Older US veterans reported using medical cannabis as a harm reduction strategy to replace opioids and benzodiazepines, but inconsistent VA policies and limited physician engagement left them navigating use largely on their own.
VA healthcare providers, veteran health policy makers, geriatric medicine specialists
32 older veterans using cannabis as harm reduction with limited clinical guidance
What the researchers found
Semi-structured interviews with 32 older veterans revealed they used medical cannabis as an adjunct or substitute for opioids and benzodiazepines for physical and mental health conditions. Veterans reported inconsistent application of cannabis policies across the Veterans Health Administration system, and limited guidance from healthcare providers despite wanting clinical support.
Why it matters
Veterans have disproportionately high rates of chronic pain and PTSD, conditions traditionally treated with opioids and benzodiazepines. Understanding how they self-manage with cannabis could inform VA policy and clinical practice.
The numbers in context
32 veterans interviewed; selected via maximum variation sampling from survey respondents
How the study worked
Qualitative study using maximum variation sampling to select 32 veterans from a larger survey sample for semi-structured interviews. Thematic analysis applied to identify patterns in cannabis use motivations, experiences, and policy concerns.
What this study cannot tell us
Qualitative design with 32 participants limits generalizability. Self-selected participants may overrepresent positive cannabis experiences. Findings specific to the US veteran population and VA system.
How to read the evidence
Qualitative interview study with purposive sampling; provides rich contextual data but small sample and self-selection limit generalizability.
When this study was published
Published 2023
The bigger picture
The disconnect between growing veteran cannabis use and the VA system that cannot prescribe or formally support it creates a situation where some of the highest-need patients are making medication decisions without clinical guidance.
Questions still open
- Would formal VA integration of medical cannabis reduce opioid and benzodiazepine prescribing? How do veteran cannabis use outcomes compare to continued pharmaceutical treatment?
Common questions
Why are older veterans using medical cannabis?
Do VA doctors help veterans with cannabis decisions?
Read the original research
Prevention, Practice, and Policy: Older US Veterans' Perspectives on Cannabis Use.
Drugs & aging, 40(1), 59-70
Citation
Bobitt, Julie; Clary, Kelly; Krawitz, Michael; Silva, Laura Quintero; Kang, Hyojung. (2023). Prevention, Practice, and Policy: Older US Veterans' Perspectives on Cannabis Use.. Drugs & aging, 40(1), 59-70. https://doi.org/10.1007/s40266-022-00995-2
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