A growing number of veterans with PTSD use cannabis to cope with symptoms, and small studies suggest benefits for sleep and nightmares, but large controlled trials are needed.
Read this if you're a veteran with PTSD considering cannabis for symptom management.
11 articles reviewed; 4 small studies suggested symptom benefits
What the researchers found
Researchers reviewed 11 articles on cannabis use by military veterans who met diagnostic criteria for PTSD. Cross-sectional studies found that veterans with more severe PTSD symptoms reported greater motivation to use cannabis for coping, particularly those with difficulty regulating emotions or tolerating stress.
Four small studies suggested cannabinoid use was associated with improvements in overall PTSD symptoms or specific symptoms like insomnia and nightmares. The pharmacologic rationale was documented: cannabinoids activate endogenous receptors involved in pleasure and memory processes, which overlap with the three core PTSD symptom clusters (re-experiencing, avoidance/numbing, and hyperarousal).
However, the authors emphasized that the evidence base consisted entirely of small, mostly uncontrolled studies, and large well-designed trials were needed before cannabis could be recommended as a treatment approach.
Why it matters
Veterans with PTSD represent one of the largest populations using cannabis therapeutically, yet the evidence supporting this use remains preliminary. Understanding their experiences and outcomes is essential for developing evidence-based treatment guidelines.
The numbers in context
11 articles reviewed. Four small studies suggested symptom improvements. Three core PTSD symptom clusters identified as potentially modulated by cannabinoids. Veterans with more severe PTSD showed greater cannabis use motivation.
How the study worked
Literature review of 11 articles identified through structured search, examining cannabis and cannabinoid use by military veterans meeting standard PTSD diagnostic criteria.
What this study cannot tell us
Only 11 articles met inclusion criteria, and most were small and uncontrolled. The review could not determine whether cannabis use improves PTSD outcomes or whether veterans with certain symptom profiles are simply more likely to self-medicate. Publication bias may favor positive results.
How to read the evidence
Review of mostly small, uncontrolled studies. The evidence base was described as insufficient for clinical recommendations.
When this study was published
Published in 2015. Several controlled trials of cannabis for PTSD have been initiated since.
The bigger picture
The mismatch between widespread cannabis use by veterans with PTSD and the lack of rigorous evidence creates a clinical dilemma. Veterans are self-medicating in large numbers, but clinicians lack the data to advise them on safety, efficacy, or optimal use patterns.
Questions still open
- Do specific cannabinoid formulations work better for PTSD than others? Does cannabis use for PTSD improve or worsen long-term outcomes? Can cannabis complement evidence-based PTSD treatments like prolonged exposure or EMDR?
Common questions
Does cannabis help with PTSD?
Why do veterans with PTSD use cannabis?
Read the original research
Use and effects of cannabinoids in military veterans with posttraumatic stress disorder.
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 72(15), 1279-84
Citation
Betthauser, Kevin; Pilz, Jeffrey; Vollmer, Laura E. (2015). Use and effects of cannabinoids in military veterans with posttraumatic stress disorder.. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 72(15), 1279-84. https://doi.org/10.2146/ajhp140523
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