In veteran communities, cannabis is often discussed the way sleep aids, pain relievers, and stress-management tools are discussed: as something that can make a hard day more manageable. Many veterans who use cannabis describe short-term benefits such as feeling less keyed up, falling asleep faster, having fewer nightmares, or “taking the edge off” hypervigilance. Clinicians also hear a practical argument: some veterans perceive cannabis as more tolerable than certain prescription medications, or as a way to reduce alcohol use. These real-world reports help explain why cannabis use shows up frequently among people receiving PTSD care, including in VA settings.
Clinical research, however, has struggled to confirm cannabis as a reliable PTSD treatment. The U.S. Department of Veterans Affairs’ PTSD center notes that, to date, research does not support cannabis as an effective treatment for PTSD, and some studies suggest potential harms—especially with long-term or heavy use. That cautious stance is reflected in the 2023 VA/DoD Clinical Practice Guideline for PTSD, which recommends against cannabis or cannabis derivatives for treating PTSD, citing very low-quality evidence of benefit alongside known risks.
Why the disconnect? One reason is that “what helps in the moment” can look different from “what improves PTSD over time.” PTSD symptoms fluctuate with stress, sleep, and triggers, so people can feel better temporarily without the underlying condition improving. In addition, cannabis products vary widely (THC-to-CBD ratios, potency, route of use), making consistent study results difficult. And placebo effects can be powerful in PTSD trials—especially when participants expect relief.
Randomized controlled trials have not provided clear proof that cannabis outperforms placebo for PTSD symptoms. For example, a federally approved clinical trial reported symptom improvements across groups but no active cannabis condition clearly beat placebo over the short study window. When larger bodies of evidence are reviewed, the pattern is similar: recent systematic reviews conclude that cannabinoids do not show major benefits for overall PTSD symptoms, although some symptom clusters may shift in certain studies. Importantly, these reviews also flag concerning signals in some reports, including worsening suicidal ideation or violent behavior, and higher risk among those with co-occurring cannabis use disorder.
The key takeaway is not that veterans are “wrong” about their experiences—it’s that personal benefit is not the same as proven, durable treatment. Current best-practice guidance still prioritizes evidence-based PTSD therapies, such as trauma-focused psychotherapies and carefully selected medications, while urging caution about cannabis as a PTSD intervention. Veterans who are using—or considering—cannabis are generally encouraged to discuss it openly with qualified clinicians so PTSD symptoms, sleep challenges, substance-use risk, and overall functioning can be addressed using evidence-based care.