As more veterans turn to cannabis to address a range of health conditions, questions about its efficacy, safety, and place in clinical care have become increasingly relevant. In this article, Ethos pharmacist Dr. David Artinger helps examine the latest research on cannabis use among veterans, discusses commonly treated conditions, and explains how cannabis compares to traditional medications.
What are the most common conditions among veterans that cannabis may be used to treat?
First, let’s clarify the most common conditions for which veterans use cannabis. In 2023, a study explored veterans using medicinal cannabis as an alternative to prescription and over-the-counter medications. Chronic pain, PTSD, anxiety, and depression were reported as the leading conditions, in order of prevalence. (McNabb, et al, 2023).
Is there clinical evidence supporting cannabis for PTSD, chronic pain, or anxiety in veterans?
There have been many small studies into the use of medical cannabis for these indications. Unfortunately, they have not generated high-quality evidence in support of the efficacy of medicinal cannabis. There have been reports of short-term improvements, but not in the long term. What this means is that there is a need for more robust randomized controlled trials done to test the effects of medicinal cannabis on the many indications for which cannabis has been shown to alleviate.
One promising study, approved by the FDA in late 2024 and funded by the Michigan Veteran Marijuana Research Grant Program, will investigate the effects of high-THC flower on PTSD symptoms in over 300 veteran participants. This study, called MPJ2, will include only veterans who are experienced with cannabis, will allow them to self-titrate, and the method of consumption will be inhaled medicinal cannabis flower, reflecting real-world usage (Storey, 2024).
Cannabis has been shown to be effective in the treatment of anxiety. This is dose-dependent, with low doses having an anxiolytic effect and higher doses resulting in increased anxiety and paranoia. CBD, on the other hand, has been shown to have anxiolytic effects, regardless of dose. Medical consideration needs to be taken when using CBD due to its potential to affect the concentrations of other prescribed medications (Kirk, 2025).
How effective is cannabis in helping veterans with insomnia or sleep disturbances, particularly those linked to PTSD or chronic pain?
Cannabis has been shown to be incredibly effective for patients suffering from insomnia or sleep disturbances due to PTSD. Nightmares caused by traumatic events in PTSD patients are a common symptom and can be resistant to traditional methods of intervention through prescription and over-the-counter sleep aids. Sleep disturbances from nightmares can further exacerbate other symptoms of PTSD, such as flashbacks, hypervigilance, numbing, and avoidance (Kirk, 2025).
In a study of nabilone, a synthetic, FDA-approved form of THC, researchers studied its effects on treatment-resistant nightmares caused by PTSD. They found complete cessation or a significant reduction of nightmares and sleep disturbances in 72% of the 47-patient population (Fraser, 2009). Although this was a small study done in Canada, it demonstrates a real need to study medicinal cannabis for treating PTSD, specifically its effects on PTSD-induced nightmares and insomnia.
Patients wanting to manage nightmares from PTSD could consider ingested THC-rich products, which can be taken about an hour before bedtime. CBN, a non-psychoactive cannabinoid that can be helpful for sleep, can be included in oral products. The effects of ingested THC last for 4 to 10 hours, depending on the product type. This allows those effects to be felt throughout a patient’s entire sleep cycle. Ethos medical professionals can help patients find products for sleep and provide dosage guidance as well.
Cannabis may be very helpful for insomnia resulting from chronic pain. It has been shown to reduce the time to fall asleep and the number of awakenings throughout the night (McNabb et al, 2023). An oral formulation that lasts 4 to 10 hours, depending on the product, offers a good way to mitigate disrupted sleep caused by chronic pain.
How does cannabis compare to opioids or NSAIDs in terms of both pain relief and quality of life?
Studies have shown that cannabis may be therapeutic in treating chronic pain. “In 2017, the NASEM committee found evidence that patients treated with cannabis or cannabinoids were more likely to see a significant reduction in pain symptoms” (McNabb et al, 2023). Such findings highlight the need for more research into medicinal cannabis for chronic pain. In one study, 91% of US veterans who used cannabis reported an improved quality of life (McNabb et al, 2023).
Opioids are effective in the treatment of chronic pain. However, they come with a list of side effects. These include respiratory depression, drowsiness, impaired motor functions, constipation, nausea, vomiting, and potential for abuse.
NSAIDs, or non-steroidal anti-inflammatory drugs, are a class of medications that reduce inflammation. In treating chronic pain, their side effect profile may be prohibitive. This is due to the long-term effects of chronic NSAID use. Extended use has been shown to cause heart problems, kidney issues, gastrointestinal problems like ulcers, and increased bleeding risk.
How does the VA currently handle cannabis use by patients under their care?
The U.S. Department of Veterans Affairs (VA) follows federal law, which means cannabis remains classified as a Schedule I controlled substance and is not an approved treatment within the VA health system. As outlined on the VA’s public health website, VA health care providers are prohibited from recommending or prescribing cannabis, even in states where it is legal for medical or recreational use. However, veterans who use cannabis will not be denied VA benefits or care, and VA clinicians will record cannabis use in the patient’s medical records to inform treatment planning. Veterans are encouraged to discuss their cannabis use openly with their VA providers without fear of punitive action or loss of benefits. [Source: U.S. Department of Veterans Affairs, https://www.publichealth.va.gov/marijuana.asp]
Despite being legal medically in more than three-quarters of states, cannabis is still federally illegal. Because of this, the Veterans Administration cannot encourage or help veterans get a medical card for cannabis, even where it is legal. However, veterans who use cannabis legally are not excluded from VA health services. In fact, they are encouraged to discuss cannabis use in their treatment with their providers without fear of punitive action or loss of benefits. (US Department of Veterans Affairs). Learn more about the VA and marijuana here.
Our Commitment to Veterans
Ethos is dedicated to supporting veterans beyond providing access to cannabis. Veterans receive a standing discount at our retail locations as a token of our gratitude for their service. Additionally, through our Ethos Cares initiative, we support and volunteer with organizations such as Battle Borne to expand our impact in the veteran community. Battle Borne’s mission is to connect veterans with the resources needed to recover from mental, emotional, and physical trauma so they can restore their lives and reintegrate into society. By supporting this initiative, we aim to ensure that veterans have access to the necessary support and resources throughout their wellness journey.
Key Takeaways
While cannabis shows promise for managing conditions commonly faced by veterans, such as chronic pain, PTSD, anxiety, and insomnia, current research is still evolving. Although some studies suggest significant improvements in quality of life and symptom management, more robust clinical trials are needed to fully understand cannabis’ benefits and risks. Veterans interested in exploring medicinal cannabis should consult with qualified medical professionals to find safe, effective, and legal options tailored to their needs.
Sources
- Kirk, R. (2025). Reefer Wellness (pp. 128-149). DK Publishing.
- Marion McNabb, Katherine A. Durante, Sarah Trocchio, David J. Ritter, Randal MacCaffrie, Ann Brum, Stephen Mandile, Steven White, Self-reported Medicinal Cannabis Use as an Alternative to Prescription and Over-the-counter Medication Use Among US Military Veterans, Clinical Therapeutics,Volume 45, Issue 6, 2023, Pages 562-577, ISSN 0149-2918, https://doi.org/10.1016/j.clinthera.2023.04.003.
- Storey, D. (2024, December 9). FDA Approves Cannabis Study for Veterans with PTSD. Psychiatrist.com. Retrieved September 29, 2025, from https://www.psychiatrist.com/news/fda-approves-cannabis-study-for-veterans-with-ptsd/
- Sulak, D., DO (2021). Handbook of Cannabis for Clinicians (1st ed., pp. 208-215). W W Norton & Company.
- (n.d.). VA and Marijuana – What Veterans need to know. US Department of Veterans Affairs. Retrieved September 29, 2025, from https://www.publichealth.va.gov/marijuana.asp
