Biopsychosocial factors and health outcomes associated with cannabis, opioids and benzodiazepines use among older veterans

Am J Drug Alcohol Abuse. 2021 Jul 4;47(4):497-507. doi: 10.1080/00952990.2021.1903479. Epub 2021 Apr 21.


Background: Older Veterans may experience injuries that result in chronic pain and mental health conditions. Given the increasing availability of medical cannabis, it is important to examine if it serves as a viable or undesirable form of care relative to existing approaches.Objectives: We compared cannabis, prescription opioids, and benzodiazepines use between older Veteran and non-Veterans, and identified outcomes of cannabis use among Veterans. Because of the physical and mental conditions experienced by older Veterans we expected Veterans to report higher use of opioids and benzodiazepines compared to non-Veterans.Methods: We collected surveys from individuals aged 60 and older enrolled in the Illinois Medical Cannabis Patient Program and conducted logistic regression to identify factors associated with cannabis, opioids and benzodiazepines use between Veterans (N = 514, 90.2% male) and Non-Veterans (N = 2758, 41.1% male) across biopsychosocial factors.Results: Both groups reported similar levels of pain, quality of life, social satisfaction, and sleep quality. Veterans were more likely to use cannabis for mental health conditions (p = <.001) while they reported lower use for pain-related conditions (p = <.001) than non-Veterans. Veterans were less likely to use opioids (p = .013) and benzodiazepines (p < .01) compared to non-Veterans. Veterans also reported desirable health outcomes of cannabis use for pain, sleep quality, health conditions, and quality of life.Conclusions: Our work provides insights for clinicians and policy makers to consider whether cannabis can be a viable option to reduce or replace opioid and benzodiazepine use by older Veterans with chronic physical and mental health conditions.

Keywords: PTSD; Veterans; aging; benzodiazepines; cannabis; chronic pain; opioids.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Analgesics, Opioid / therapeutic use*
  • Benzodiazepines / therapeutic use*
  • Chronic Pain / drug therapy*
  • Female
  • Humans
  • Male
  • Medical Marijuana / therapeutic use*
  • Mental Disorders / drug therapy
  • Middle Aged
  • Outcome Assessment, Health Care
  • Quality of Life
  • Sleep / drug effects
  • Veterans / psychology*


  • Analgesics, Opioid
  • Medical Marijuana
  • Benzodiazepines