Cannabis use disorder diagnoses rose faster among veterans with psychiatric conditions than those without

An analysis of over 4.3 million VA patient records from 2005 to 2019 found that cannabis use disorder diagnoses increased disproportionately among veterans with psychiatric disorders, especially those with bipolar or psychotic spectrum conditions.

Livne, Ofir et al.·The American journal of psychiatry·2024·Moderate-HighLongitudinal cohort study
RTHC-05488Longitudinal cohort studyModerate-High2024RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal cohort study
Evidence
Moderate-High
Sample
Not reported

What This Study Found

Cannabis use disorder prevalence increased more among veterans with psychiatric disorders than those without (difference in prevalence change: 1.91% from 2005-2014, 0.34% from 2016-2019). The greatest increases were among patients with bipolar and psychotic spectrum disorders.

Key Numbers

4.3 to 5.7 million VHA patient records per year. CUD prevalence gap between psychiatric and non-psychiatric patients widened by 1.91 percentage points (2005-2014) and 0.34 percentage points (2016-2019). Biggest increases among patients under 35 (earlier period) and over 65 (later period).

How They Did This

Analysis of Veterans Health Administration electronic health records from 2005 to 2019, covering 4.3 to 5.7 million patients annually. Examined overall and age-group-specific trends in CUD diagnoses stratified by psychiatric disorder status, with separate analyses for ICD-9 (2005-2014) and ICD-10 (2016-2019) periods.

Why This Research Matters

Veterans with mental health conditions appear to be developing cannabis use disorder at faster rates than other veterans. As cannabis becomes more available, this population may need more targeted screening and intervention.

The Bigger Picture

The intersection of expanding cannabis access and high rates of psychiatric conditions among veterans creates a growing clinical challenge. These data suggest the mental health system may need to prepare for rising rates of co-occurring cannabis use disorder.

What This Study Doesn't Tell Us

Based on diagnoses in medical records, which may reflect changes in screening practices or coding rather than true prevalence changes. VHA population may not represent all veterans or the general population.

Questions This Raises

  • ?Is the increase driven by more cannabis use, better screening, or changes in diagnostic thresholds?
  • ?Would targeted cannabis use screening for veterans with psychiatric disorders reduce CUD rates?

Trust & Context

Key Stat:
CUD grew 1.91% faster in veterans with psychiatric disorders (2005-2014)
Evidence Grade:
Large-scale longitudinal analysis of health system records spanning 15 years, though limited by diagnostic coding changes and the observational design.
Study Age:
2024 publication analyzing 2005-2019 data.
Original Title:
Trends in Prevalence of Cannabis Use Disorder Among U.S. Veterans With and Without Psychiatric Disorders Between 2005 and 2019.
Published In:
The American journal of psychiatry, 181(2), 144-152 (2024)
Database ID:
RTHC-05488

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

How much faster did cannabis use disorder increase among veterans with psychiatric conditions?

CUD prevalence grew 1.91 percentage points faster among veterans with psychiatric disorders compared to those without between 2005 and 2014.

Which psychiatric conditions had the highest CUD increases?

Veterans with bipolar and psychotic spectrum disorders saw the greatest increases in CUD diagnoses.

Did age matter?

Yes. The disparity was largest among veterans under 35 in the earlier period (2005-2014) and among those 65 and older in the later period (2016-2019).

Read More on RethinkTHC

Cite This Study

RTHC-05488·https://rethinkthc.com/research/RTHC-05488

APA

Livne, Ofir; Malte, Carol A; Olfson, Mark; Wall, Melanie M; Keyes, Katherine M; Maynard, Charles; Gradus, Jaimie L; Saxon, Andrew J; Martins, Silvia S; Keyhani, Salomeh; McDowell, Yoanna; Fink, David S; Mannes, Zachary L; Gutkind, Sarah; Hasin, Deborah S. (2024). Trends in Prevalence of Cannabis Use Disorder Among U.S. Veterans With and Without Psychiatric Disorders Between 2005 and 2019.. The American journal of psychiatry, 181(2), 144-152. https://doi.org/10.1176/appi.ajp.20230168

MLA

Livne, Ofir, et al. "Trends in Prevalence of Cannabis Use Disorder Among U.S. Veterans With and Without Psychiatric Disorders Between 2005 and 2019.." The American journal of psychiatry, 2024. https://doi.org/10.1176/appi.ajp.20230168

RethinkTHC

RethinkTHC Research Database. "Trends in Prevalence of Cannabis Use Disorder Among U.S. Vet..." RTHC-05488. Retrieved from https://rethinkthc.com/research/livne-2024-trends-in-prevalence-of

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.