alcohol and cannabis use and clinical symptoms were assessed at baseline and at 2, 8, and 12 weeks posttrauma. Latent class mixture modeling identified substance use trajectories.

Why This Research Matters

Understanding how substance use patterns relate to post-trauma mental health trajectories could help clinicians identify who is most at risk for developing chronic PTSD and depression after a traumatic event.

The Bigger Picture

The finding that pre-existing substance use patterns predict post-trauma symptom severity and trajectories supports the idea that substance use may reduce resilience to trauma, creating a self-reinforcing cycle.

What This Study Doesn't Tell Us

Self-reported substance use; 12-week follow-up may be too short to capture long-term trajectories; cannot determine whether substance use causes worse symptoms or whether shared risk factors drive both; emergency department recruitment may not represent all trauma-exposed individuals

Questions This Raises

  • ?Would early intervention targeting substance use in trauma-exposed individuals improve PTSD outcomes?
  • ?Why did symptoms peak at 8 weeks, and does this timing window offer a critical intervention opportunity?

Trust & Context

Key Stat:
1,618 trauma-exposed civilians tracked for 12 weeks
Evidence Grade:
Large multi-site longitudinal study with sophisticated trajectory modeling, though limited by self-report and 12-week follow-up.
Study Age:
2024 study
Original Title:
Associations of alcohol and cannabis use with change in posttraumatic stress disorder and depression symptoms over time in recently trauma-exposed individuals.
Published In:
Psychological medicine, 54(2), 338-349 (2024)
Authors:
Hinojosa, Cecilia A, Liew, Amanda, An, Xinming(4), Stevens, Jennifer S, Basu, Archana, van Rooij, Sanne J H, House, Stacey L, Beaudoin, Francesca L, Zeng, Donglin, Neylan, Thomas C, Clifford, Gari D, Jovanovic, Tanja, Linnstaedt, Sarah D, Germine, Laura T, Rauch, Scott L, Haran, John P, Storrow, Alan B, Lewandowski, Christopher, Musey, Paul I, Hendry, Phyllis L, Sheikh, Sophia, Jones, Christopher W, Punches, Brittany E, Kurz, Michael C, Swor, Robert A, Hudak, Lauren A, Pascual, Jose L, Seamon, Mark J, Datner, Elizabeth M, Chang, Anna M, Pearson, Claire, Peak, David A, Merchant, Roland C, Domeier, Robert M, Rathlev, Niels K, Sergot, Paulina, Sanchez, Leon D, Bruce, Steven E, Miller, Mark W, Pietrzak, Robert H, Joormann, Jutta, Pizzagalli, Diego A, Sheridan, John F, Harte, Steven E, Elliott, James M, Kessler, Ronald C, Koenen, Karestan C, McLean, Samuel A, Ressler, Kerry J, Fani, Negar
Database ID:
RTHC-05378

Evidence Hierarchy

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

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

How did cannabis use affect recovery from trauma?

People who were already heavy cannabis users before their traumatic event had significantly worse PTSD and depression symptoms from the start. Their symptoms, like those of other groups, peaked around 8 weeks after the trauma before beginning to decline at 12 weeks.

Did some people increase substance use after trauma?

Yes. The analysis identified an "increasing use" trajectory class for both cannabis and alcohol, representing people who escalated their substance use following trauma. These individuals also showed elevated PTSD and depression symptoms.

Read More on RethinkTHC

Cite This Study

RTHC-05378·https://rethinkthc.com/research/RTHC-05378

APA

Hinojosa, Cecilia A; Liew, Amanda; An, Xinming; Stevens, Jennifer S; Basu, Archana; van Rooij, Sanne J H; House, Stacey L; Beaudoin, Francesca L; Zeng, Donglin; Neylan, Thomas C; Clifford, Gari D; Jovanovic, Tanja; Linnstaedt, Sarah D; Germine, Laura T; Rauch, Scott L; Haran, John P; Storrow, Alan B; Lewandowski, Christopher; Musey, Paul I; Hendry, Phyllis L; Sheikh, Sophia; Jones, Christopher W; Punches, Brittany E; Kurz, Michael C; Swor, Robert A; Hudak, Lauren A; Pascual, Jose L; Seamon, Mark J; Datner, Elizabeth M; Chang, Anna M; Pearson, Claire; Peak, David A; Merchant, Roland C; Domeier, Robert M; Rathlev, Niels K; Sergot, Paulina; Sanchez, Leon D; Bruce, Steven E; Miller, Mark W; Pietrzak, Robert H; Joormann, Jutta; Pizzagalli, Diego A; Sheridan, John F; Harte, Steven E; Elliott, James M; Kessler, Ronald C; Koenen, Karestan C; McLean, Samuel A; Ressler, Kerry J; Fani, Negar. (2024). Associations of alcohol and cannabis use with change in posttraumatic stress disorder and depression symptoms over time in recently trauma-exposed individuals.. Psychological medicine, 54(2), 338-349. https://doi.org/10.1017/S0033291723001642

MLA

Hinojosa, Cecilia A, et al. "Associations of alcohol and cannabis use with change in posttraumatic stress disorder and depression symptoms over time in recently trauma-exposed individuals.." Psychological medicine, 2024. https://doi.org/10.1017/S0033291723001642

RethinkTHC

RethinkTHC Research Database. "Associations of alcohol and cannabis use with change in post..." RTHC-05378. Retrieved from https://rethinkthc.com/research/hinojosa-2024-associations-of-alcohol-and

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.