Cannabis Use Disorder Was Linked to Suicide Attempts in Iraq/Afghanistan Veterans

Among 3,233 Iraq/Afghanistan-era veterans, those with cannabis use disorder had 2.3 times the odds of a lifetime suicide attempt, even after accounting for PTSD, depression, alcohol, and combat exposure.

Kimbrel, Nathan A et al.·Journal of psychiatric research·2017·Moderate EvidenceCross-Sectional
RTHC-01420Cross SectionalModerate Evidence2017RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=3,233

What This Study Found

This study examined the relationship between cannabis use disorder (CUD) and suicidal behavior in a large sample of 3,233 Iraq/Afghanistan-era veterans.

Veterans with lifetime CUD had significantly higher odds of both current suicidal ideation (OR = 1.683) and lifetime suicide attempts (OR = 2.306). What makes this finding notable is that these associations persisted after statistically controlling for numerous other risk factors: sex, PTSD, depression, alcohol use disorder, non-cannabis drug use disorder, childhood sexual abuse history, and combat exposure.

The fact that CUD predicted suicide attempts independently of PTSD, depression, and other substance use disorders suggests it may represent a unique risk factor rather than simply a marker of other problems. This is particularly relevant for veteran populations, where suicide prevention is a critical priority.

Key Numbers

3,233 veterans. CUD associated with suicidal ideation OR = 1.683 (p = 0.008). CUD associated with suicide attempts OR = 2.306 (p < 0.0001). Associations held after controlling for sex, PTSD, depression, alcohol use disorder, other drug use disorder, childhood sexual abuse, and combat exposure.

How They Did This

Cross-sectional analysis of 3,233 Iraq/Afghanistan-era veterans using well-validated instruments to assess cannabis use disorder, suicidal ideation, suicide attempt history, and relevant covariates including PTSD, depression, alcohol use disorder, other drug use disorder, childhood sexual abuse, and combat exposure.

Why This Research Matters

Veteran suicide remains a national crisis. Identifying CUD as an independent risk factor for suicide attempts provides a specific, actionable screening target. Veterans with CUD may benefit from additional suicide risk assessment and prevention efforts.

The Bigger Picture

This study adds cannabis use disorder to the list of independent suicide risk factors in veteran populations. Given that cannabis use is increasing among veterans (some using it to self-medicate PTSD), the finding that CUD independently predicts suicide attempts creates an important clinical tension: veterans may use cannabis hoping to reduce distress, but problematic use patterns may independently increase suicide risk.

What This Study Doesn't Tell Us

Cross-sectional design cannot establish whether CUD contributes to suicide risk or whether underlying factors drive both CUD and suicidal behavior. Self-reported data may be affected by recall bias. The veteran population may not generalize to civilian populations.

Questions This Raises

  • ?Does cannabis use disorder increase suicide risk through a specific mechanism (impulsivity, withdrawal dysphoria)?
  • ?Would effective CUD treatment reduce suicide risk in veterans?
  • ?Is it the cannabis use disorder specifically, or any pattern of problematic substance use, that drives this association?

Trust & Context

Key Stat:
Veterans with cannabis use disorder had 2.3x the odds of a lifetime suicide attempt
Evidence Grade:
Large cross-sectional study with comprehensive covariate controls. Moderate because the cross-sectional design limits causal inference.
Study Age:
Published in 2017.
Original Title:
Cannabis use disorder and suicide attempts in Iraq/Afghanistan-era veterans.
Published In:
Journal of psychiatric research, 89, 1-5 (2017)
Database ID:
RTHC-01420

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 use increase suicide risk in veterans?

This study found that cannabis use disorder was independently associated with more than double the odds of a lifetime suicide attempt among Iraq/Afghanistan-era veterans, even after accounting for PTSD, depression, and other known risk factors.

Is this about all cannabis use or just problematic use?

The study specifically examined cannabis use disorder (problematic patterns meeting diagnostic criteria), not casual or occasional use. Whether casual cannabis use carries the same risk was not assessed.

Read More on RethinkTHC

Cite This Study

RTHC-01420·https://rethinkthc.com/research/RTHC-01420

APA

Kimbrel, Nathan A; Newins, Amie R; Dedert, Eric A; Van Voorhees, Elizabeth E; Elbogen, Eric B; Naylor, Jennifer C; Ryan Wagner, H; Brancu, Mira; Beckham, Jean C; Calhoun, Patrick S. (2017). Cannabis use disorder and suicide attempts in Iraq/Afghanistan-era veterans.. Journal of psychiatric research, 89, 1-5. https://doi.org/10.1016/j.jpsychires.2017.01.002

MLA

Kimbrel, Nathan A, et al. "Cannabis use disorder and suicide attempts in Iraq/Afghanistan-era veterans.." Journal of psychiatric research, 2017. https://doi.org/10.1016/j.jpsychires.2017.01.002

RethinkTHC

RethinkTHC Research Database. "Cannabis use disorder and suicide attempts in Iraq/Afghanist..." RTHC-01420. Retrieved from https://rethinkthc.com/research/kimbrel-2017-cannabis-use-disorder-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.