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Study breakdown

Veteran Cannabis Use Varies Dramatically by US Region

Cross SectionalModerate evidence
The takeaway

Significant regional differences exist in cannabis use and cannabis use disorder among US veterans, with certain regions showing substantially higher rates — highlighting the need for geographically tailored screening and treatment programs.

VA healthcare administrators, veteran health researchers, military substance use counselors, and policy makers planning resource allocation.

What the researchers found

Among 2,441 veterans, 11.6% reported cannabis use and 2.9% screened positive for probable CUD, with significant regional variation across 9 US Census regions (χ²=73.33, p<0.001), revealing geographic hotspots requiring targeted intervention.

Why it matters

VA healthcare systems serving veterans in high-prevalence regions need to prioritize cannabis screening and CUD treatment resources, while lower-prevalence regions may have different intervention needs.

The numbers in context

N=2,441 veterans; 85.5% no use; 11.6% cannabis use; 2.9% probable CUD; significant variation across 9 Census regions (p<0.001)

How the study worked

Cross-sectional analysis of the 2022 National Health and Resilience in Veterans Study (N=2,441), a nationally representative sample, examining cannabis use and probable CUD across 9 US Census Bureau-defined regions using weighted chi-square tests.

What this study cannot tell us

Cross-sectional snapshot; self-report may underestimate use; 2022 data predates some state legalization changes; veteran population may differ from general population; regional groupings may mask within-region variation.

How to read the evidence

Nationally representative veteran sample with validated measures, though cross-sectional design and self-report limit depth of regional analysis.

When this study was published

Published 2026; 2022 survey data.

The bigger picture

Regional variation in veteran cannabis use likely reflects both state legalization status and local cultural factors, suggesting that national VA policies need regional adaptation.

Questions still open

  • How much of the regional variation is explained by state legalization status? Do VA treatment resources match regional need? Would standardized VA screening reduce regional disparities in CUD detection?

Common questions

How common is cannabis use among veterans?
About 11.6% of US veterans report cannabis use and 2.9% screen positive for cannabis use disorder, but rates vary significantly by region — with some areas showing much higher prevalence.
Should VA clinics screen for cannabis use?
This study supports routine screening, especially in higher-prevalence regions, given that nearly 3% of veterans may have cannabis use disorder — a rate likely to grow as more states legalize.

Read the original research

Geographic Differences in Cannabis Use and Cannabis Use Disorder in the US Veteran Population.

The Journal of clinical psychiatry, 87(1)

Citation

Joseph Denk, Annie-Lori; True, Sarah B; Hill, Melanie L; Fischer, Ian C; Na, Peter Jongho; Pietrzak, Robert H. (2026). Geographic Differences in Cannabis Use and Cannabis Use Disorder in the US Veteran Population.. The Journal of clinical psychiatry, 87(1). https://doi.org/10.4088/JCP.25m16141

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