The use of cannabis and cannabis use disorder were found to be more prevalent among vulnerable subgroups of veterans — such as those with psychiatric disorders — according to authors of a study published in the American Journal of Psychiatry.

Data for this study were sourced from the National Epidemiologic Survey on Alcohol and Related Conditions–III (NESARC-III). From April 2012 to June 2013, noninstitutionalized civilians living in the United States were interviewed about their substance use and use disorders. Individuals were compensated $90 for their participation.

The participants evaluated in the current study were veterans no longer on active duty (N=3119). The majority were men (90.2%), aged 45 years and older (81.2%), White (79.5%), and married or cohabitating (67.6%).


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Cannabis use was reported among 7.3% and cannabis use disorder among 1.8% of the veterans during the previous 12 months and among 32.5% and 5.7% for lifetime use and use disorder, respectively. During the previous 12 months, 84.9% of the veterans reported nonmedical use only, 4.0% reported medical use only, and 11.2% reported using cannabis for both motivations. Among veterans endorsing lifetime cannabis use, 95.5% endorsed nonmedical use only.

Nonmedical cannabis use during the prior 12 months was associated most strongly with veterans aged 18 to 29 years (adjusted odds ratio [aOR], 9.02), followed by those aged 30 to 44 years (aOR, 8.77) and those aged 45 to 64 years (aOR, 4.94). Nonmedical cannabis use during this period was also associated with male veterans (aOR, 2.18); unmarried veterans (aOR, 2.70); veterans who were widowed, separated, or divorced (aOR, 2.26); those earning less than $20,000 annually (aOR, 2.35); and those earning $20,000 to $34,999 annually (aOR, 1.82).

Nonmedical cannabis use during the prior 12 months was increased among veterans who reported having a drug use disorder (aOR, 12.64), an opioid use disorder (aOR, 4.73), alcohol use disorder (aOR, 3.37), any mood disorder (aOR, 2.90), any anxiety disorder (aOR, 2.27), and tobacco use disorder (aOR, 2.01).

Cannabis use disorder during the prior 12 months was associated with veterans aged 30 to 44 years (aOR, 2.79); male veterans (aOR, 10.63); those who were widowed, separated, or divorced (aOR, 2.75); and those earning less than $20,000 annually (aOR, 5.00).

Cannabis use disorder was increased among those who reported having alcohol use disorder (aOR, 5.87), any mood disorder (aOR, 4.37), any anxiety disorder (aOR, 2.99), and tobacco use disorder (aOR, 2.09).

Stratified by location, individuals who lived in states with a medical marijuana law as of 2012 were more likely to report daily or nearly daily nonmedical cannabis use (aOR, 3.08), cannabis use disorder (aOR, 2.68), medical and nonmedical use (aOR, 2.09), any nonmedical use (aOR, 1.91), and nonmedical use of cannabis only (aOR, 1.63).

This study likely included some bias, given that the participants self-reported their cannabis use.

The investigators concluded that their data indicate vulnerable subgroups of veterans in the United States may be at increased risk for cannabis use and use disorder; these subgroups include individuals of low socioeconomic status and those with psychiatric disorders. Veterans living in states with medical marijuana laws were likely at higher risk than those residing in states where access was more limited.

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.

Reference

Browne KC, Stohl M, Bohnert KM, et al. Prevalence and correlates of cannabis use and cannabis use disorder among U.S. veterans: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III). Am J Psychiatry. Published online August 19, 2021. doi:10.1176/appi.ajp.2021.20081202