Biopsychosocial factors and health outcomes associated with cannabis, opioids and benzodiazepines use among older veterans

ABSTRACT

Background: Older Veterans may experience injuries that result in chronic pain and mental health conditions. Given the increasing availability of medical cannabis, it is important to examine if it serves as a viable or undesirable form of care relative to existing approaches.

Objectives: We compared cannabis, prescription opioids, and benzodiazepines use between older Veteran and non-Veterans, and identified outcomes of cannabis use among Veterans. Because of the physical and mental conditions experienced by older Veterans we expected Veterans to report higher use of opioids and benzodiazepines compared to non-Veterans.

Methods: We collected surveys from individuals aged 60 and older enrolled in the Illinois Medical Cannabis Patient Program and conducted logistic regression to identify factors associated with cannabis, opioids and benzodiazepines use between Veterans (N = 514, 90.2% male) and Non-Veterans (N = 2758, 41.1% male) across biopsychosocial factors.

Results: Both groups reported similar levels of pain, quality of life, social satisfaction, and sleep quality. Veterans were more likely to use cannabis for mental health conditions (p = <.001) while they reported lower use for pain-related conditions (p = <.001) than non-Veterans. Veterans were less likely to use opioids (p = .013) and benzodiazepines (p < .01) compared to non-Veterans. Veterans also reported desirable health outcomes of cannabis use for pain, sleep quality, health conditions, and quality of life.

Conclusions: Our work provides insights for clinicians and policy makers to consider whether cannabis can be a viable option to reduce or replace opioid and benzodiazepine use by older Veterans with chronic physical and mental health conditions.

KEYWORDS:

• Veterans
• aging
• cannabis
• PTSD
• opioids
• benzodiazepines
• chronic pain

Acknowledgements

We would like to thank Karen Mancera-Cuevas, Paula Atteberry and Elaine Ewing from the Illinois Department of Public Health for providing feedback during project development. We would also like to thank Kanika Arora and Gary Milavetz from The University of Iowa for their contributions to the survey design and Cydney Natzke for her role in developing the online version of the survey instrument.

Additional information

Funding

This work was supported by the Illinois Department of Public Health [93107003].