Among hospitalized Nigerian army veterans from peacekeeping operations, 22% had PTSD, which was significantly associated with longer deployment, current alcohol use, and lifetime cannabis use.
Read this if you want to understand the relationship between military PTSD and substance use across different cultural contexts.
22% PTSD rate among Nigerian veterans, significantly associated with lifetime cannabis use
What the researchers found
Researchers assessed hospitalized Nigerian army veterans evacuated from peacekeeping operations in Liberia and Sierra Leone (1990-1994). The prevalence of PTSD was 22%, and survivor guilt was found in 38% of respondents.
PTSD was significantly associated with long duration of stay in the mission area, current alcohol use, lifetime use of an alcohol/gunpowder mixture (a local practice), and lifetime cannabis use. Survivor guilt was associated with avoidance of trauma-related stimuli but not with duration of combat exposure.
The authors concluded that PTSD might be common but undetected among Nigerian military personnel, and recommended deliberate screening and primary prevention efforts regarding alcohol and cannabis use.
Why it matters
This study documented PTSD and substance use in a military population rarely studied in the research literature. The association between PTSD and cannabis use in Nigerian veterans parallels findings in Western military populations, suggesting the PTSD-substance use relationship crosses cultural boundaries.
The numbers in context
PTSD prevalence: 22%. Survivor guilt: 38%. PTSD significantly associated with: long deployment, current alcohol use, alcohol/gunpowder mixture use, lifetime cannabis use.
How the study worked
Cross-sectional study of hospitalized patients from military operations at the 68 Nigerian Army Reference Hospital, Lagos. Socio-demographic questionnaire, PTSD checklist, and WHO substance use survey instrument administered to all physically capable patients over a 4-year period.
What this study cannot tell us
Cross-sectional design cannot determine whether cannabis use preceded or followed PTSD development. The hospitalized sample may not represent all veterans. The specific military context (peacekeeping operations) and cultural context (Nigeria) may limit generalizability. Assessment was over a broad 4-year period.
How to read the evidence
Cross-sectional study from a specific military population. Provides prevalence data and associations but cannot establish causal direction.
When this study was published
Published in 2006. Research on PTSD and cannabis in military populations has expanded substantially since then, with some studies examining cannabis as a potential PTSD treatment.
The bigger picture
The relationship between PTSD and cannabis use has been documented in multiple military populations worldwide. Whether cannabis use is a risk factor for PTSD, a form of self-medication, or both remains debated. This study in a Nigerian context adds to the cross-cultural evidence for this association.
Questions still open
- Does cannabis use increase vulnerability to developing PTSD after trauma, or do veterans with PTSD turn to cannabis for symptom relief? Would screening and treating substance use reduce PTSD severity in military populations?
Common questions
Is cannabis use related to PTSD in military veterans?
How common was PTSD in these veterans?
Read the original research
Post-traumatic stress disorder, survivor guilt and substance use--a study of hospitalised Nigerian army veterans.
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 96(2), 144-6
Citation
Okulate, G T; Jones, O B E. (2006). Post-traumatic stress disorder, survivor guilt and substance use--a study of hospitalised Nigerian army veterans.. South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde, 96(2), 144-6.
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