SUBSTANCE USE

What Veterans Report

Some veterans report that cannabis has been a positive force in their lives — replacing alcohol, reducing opioid use, or providing relief that other treatments did not. These experiences are real and valid.

Other veterans report that cannabis became a problem. They developed tolerance, needed more for the same effect, and struggled to stop. Some experienced withdrawal — insomnia, irritability, anxiety, loss of appetite. These experiences are equally real and valid.

What Observational Research Shows

Approximately 2.5% of U.S. adults meet criteria for cannabis use disorder (CUD) in a given year. Prevalence is higher among individuals with co-occurring mental health conditions, including veterans with PTSD. CUD involves problematic use that causes significant impairment or distress.

What Randomized Trials Show

Research on cannabis use disorder treatment is limited. No medication is FDA-approved for CUD. Evidence-based treatments include cognitive behavioral therapy (CBT) and motivational enhancement therapy (MET). The VA offers treatment for substance use disorders, including CUD.

What Systematic Reviews Say

Systematic reviews have confirmed that cannabis can produce tolerance, dependence, and withdrawal. Cannabis withdrawal syndrome is recognized in the DSM-5. Symptoms include irritability, anxiety, sleep difficulty, decreased appetite, and physical discomfort.

What the VA Says

The VA offers treatment for substance use disorders, including cannabis use disorder. Veterans can ask their VA provider for help. Treatment options include therapy, support groups, and in some cases medication for co-occurring conditions.

The SAMHSA National Helpline (1-800-662-4357) provides free, confidential, 24/7 treatment referral and information.

Known Risks

Regular cannabis use can lead to tolerance (needing more for the same effect), dependence (experiencing withdrawal without it), and cannabis use disorder (problematic use despite negative consequences). These risks increase with frequency of use, potency of products, and younger age of first use.

Cannabis withdrawal is real and can be uncomfortable. Symptoms typically begin within 1-3 days of stopping, peak in the first week, and resolve within 1-2 weeks. Sleep disturbance can persist longer.

What Remains Unknown

We do not fully understand which individuals are most at risk for developing CUD. We do not know how product potency (THC percentage) affects CUD risk. We do not have highly effective treatments for CUD.

Questions to Ask Your Healthcare Provider

• How can I tell if my cannabis use is becoming a problem? • What treatment options are available through the VA for cannabis use disorder? • What should I expect if I stop using cannabis? • Are there support groups for veterans who want to reduce or stop cannabis use? • How can I talk to my family about my cannabis use?

Sources