Cannabis use disorder and suicide attempts in Iraq/Afghanistan-era veterans

Abstract

The objective of the present research was to examine the association between lifetime cannabis use disorder (CUD), current suicidal ideation, and lifetime history of suicide attempts in a large and diverse sample of Iraq/Afghanistan-era veterans (N = 3,233) using a battery of well-validated instruments. As expected, CUD was associated with both current suicidal ideation (OR = 1.683, p = 0.008) and lifetime suicide attempts (OR = 2.306, p < 0.0001), even after accounting for the effects of sex, posttraumatic stress disorder, depression, alcohol use disorder, non-cannabis drug use disorder, history of childhood sexual abuse, and combat exposure. Thus, the findings from the present study suggest that CUD may be a unique predictor of suicide attempts among Iraq/Afghanistan-era veterans; however, a significant limitation of the present study was its cross-sectional design. Prospective research aimed at understanding the complex relationship between CUD, mental health problems, and suicidal behavior among veterans is clearly needed at the present time.

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

“…Marijuana use also predicted an increased likelihood of suicidal behavior as well as less of a decline in PTSD symptoms over the following year for those with elevated PTSD symptoms at baseline. These findings are in line with those of Kimbrel et al (), who found that the presence of a lifetime CUD diagnosis was associated with current suicidal ideation and with lifetime suicide attempts in a large sample of OEF/OIF veterans. Although Kimbrel et al () and colleagues found significant direct effects of CUD on suicidal behavior controlling for a PTSD diagnosis, this may be due to the cross‐sectional nature of their study or the treatment of CUD and PTSD as dichotomous variables as we found PTSD severity to moderate the relation between days using marijuana and suicidal behavior.…”

“…These findings are in line with those of Kimbrel et al (), who found that the presence of a lifetime CUD diagnosis was associated with current suicidal ideation and with lifetime suicide attempts in a large sample of OEF/OIF veterans. Although Kimbrel et al () and colleagues found significant direct effects of CUD on suicidal behavior controlling for a PTSD diagnosis, this may be due to the cross‐sectional nature of their study or the treatment of CUD and PTSD as dichotomous variables as we found PTSD severity to moderate the relation between days using marijuana and suicidal behavior. This study also extends the findings of a recent literature review conducted by Borges, Bagge, and Orozco () who concluded that there was strong evidence for an association between chronic marijuana use and elevated suicidal ideation and behavior.…”

“…Findings regarding the relations between marijuana use and suicide outcomes are mixed. Among operation enduring freedom/operation Iraqi freedom (OEF/OIF) veterans cannabis use disorders (CUDs) are associated with higher odds of current ideation, lifetime attempts, and suicidal self‐injury after controlling for key covariates (Kimbrel et al, ). However, a study of 50,087 Swedish men conscripted for military service found that the relation between CUD and completed suicides over a 33‐year period may be explained by co‐occurring mental health problems (Price, Hemmingsson, Lewis, Zammit, & Allebeck, ).…”

Effect of cannabis liberalization on suicide and mental illness following recreational access: a state-level longitudinal analysis in the USA

“…Critics of marijuana legalization point to studies showing correlations between heavy cannabis use and suicide, depression, and mental health disorders. [29] However, such studies that demonstrate correlation have yet to confirm causation, which should be determined by a model’s ability to predict. [59] Although those reporting depression to SAMHSA have increasingly used marijuana since states began increasing access to regulated cannabis, [10] we observe no evidence that cannabis liberalization has predictive relationships with reports of any mental illness.…”

Effect of cannabis use on PTSD treatment outcomes in veterans

“…Authors noted that despite validated assessments indicating worsening PTSD symptoms, participants reported feeling the substances improved symptoms. Authors of another study 8 found that Iraq/Afghanistan-era veterans who met criteria for cannabis use disorder had 1.7 times higher current suicidal ideation and 2.3 times higher lifetime suicide attempts compared to those who did not meet criteria.…”