Veterans' Daily Cannabis Use Linked to Same-Day Stress Relief and Better Sleep, But Alcohol Use Worsened Next Day | Research

The takeaway

In a 3-month daily diary study of 74 veterans, cannabis use was associated with lower stress and better sleep that same day, while poor sleep predicted more stress and alcohol use the following day.

Veterans using cannabis and/or alcohol; VA clinicians; substance use researchers studying polysubstance use

Cannabis: same-day stress relief with no next-day hangover effect. Alcohol: poor sleep drives next-day stress and more drinking.

What the researchers found

Within-day: higher cannabis use was associated with lower stress and better sleep quality that same night. Day-to-day: worse sleep predicted higher next-day stress, which predicted greater alcohol use. Stress mediated the relationship between poor sleep and increased alcohol consumption. No day-to-day lagged effects were found for cannabis.

Why it matters

This companion study to RTHC-06303 reveals that cannabis and alcohol play different roles in the stress-sleep cycle. Cannabis appears to provide same-day relief without next-day consequences, while alcohol use follows a harmful next-day stress pattern.

The numbers in context

74 veterans, 3-month diary. Cannabis: same-day association with lower stress and better sleep, no next-day lagged effects. Alcohol: poor sleep predicted next-day stress predicted more alcohol use. Stress mediated sleep-to-alcohol relationship.

How the study worked

74 veterans with elevated PTSD symptoms and problematic cannabis use completed 3 months of daily diaries via mobile app. Dynamic structural equation modeling examined within-day and lagged associations between sleep, stress, cannabis, and alcohol.

What this study cannot tell us

Secondary analysis of an existing dataset. Sample selected for problematic cannabis use, creating selection bias. Cannot establish causation from observational data. Self-reported measures.

How to read the evidence

Intensive longitudinal design with DSEM modeling; moderate despite secondary analysis, because within-person design controls for individual differences.

When this study was published

2025 publication using 3-month daily diary data

The bigger picture

These contrasting patterns for cannabis and alcohol have clinical implications. If cannabis provides same-day relief without exacerbating next-day symptoms, while alcohol worsens the cycle, substitution of cannabis for alcohol could theoretically reduce harm.

Questions still open

Would reducing alcohol use in veterans who use both substances improve their PTSD and sleep outcomes? Is the absence of next-day cannabis effects truly benign, or does chronic use have cumulative effects not captured in daily data?

Common questions

Is cannabis better than alcohol for veterans with PTSD?

This study found that cannabis was associated with same-day stress relief without worsening next-day symptoms, while alcohol use was part of a harmful cycle of poor sleep, stress, and more drinking. However, this observational data cannot make definitive treatment recommendations.

Why was there no next-day effect for cannabis?

The researchers found that cannabis effects appeared to be contained within the same day. Unlike alcohol, which was linked to a next-day worsening cycle, cannabis use one day did not predict stress, PTSD symptoms, or sleep quality the following day.

Read the original research

Daily associations between sleep quality, stress, and cannabis or alcohol use among veterans.

Drug and alcohol dependence, 271, 112661

View on PubMed ↗Publisher’s paper ↗

Citation

Davis, Jordan P; Saba, Shaddy K; Leightley, Daniel; Pedersen, Eric R; Prindle, John; Senator, Ben; Dilkina, Bistra; Dworkin, Emily; Howe, Esther; Cantor, Jonathan; Sedano, Angeles. (2025). Daily associations between sleep quality, stress, and cannabis or alcohol use among veterans.. Drug and alcohol dependence, 271, 112661. https://doi.org/10.1016/j.drugalcdep.2025.112661