Perceptions and Use of Alcohol and Medical Cannabis among Canadian Military Veterans Living with PTSD
Abstract: Posttraumatic stress disorder (PTSD) is a common psychiatric diagnosis among Canadian military veterans, and alcohol and medical cannabis are commonly used by this group to cope with PTSD symptoms. This paper is part of a larger study that examined a cohort of 5 veterans, over a 1-year period, who used both medical cannabis and alcohol and were matched with a PTSD service dog. This paper compares the perceptions and use of alcohol and medical cannabis among the veterans to cope with their PTSD symptoms and outlines key implications. Semi-structured interviews offer insight into similarities and differences between the veterans’ perceptions and use of the two substances. Both substances are used by the veterans to manage their PTSD symptoms, typically worsening them if used in excess. Medical cannabis is a prescribed medication; however, it is perceived by the veterans to be associated with a negative discourse and in particular stigma. This is not the case for alcohol. The veterans identified alcohol use as more influenced by social norms and perceived it as more of a concern for addiction compared to medical cannabis. This did not, however, appear to impact the level of alcohol use. These findings offer unique insight into the military culture’s general acceptance of alcohol but not medical cannabis use. This has possible implications for veterans’ use of alcohol and/or medical cannabis to help manage their PTSD symptoms.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.