PTSD Uniquely Drives Cannabis Use in Deployed Military Personnel
Among 238 deployed military personnel, PTSD symptoms were uniquely associated with past-week cannabis use, while combat exposure and moral injury specifically predicted prescription drug misuse — revealing distinct pathways to different substance use patterns.
Quick Facts
What This Study Found
Higher PTSD symptom scores were uniquely associated with past-week cannabis use (vs. no use), while combat exposure and moral injury were uniquely associated with misuse of prescription opioids, sedatives, and both combined. Hazardous alcohol use (46.2%) was predicted by combat exposure.
Key Numbers
N=238; 21% opiate misuse; 25.6% sedative misuse; 16.4% both; 14.7% cannabis use; 46.2% hazardous alcohol; PTSD uniquely predicted cannabis; combat exposure + moral injury predicted prescription misuse; combat predicted hazardous alcohol
How They Did This
Cross-sectional survey of 238 US military personnel with one or more deployments (71% male, mean age 33.3), using multivariable multinomial logistic regression examining combat exposure, moral injury, PTSD, and pain as predictors of substance use patterns.
Why This Research Matters
Understanding that different military experiences drive different substance use patterns — PTSD→cannabis, combat/moral injury→prescription misuse — can guide targeted intervention strategies.
The Bigger Picture
Military substance use is not monolithic — the specificity of PTSD-cannabis and moral injury-prescription drug pathways suggests that treating the underlying psychological wound matters more than addressing substance use generically.
What This Study Doesn't Tell Us
Cross-sectional design; convenience community sample; self-report measures; relatively small sample; cannot determine if cannabis use is self-medication for PTSD or coincidental; no assessment of cannabis for therapeutic PTSD use.
Questions This Raises
- ?Are military personnel using cannabis specifically to self-medicate PTSD?
- ?Would PTSD-focused treatment reduce cannabis use?
- ?Should military substance use programs differentiate between combat-related and PTSD-related pathways?
Trust & Context
- Key Stat:
- Evidence Grade:
- Well-designed multivariable analysis parsing distinct psychosocial predictors, but small cross-sectional sample limits causal inference.
- Study Age:
- Published 2026; reflects current military substance use landscape.
- Original Title:
- Substance use in Military Personnel: Associations with Combat Exposure, Moral Injury, Posttraumatic Stress Disorder and Pain.
- Published In:
- Journal of drug education, 55(1), 3-20 (2026)
- Authors:
- Kelley, Michelle L, Gabelmann, Jeffrey M, Strowger, Megan, Hearton, John, Folivi, Folly, Bravo, Adrian J, Noh, Jinjoo, Kuskye, Kristin, Haber, William, McGuire, Adam P
- Database ID:
- RTHC-08380
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Why do military personnel use cannabis?
This study found that PTSD symptoms were the unique driver of cannabis use in deployed personnel, distinct from combat exposure and moral injury which drove prescription drug misuse — suggesting cannabis may serve as self-medication specifically for PTSD symptoms.
How common is substance use in the military?
Among deployed personnel in this study: 46% reported hazardous alcohol use, 26% misused sedatives, 21% misused opioids, and 15% used cannabis in the past week — with different military experiences driving different substance patterns.
Read More on RethinkTHC
- anxiety-leaving-house-weed-withdrawal-agoraphobia
- anxiety-response-technique-weed-withdrawal
- anxiety-toolkit-weed-withdrawal
- anxiety-worse-after-quitting-weed
- breathing-exercises-weed-withdrawal-anxiety
- cannabis-induced-anxiety
- does-weed-help-anxiety
- grounding-techniques-weed-withdrawal
- health-anxiety-weed-withdrawal
- manage-anxiety-without-weed
- quitting-weed-anxiety-disorder
- quitting-weed-anxiety-medication-ssri
- self-medicating-anxiety-with-weed
- therapy-quitting-weed-anxiety
- weed-and-anxiety
- weed-biphasic-effect-anxiety
- weed-generalized-anxiety-disorder
- weed-panic-attacks
- weed-paranoia
- weed-social-anxiety
- weed-tolerance-anxiety-stopped-working
- weed-withdrawal-anxiety
- weed-withdrawal-panic-attacks-night
- weed-withdrawal-work-anxiety
- withdrawal-anxiety-vs-real-anxiety
- cannabis-military-rules-testing-career
Cite This Study
https://rethinkthc.com/research/RTHC-08380APA
Kelley, Michelle L; Gabelmann, Jeffrey M; Strowger, Megan; Hearton, John; Folivi, Folly; Bravo, Adrian J; Noh, Jinjoo; Kuskye, Kristin; Haber, William; McGuire, Adam P. (2026). Substance use in Military Personnel: Associations with Combat Exposure, Moral Injury, Posttraumatic Stress Disorder and Pain.. Journal of drug education, 55(1), 3-20. https://doi.org/10.1177/00472379251394435
MLA
Kelley, Michelle L, et al. "Substance use in Military Personnel: Associations with Combat Exposure, Moral Injury, Posttraumatic Stress Disorder and Pain.." Journal of drug education, 2026. https://doi.org/10.1177/00472379251394435
RethinkTHC
RethinkTHC Research Database. "Substance use in Military Personnel: Associations with Comba..." RTHC-08380. Retrieved from https://rethinkthc.com/research/kelley-2026-substance-use-in-military
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.