Posttraumatic Stress Symptoms Moderate the Relationship Between Chronic Pain and Adverse Cannabis Outcomes: A Pilot Study

Abstract

Objective: Increasingly, cannabis is being prescribed/used to help manage posttraumatic stress symptoms (PTSS) or chronic pain, as cannabis has been argued to be beneficial for both types of symptoms. However, the evidence on efficacy is conflicting with evidence of risks mounting, leading some to caution against the use of cannabis for the management of PTSS and/or chronic pain. We examined the main and interactive effects of PTSS and chronic pain interference on adverse cannabis outcomes (a composite of cannabis use levels and cannabis use disorder, CUD, symptoms). We hypothesized that chronic pain interference and PTSS would each significantly predict adverse cannabis outcomes, and that chronic pain interference effects on adverse cannabis outcomes would be strongest among those with greater PTSS. Method: Forty-seven current cannabis users with trauma histories and chronic pain (34% male; mean age = 32.45 years) were assessed for current PTSS, daily chronic pain interference, past month cannabis use levels (grams), and CUD symptom count. Results: Moderator regression analyses demonstrated chronic pain interference significantly predicted the adverse cannabis outcomes composite, but only at high levels of PTSS. Conclusions: Cannabis users with trauma histories may be at greatest risk for heavier/more problematic cannabis use if they are experiencing both chronic pain interference and PTSS.