Pre-Trauma THC Use Is Associated With a Positive Posttraumatic Adjustment Scale Screening.
Jeremy Miller, Claudia Alvarez, Lauren Berki, Catherine Linsley, John Woods, Aaron Strumwasser, Danielle Vanderet, Mallory Jebbia
The American Surgeon™ March 2026 DOI: 10.1177/00031348251381622 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective cohort study Peer reviewed |
|---|---|
| Sample size | 1,960 |
| Population | Adult trauma patients at a Level 1 trauma center who completed inpatient Posttraumatic Adjustment Scale screening |
| Measures | Posttraumatic Adjustment Scale (PAS) |
| Topics | Cannabis |
| Keywords | Trauma acute care |
| Key findings | Recent THC use was independently associated with a positive posttraumatic stress symptom screen in trauma patients (OR 1.66, 95% CI 1.23-2.24), with 22.3% of 1,960 patients screening positive. The authors suggest baseline cannabis use may signal heightened vulnerability to psychological distress after trauma and raise concern about THC as self-medication. |
Abstract
BackgroundCannabis use has increased in recent years, often perceived as therapeutic for psychiatric symptoms including those of posttraumatic stress disorder (PTSD). However, the relationship between pre-trauma tetrahydrocannabinol (THC) use and development of PTSD symptoms after injury remains poorly defined. The purpose of this study was to determine the association between THC use and positive screening for posttraumatic stress symptoms using the Posttraumatic Adjustment Scale (PAS) in trauma patients.MethodsThis retrospective cohort study used data from a Level 1 trauma center between January 2023 and December 2024. Adult trauma patients who completed inpatient PAS screening were included. Patients were stratified into PAS-positive and PAS-negative groups. THC use was identified via urine drug screen on admission. Multivariable logistic regression was used to evaluate independent predictors of a positive PAS screen, adjusting for age, sex, injury severity, assault mechanism, polysubstance use, ICU admission, and in-hospital complications.ResultsAmong 1960 patients, 437 (22.3%) screened positive on PAS. Tetrahydrocannabinol use was more common in PAS-positive patients (19.6% vs 13.2%, P = 0.001) and remained independently associated with a positive PAS screen after adjustment (OR 1.66, 95% CI 1.23-2.24, P = 0.001). Other independent predictors included polysubstance use, younger age, assault-related injury, and longer hospital stay. Male sex was associated with lower odds of a positive PAS screen.ConclusionsRecent THC use is independently associated with positive PAS screening in trauma patients, suggesting that baseline cannabis use may signal heightened vulnerability to psychological distress following trauma. These findings raise concern about the role of THC as self-medication and highlight the need for targeted screening and intervention.
Comparable studies
Other observational and cohort studies on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| High-potency cannabis and the risk of psychosis People with first episode of psychosis and healthy controls from the local population | 2009 | Case-control study | n = 454 |
| Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada Rural aboriginal population | 2013 | Observational study | |
| Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people | 2000 | Observational | |
| Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study Individuals from the general population in Germany aged 14-24 at baseline | 2011 | Observational cohort | n = 1,923 |
| Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases Patients treated for cannabis-induced psychotic symptoms in Denmark between 1994 and... | 2005 | Observational cohort | n = 535 |