Veterans Health Administration Policy on Cannabis as an Adjunct to Pain Treatment with Opiates

Medicinal versus recreational cannabis use among returning veterans.

“…Like non-veteran MC users, OEF/OIF/OND soldiers, particularly those with PTSD, also report poor general health and increased somatic symptoms such as chronic pain (Gironda, Clark, Massengale, & Walker, 2006; Spiro, Hankin, Mansell, & Kazis, 2006), greater medical services utilization (Cohen et al, 2010; Kim, Thomas, Wilk, Castro, & Hoge, 2010) and worse sleep (Capaldi, Guerrero, & Killgore, 2011; Lavie, Katz, Pillar, & Zinger, 1998; Lew et al, 2009; Mysliwiec et al, 2013). Anecdotal reports indicate returning veterans also use cannabis as a substitute for other prescribed and non-prescribed substances and may perceive cannabis to be less harmful than opioids (Krawitz, 2015). Cannabis use also increases the perception of poor health above and beyond cigarette smoking and other relevant factors (Bonn-Miller, Zvolensky, Leen-Feldner, Feldner, & Yartz, 2005).…”

Cannabis demand and use among veterans: A prospective examination.

“…Veterans report increasingly favorable attitudes toward cannabis (Wilkinson et al, 2016), and of those who endorse pastyear cannabis use, use for medical purposes is more than double that of the general United States population (Davis et al, 2018). Research suggests that some veterans use cannabis as a substitute for other prescribed and nonprescribed medications (Metrik et al, 2018), and often perceive cannabis to be less harmful than other medications, including opioids (Krawitz, 2015). Veterans are using cannabis at high rates and may be doing so to combat service-related issues such as posttraumatic stress disorder, traumatic brain injury, anxiety, and depression (Metrik et al, 2018(Metrik et al, , 2022Metrik, Jackson, et al, 2016), despite some research indicating that cannabis may actually worsen long-term outcomes such as posttraumatic stress disorder (Metrik et al, 2022).…”