Associations of PTSD, chronic pain, and their comorbidity on cannabis use disorder: Results from an American nationally representative study. Issue 11 (29th July 2019)

• Record Type: Journal Article
• Authors: Bilevicius, Elena; Sommer, Jordana L.; Asmundson, Gordon J. G.; El‐Gabalawy, Renée
• Is Part Of: Depression and anxiety. Volume 36:Issue 11(2019)
• Page Start: 1036
• Page End: 1046
• Publication Date: 2019-07-29
• Subjects: cannabis use disorder -- chronic pain -- epidemiology -- NESARC‐III -- posttraumatic stress disorder; Anxiety -- Periodicals; Depression, Mental -- Periodicals; Depression -- Periodicals; Anxiety -- Periodicals; Anxiety Disorders -- Periodicals; 616.8527005
• DOI: 10.1002/da.22947
• Languages: English
• ISSNs: 1091-4269

Abstract

Abstract: Background: Cannabis can be prescribed for posttraumatic stress disorder (PTSD) and chronic pain, and comorbid cannabis use disorder (CUD) can occur in both conditions. Research demonstrates that PTSD and chronic pain commonly co‐occur. Methods: Data were acquired from the National Epidemiologic Survey on Alcohol and Related Conditions‐III ( N = 36, 309). Past‐year CUD and PTSD were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule‐5. Past‐year physician‐confirmed chronic pain was self‐reported and classified as musculoskeletal (e.g., arthritis), digestive (e.g., pancreatitis), and nerve (e.g., reflex sympathetic dystrophy) pain. Weighted cross‐tabulations assessed sociodemographic, psychiatric, and chronic pain condition variables among those with PTSD versus no PTSD, among the entire sample and among those with CUD and chronic pain. Multiple logistic regressions examined the relationship between PTSD and chronic pain with CUD. CUD characteristics were also evaluated across PTSD and chronic pain groups. Results: Rates of CUD were elevated in PTSD (9.4%) compared to those without (2.2%). The odds of CUD were greater for PTSD+digestive pain, PTSD+nerve pain, and PTSD+any chronic pain compared to having neither PTSD nor chronic pain (odds ratio range: 1.88–2.32). PTSD with and without comorbid chronic pain was associated with overall elevated rates of adverse CUD characteristics, including earlier age of onset, greater usage, and greater CUD severity. Conclusions: PTSD with and without chronic pain is associated with elevated rates and severity of CUD. These results may have implications for prescribing practices and understanding individuals at risk for developing CUD. HIGHLIGHTS: The prevalence of cannabis use disorder (CUD) is higher in individuals with posttraumatic stress disorder (PTSD) compared to those without The odds of CUD are greater in comorbid PTSD and chronic pain compared to having neither PTSD nor chronic pain PTSD appears to be driving the relationship with CUD in comorbid relationships PTSD with and without chronic pain is associated with greater severity of CUD