Veterans in Addiction Treatment Describe Using Cannabis to Manage Pain

Veterans in substance use treatment described using cannabis to reduce chronic pain and related anxiety and sleep problems — often viewing it as a safer alternative to the substances they were trying to quit.

Pleasant, Traben et al.·Harm reduction journal·2026·Preliminary EvidenceQualitative Study·1 min read
RTHC-08560QualitativePreliminary Evidence2026RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Qualitative Study
Evidence
Preliminary Evidence
Sample
N=33
Participants
N=33 U.S. military veterans with chronic pain, enrolled in a Veterans Affairs SUD treatment program

What This Study Found

Through interviews with 33 veterans receiving care in a VA substance use disorder treatment program, researchers documented how veterans with chronic pain viewed and used cannabis alongside their addiction treatment.

Most participants had a primary diagnosis of alcohol use disorder (70%), followed by opioid use disorder (18%) and stimulant use disorder (12%). The treatment program allowed continued use of substances other than the primary focus of treatment as a harm reduction strategy — meaning cannabis use was permitted while patients worked on quitting alcohol, opioids, or stimulants.

Veterans described using cannabis to manage three interconnected problems: chronic pain itself, pain-related anxiety, and pain-disrupted sleep. Many framed cannabis as a harm reduction tool — a less dangerous substitute for the opioids, alcohol, or other substances they were trying to stop using. This framing positioned cannabis not as recreational drug use but as self-directed pain management.

The interviews revealed the complexity of cannabis's role in this population: it was simultaneously a potential therapeutic tool for pain and a substance with its own use disorder potential, used within a treatment program that pragmatically accepted this tension.

Key Numbers

33 veterans interviewed. Primary SUD diagnoses: alcohol (70%), opioid (18%), stimulant (12%). All had comorbid chronic pain. Cannabis used for pain, anxiety, and sleep in the context of harm reduction-oriented addiction treatment.

How They Did This

Qualitative study using interviews with 33 US military veterans diagnosed with chronic pain who were enrolled in a VA substance use disorder treatment program. Thematic analysis of interview transcripts exploring perspectives on cannabis use for pain management during addiction treatment.

Why This Research Matters

Veterans have disproportionately high rates of both chronic pain and substance use disorders, and the intersection of these conditions drives much of the opioid crisis among this population. Understanding how veterans conceptualize cannabis within their pain management and recovery adds patient perspectives to the clinical and pharmacological evidence — a dimension often missing from the research.

The Bigger Picture

This qualitative evidence connects to the quantitative pain literature (RTHC-00233, RTHC-00225) showing modest cannabinoid pain relief in trials, and to the PTSD-cannabis research (RTHC-00274, RTHC-00276) documenting the complex relationship between cannabis and trauma symptoms. The veterans' harm reduction framing — cannabis as a less harmful substitute — reflects a real-world clinical pragmatism that the JAMA therapeutic review (RTHC-00250) doesn't fully capture.

What This Study Doesn't Tell Us

Small qualitative sample from a single VA program with an unusually permissive harm reduction approach. Veterans' perspectives on cannabis may differ from civilian populations. Self-reported cannabis use for pain cannot verify therapeutic effect. The harm reduction treatment model is not standard across VA or civilian SUD programs.

Questions This Raises

  • ?Do veterans who use cannabis as a substitute for other substances have better long-term recovery outcomes?
  • ?Should SUD treatment programs formally integrate cannabis as a harm reduction tool, or does this risk replacing one dependency with another?
  • ?How do clinicians in more traditional abstinence-based programs handle patients who want to use cannabis for pain?

Trust & Context

Key Stat:
Evidence Grade:
Qualitative interview study — provides rich patient perspectives but cannot measure whether cannabis use actually improved pain or recovery outcomes.
Study Age:
Published in 2026, reflecting current veteran perspectives on cannabis in an era of expanding legal access and evolving VA substance use policies.
Original Title:
A qualitative study on cannabis use for harm reduction and pain among veterans enrolled in an SUD treatment program.
Published In:
Harm reduction journal (2026)Harm Reduction Journal focuses on research and discussions related to harm reduction strategies in health.
Database ID:
RTHC-08560

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Uses interviews or focus groups to understand experiences in depth.

What do these levels mean? →

Read More on RethinkTHC

Cite This Study

RTHC-08560·https://rethinkthc.com/research/RTHC-08560

APA

Pleasant, Traben; Ono, Sarah; Kansagara, Devan; Lovejoy, Jennette; Lovejoy, Travis; Wyse, Jessica. (2026). A qualitative study on cannabis use for harm reduction and pain among veterans enrolled in an SUD treatment program.. Harm reduction journal. https://doi.org/10.1186/s12954-026-01412-2

MLA

Pleasant, Traben, et al. "A qualitative study on cannabis use for harm reduction and pain among veterans enrolled in an SUD treatment program.." Harm reduction journal, 2026. https://doi.org/10.1186/s12954-026-01412-2

RethinkTHC

RethinkTHC Research Database. "A qualitative study on cannabis use for harm reduction and p..." RTHC-08560. Retrieved from https://rethinkthc.com/research/pleasant-2026-a-qualitative-study-on

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.