Veterans, Chronic Pain and Cannabis: Exploring an Alternative to Opioids

Many former service members live with a difficult double burden: chronic pain and a long history of opioid prescribing inside and outside the VA system. At the same time, the Department of Veterans Affairs has aggressively tried to move away from opioids, cutting the number of veterans with opioid prescriptions by about 67% between 2012 and 2023. That shift has fueled interest in whether cannabis could play a role as a safer alternative for at least some veterans.

Surveys suggest many are already experimenting. A recent study reported that around 40% of military veterans with chronic pain use marijuana to manage symptoms. Among veterans with PTSD who use cannabis, one analysis found that about one in five said they reduced opioid use while using cannabis. These are self-reported numbers, but they highlight a clear pattern: veterans are turning to cannabis to cope with pain, sleep issues, and trauma-related symptoms.

Public opinion among veterans strongly supports deeper study. An American Legion–commissioned poll found that more than 90% of veteran households support expanded research into medical cannabis, and over 80% believe federal doctors should be allowed to recommend it. Major veteran service organizations, including the American Legion and Disabled American Veterans, have formally called for robust federally funded research rather than anecdote-driven policy.

That research is starting to take shape. In Michigan, a survey of chronic pain patients (not limited to veterans) found that medical cannabis use was associated with a 64% decrease in opioid use, fewer medication side effects, and improved quality of life. Building on those signals, the State of Michigan recently awarded roughly $7.4 million to University of Michigan researchers specifically to study how CBD and medical cannabis therapies affect veterans’ chronic pain, including whether they can safely reduce or replace opioids.

Qualitative work inside the VA has also begun to map how veterans use cannabis day-to-day: tailoring THC and CBD ratios, experimenting with edibles versus inhaled products, and combining cannabis with non-drug therapies such as physical therapy or mindfulness practices. These studies don’t yet prove that cannabis “solves” the opioid crisis, but they show veterans actively seeking more personalized, multimodal pain strategies.

At the same time, the emerging data offer important cautions. A large VA cohort study from 2005–2022 found that states enacting medical and recreational cannabis laws did not see clear reductions in diagnosed opioid use disorder (OUD) among VA patients; in some groups, OUD prevalence was slightly higher after cannabis laws took effect. In other words, legalization alone is not a magic bullet, and simply adding cannabis to the mix without careful oversight may not reduce opioid addiction at a population level.

For former service members, the most responsible path forward is evidence-based, veteran-centered care: rigorous clinical trials, clear dosing guidelines, screening for cannabis use disorder, and honest conversations about benefits and risks. Veterans considering cannabis as an opioid alternative should talk with their health-care teams, understand local laws, and recognize that what works for one person may not work for another.

The promise is real—but so is the need for solid science. Veterans have made it clear they want options beyond opioids. The next step is making sure those options are backed by data, not just hope.