Interactive effects of PTSD and substance use on suicidal ideation and behavior in military personnel: Increased risk from marijuana use

Post-traumatic stress disorder (PTSD) is the most common mental disorder among active-duty soldiers and veterans, and is a major risk factor for suicidal thoughts and attempts in this population. As of 2018, medical marijuana is legal in 30 states and can be prescribed to treat PTSD symptoms in the majority of these states. In fact, legislative efforts to establish medical marijuana as a therapy for PTSD have been on a surge in recent years based on some supporting evidence from small, non-randomized clinical trials.

A study systematically measuring the longitudinal and interactive impact of substance use and PTSD symptoms on later symptoms of the same disorder, suicidal ideation, and suicidal behavior, however, suggested the contrary. Researchers surveyed 585 current and former military personnel over a 12-month period. They found that those with more frequent marijuana use at any point were significantly more likely to form suicidal thoughts and plan 1 month later. Especially, for those with the most severe PTSD conditions at the initial assessment, marijuana use also predicted worsened PTSD symptoms and increased likelihood of attempts at suicide over the following year.

What, exactly, is the mechanism through which marijuana exacerbates PTSD and suicidal risk among soldiers and veterans, while it has been shown to alleviate anxiety and sleep problems – major components of this disorder? Such a question remains the topic of further study. Nonetheless, based on the above findings, the authors warned that prescribing marijuana for military personnel with PTSD who are at risk for suicide is a precarious practice that should be avoided until more evidence is gathered.

Do you have experience with PSTD and cannabis use? We would love to hear your thoughts!


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