Nearly 12% of US veterans reported cannabis use, with much higher rates among those with psychiatric conditions

What the researchers found

Cannabis use prevalence among veterans was estimated at 11.9%, up from 9% in 2014. Among younger veterans, 20.2% reported use and 5.6% screened positive for CUD. Veterans with psychiatric conditions had use rates of 24-30% and CUD rates of 8.9-13%. Depression was independently associated with CUD (OR=2.76). Physical disability (OR=3.59) and combat veteran status (OR=2.84) most strongly predicted medical card possession.

Why it matters

Veteran cannabis use appears to be increasing at a time when more states are legalizing. The concentration of use among veterans with psychiatric conditions raises questions about whether cannabis is being used as self-medication and whether it helps or complicates their mental health care.

The numbers in context

4,069 veterans. Overall use: 11.9%. CUD: 2.7%. Medical card: 1.5%. Younger veterans: 20.2% use, 5.6% CUD. Psychiatric conditions: 24-30% use, 8.9-13% CUD. Depression OR for CUD: 2.76. Physical disability OR for medical card: 3.59.

How the study worked

Cross-sectional analysis of the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), a nationally representative survey of 4,069 veterans ages 22-99. Assessed past-6-month cannabis use, CUD symptoms, and medical cannabis card possession.

What this study cannot tell us

Cross-sectional design. Self-reported cannabis use and CUD screening (not clinical diagnosis). Cannot determine whether cannabis use preceded or followed psychiatric conditions. Past-6-month use window may miss some users.

How to read the evidence

Large nationally representative veteran sample with validated screening tools. Strong for prevalence estimates, limited by cross-sectional design for causal inference.

When this study was published

2021 study with data from 2019-2020.

The bigger picture

The jump from 9% (2014) to nearly 12% (2019-2020) in veteran cannabis use mirrors broader population trends but is notable given the high prevalence of PTSD, chronic pain, and depression in this population. Whether increasing use represents effective self-care or concerning self-medication remains an open question.

Questions still open

• Is cannabis use among veterans with psychiatric conditions helping or worsening their mental health? How do veteran cannabis use rates compare to the general population with similar psychiatric burden? What role does VA policy play in shaping veteran cannabis use?

Common questions

Read the original research

Prevalence of cannabis use, disorder, and medical card possession in U.S. military veterans: Results from the 2019-2020 National Health and Resilience in Veterans Study.

Addictive behaviors, 120, 106963

Citation

Hill, Melanie L; Loflin, Mallory; Nichter, Brandon; Norman, Sonya B; Pietrzak, Robert H. (2021). Prevalence of cannabis use, disorder, and medical card possession in U.S. military veterans: Results from the 2019-2020 National Health and Resilience in Veterans Study.. Addictive behaviors, 120, 106963. https://doi.org/10.1016/j.addbeh.2021.106963

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