Veterans in interviews and focus groups compared cannabis favorably to alcohol and pharmaceuticals for PTSD, viewing it as more effective with fewer side effects, though some acknowledged avoidant coping risks.
Read this if you're a veteran using cannabis for PTSD and want to see how others describe their experience.
Veterans consistently favored cannabis over alcohol and prescriptions
What the researchers found
Researchers conducted interviews and focus groups with veterans of Iraq and Afghanistan about their cannabis use for PTSD coping. Veterans consistently compared cannabis more favorably than alcohol or prescription medications, describing it as more effective for symptom management with fewer complications and side effects.
Some veterans described cannabis as enabling an "approach-based" coping strategy, helping them engage in introspection and directly confront traumatic memories. Others recognized that their cannabis use represented avoidant coping, using it to numb or escape rather than address trauma.
A nuanced group of veterans described motivations that did not fit neatly into approach or avoidance categories. They used cannabis primarily for symptom alleviation (sleep, anxiety, hyperarousal) without a specific intent to either confront or avoid their trauma. The authors suggested that coping theory may need more nuanced categories to capture how veterans actually use cannabis.
Why it matters
Veterans' own perspectives on cannabis for PTSD are often missing from clinical and policy discussions. Their comparisons to alcohol and prescriptions, and their nuanced descriptions of how cannabis fits into coping strategies, provide important context for treatment development.
The numbers in context
Qualitative study with veterans of Iraq and Afghanistan conflicts. Three coping patterns identified: approach-based, avoidance-based, and symptom-alleviation-focused. Cannabis consistently compared favorably to alcohol and pharmaceuticals.
How the study worked
Qualitative study using semi-structured interviews and focus groups with veterans of recent Iraq and Afghanistan conflicts in New York City. Thematic analysis examined cannabis use patterns, motivations, and comparisons with other substances.
What this study cannot tell us
Qualitative study with a self-selected sample from one city. Veterans willing to discuss cannabis use may differ from those who are not. No outcome data to determine whether cannabis coping was actually beneficial or harmful in the long term.
How to read the evidence
Qualitative interview and focus group study. Provides rich experiential data but no quantitative outcomes.
When this study was published
Published in 2015 with veterans of post-9/11 conflicts.
The bigger picture
The veteran cannabis-PTSD conversation is often framed as either "cannabis helps PTSD" or "cannabis is avoidance coping." This study shows the reality is more complex, with different veterans using cannabis in fundamentally different ways for different reasons.
Questions still open
- Could clinical programs harness the approach-based coping potential while mitigating avoidance patterns? How do veterans' subjective assessments compare to objective treatment outcomes? Would guided cannabis use produce different results than self-directed use?
Common questions
Do veterans prefer cannabis over prescriptions for PTSD?
Is cannabis use for PTSD considered avoidance coping?
Read the original research
PTSD and Cannabis-Related Coping Among Recent Veterans in New York City.
Contemporary drug problems, 42(1), 60-76
Citation
Elliott, Luther; Golub, Andrew; Bennett, Alexander; Guarino, Honoria. (2015). PTSD and Cannabis-Related Coping Among Recent Veterans in New York City.. Contemporary drug problems, 42(1), 60-76. https://doi.org/10.1177/0091450915570309
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