title: Factors associated with having a medical marijuana card among Veterans with recent substance use in VA outpatient treatment.
abstract: Psychiatric symptoms, somatic problems, and co-occurring substance use have been associated with medical marijuana consumption among civilian patients with substance use disorders. It is possible that these factors may impact Veterans' ability to engage in or adhere to mental health and substance use disorder treatment. Therefore, we examined whether psychiatric functioning, substance use, and somatic problems were associated with medical marijuana use among Veterans receiving substance use disorder and/or mental health treatment. Participants (n=841) completed screening measures for a randomized controlled trial and 67 (8%) reported that they had a current medical marijuana card. Most of these participants (78%) reported using marijuana to treat severe/chronic pain. Significant bivariate differences revealed that, compared to participants without a medical marijuana card, those with a card were more likely to be in a middle income bracket, unemployed, and they had a significantly higher number of recent days of marijuana use, synthetic marijuana use, and using sedatives prescribed to them. Additionally, a significantly higher proportion of participants with a medical marijuana card scored above the clinical cutoff for posttraumatic stress disorder (PTSD) symptoms, had significantly higher severity of sleep-related problems, and reported a higher level of pain. These findings highlight the co-occurrence of substance use, PTSD symptoms, sleep-related problems, and chronic pain among Veterans who use medical marijuana. Future research should investigate the inter-relationships among medical marijuana use and other clinical issues (e.g., PTSD symptoms, sleep, pain) over time, and potential implications of medical marijuana use on treatment engagement and response.
authors.affiliation: Department of Psychology, Bowling Green State University, 822 E. Merry Ave, Bowling Green, OH 43403, USA; HSR&D Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Floor 2, Ann Arbor, MI 48109, USA. Electronic address: alan.kooi.davis@gmail.com.
authors.forename: Alan K
authors.initials: AK
authors.lastname: Davis
authors.affiliation: University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Bonar
authors.affiliation: HSR&D Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Floor 2, Ann Arbor, MI 48109, USA; University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ilgen
authors.affiliation: University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA; University of Michigan Injury Center, University of Michigan School of Medicine, 2800 Plymouth Road, NCRC10-G080, Ann Arbor, MI, 48109, USA.
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Walton
authors.affiliation: School of Social Work, University of Michigan, 1080 S. University, Ann Arbor, MI 48109, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Perron
authors.affiliation: HSR&D Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, 2800 Plymouth Road, Building 16, Floor 2, Ann Arbor, MI 48109, USA; University of Michigan Addiction Center, Department of Psychiatry, University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Chermack
mesh_terms: D059350:Chronic Pain / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D064086:Medical Marijuana / Q000627:therapeutic use*; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data*; D012893:Sleep Wake Disorders / Q000150:complications / Q000188:drug therapy; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy*; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D064086:Medical Marijuana
keywords: Cannabis; Marijuana; Substance use problems; Treatment; Veterans