Characterizing the Prevalence and Nature of Cannabis Use Disorder and Comorbidities in Older Veterans

The DSM-5 defines cannabis use disorder (CUD) as continued use despite the occurrence of clinically significant physical and psychosocial issues, including tolerance and withdrawal. Cannabis use is common among US military Veterans. Over 10 percent of Veterans reported past six-month use in 2019 and 2020 (Hill, Nichter, Norman, Loflin, & Pietrzak, 2021), suggesting that many Veterans may be at risk for developing CUD. Veterans with CUD are more likely to have or develop lifetime posttraumatic stress disorder (PTSD), anxiety, mood disorders, nicotine addiction, alcohol dependence, and suicidal thoughts (Hill, Nichter, Norman, Loflin, & Pietrzak, 2021). Co-occurring disorders are termed “comorbidities.� The prevalence of CUD is higher among younger Veterans, at 5.6 percent (Hill, Loflin, Nichter, Norman, & Pietrzak, 2021; Pedersen, Marshall, & Kurz, 2017). These younger Veterans have served in recent conflicts like Operations Enduring Freedom, Iraqi Freedom, and New Dawn and are referred to as OEF/OIF/OND Veterans. Because existing research focuses on characterizing CUD in younger Veterans, the prevalence and nature of CUD in older Veterans are not well-understood. This research aimed to characterize CUD and comorbidities in older Veterans. CUD in older Veterans can co-occur with other substance use disorders like alcohol use disorder, cocaine use disorder, and tobacco use disorder. Although younger Veterans are more likely to have CUD and other comorbidities, older Veterans have very high rates of comorbidities, including depression and PTSD. Further investigating CUD in older Veterans with comorbidities and encouraging their recovery from CUD may significantly impact their overall health.