Study Finds Veterans With SUD Used Cannabis to Alleviate Pain, Anxiety, and Improve Poor Sleep Quality

About one-third of patients in a Veteran Affairs (VA) Substance Use Disorder (SUD) treatment program reported using cannabis during SUD treatment, according to authors of research published in Harm Reduction Journal.¹

There is evidence that cannabidiol (CBD), a phytocannabinoid with antiaddictive properties derived from the cannabis plant, may offer therapeutic potential for patients with SUD, particularly when it is related to nicotine, cannabis, and opioid use disorders. One systematic review published in Additive Behaviors determined a positive impact of CBD in the context of alcohol, opioids, and methamphetamine use (eg, diminishing of drug-seeking behaviors) in animal studies, as well as nicotine, cannabis, and opioid use (eg, frequency and quantity of consumption) in human studies. Cocaine use results were mixed among reviewed studies, and CBD was not found to have an effect in animal studies on cannabis use.²

Despite this positive indication, available research is considered sparse, and more data on humans is needed.²

According to the authors of the current study, two-thirds of US adults find recreational and medical cannabis use acceptable. Some evidence shows that cannabis use is an effective treatment for pain and a harm-reducing therapeutic for those with SUD. Contrary to most SUD treatment models, some models allow illegal substance use as a harm reduction strategy, which is the case for the SUD treatment program examined in this study.¹

The authors wrote that little is known about veterans with SUD and their perspectives on cannabis use to treat pain. Their study characterizes veteran perspectives on cannabis use during treatment for SUD unrelated to cannabis use. A total of 33 US military veterans with a diagnosis of chronic pain, who were receiving care from a VA SUD treatment program, were eligible to participate. Patients with polysubstance use could continue to use substances; however, they had to remain committed to a goal of abstaining from the substance that was the primary focus of their SUD treatment.¹

Most enrolled patients had a primary diagnosis of alcohol use disorder (70%), followed by opioid use disorder (18%) and stimulant use disorder (12%). Patients with a primary cannabis SUD were not eligible for inclusion. Patients completed a semistructured interview.¹

About one-third of patients reported cannabis use during SUD treatment and that their reasons for use were to alleviate pain, pain-related anxiety, and poor sleep quality and viewing cannabis as a harm-reducing therapeutic. The authors reported that about half of patients abstained from cannabis because of negative physical and mental effects they experienced in the past, fear of returning to use their primary SUD substance, and to avoid the violation of policies or laws that prohibit cannabis use. Additionally, some patients who did not use cannabis showed interest in future cannabis use for pain based on recent research studying cannabis, laymen knowledge, and curiosity.¹

The investigators suggest that VA and other federally employed health care professionals—particularly in US states where cannabis is legal—should prepare to educate patients on the medical evidence, gaps, policies, and laws related to cannabis, which will allow patients to make more informed health care decisions related to cannabis use.¹

REFERENCES

1. Pleasant T, Ono S, Kansagara D, Lovejoy J, Lovejoy T, Wyse J. A qualitative study on cannabis use for harm reduction and pain among veterans enrolled in an SUD treatment program. Harm Reduct J. 2026 Feb 19. doi:10.1186/s12954-026-01412-2. Epub ahead of print. PMID: 41715102.

2. Paulus V, Billieux J, Benyamina A, Karila L. Cannabidiol in the context of substance use disorder treatment: A systematic review. Addict Behav. 2022;132:107360. doi:10.1016/j.addbeh.2022.107360