Cannabis use disorder and post-traumatic stress disorder: The prevalence of comorbidity in veterans of recent conflicts

Abstract

AimsVeterans have high rates of cannabis use, and rates of cannabis use disorder (CUD) are rising among this population. These rising rates are particularly true for veterans with post-traumatic stress disorder (PTSD), which is common among veterans of recent conflicts, Operations Enduring Freedom, Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND). Although prior work has documented links between PTSD and cannabis use, a better understanding of the intersection among CUD, PTSD, and other disorders in real-world clinical practice can inform prevention and treatment efforts. This study examined the prevalence and comorbidities of CUD and PTSD in OFE/OIF/OND veterans. MethodThe study analyzed data from the Veterans Affairs Corporate Data Warehouse (2010–2016) for returning war veterans who were diagnosed with CUD (N = 46,268). The study determined prevalence of PTSD, and examined additional differences in comorbidities. ResultsThe prevalence of a comorbid PTSD diagnosis among OEF/OIF/OND veterans with a CUD diagnosis was 72.3%. Further analysis revealed additional co-occurring disorders. Veterans with a diagnosis of CUD and PTSD were more likely to have a comorbid diagnosis of depression (odds ratio, 1.69; 95% CI, 1.62–1.71), panic disorder (odds ratio; 1.58; 95% CI, 1.43–1.75), alcohol use disorder (odds ratio; 1.30; 95% CI, 1.24–1.35), opioid use disorder (odds ratio; 1.52; 95% CI, 1.43–1.62), and insomnia (odds ratio; 1.74; 95% CI, 1.65–1.84) than veterans without a PTSD diagnosis. ConclusionsFindings highlight that the majority of returning war veterans with CUD are highly complex. Our findings substantiate the need for urgent, comprehensive care for veterans with co-occurring CUD and PTSD, including integrated and transdiagnostic treatment approaches.