Geographic Differences in Cannabis Use and Cannabis Use Disorder in the US Veteran Population

Objective: To examine regional differences in cannabis use and probable cannabis use disorder (CUD) in US veterans.

Methods: Participants (N = 2,441) were drawn from a nationally representative sample of US veterans who participated in the 2022 National Health and Resilience in Veterans Study, conducted from August 11 to September 12, 2022. Weighted estimates indicated that 85.5% reported no cannabis use, 11.6% reported cannabis use, and 2.9% screened positive for probable CUD. Chi-square tests were conducted to assess differences in cannabis use and probable CUD across 9 US Census Bureau-defined regions: New England, Middle Atlantic, East and West North Central, South Atlantic, East and West South Central, Mountain, and Pacific.

Results: Significant regional differences were observed in cannabis use and CUD across the 9 regions (χ²₁₆ = 73.33, P < .001). Veterans in the Pacific region exhibited the highest rates of cannabis use (18.6%) compared to all other regions except New England (8.2%-13.4%, Ps < .05). The Pacific region also had significantly higher rates of probable CUD (8.8%) relative to all other regions (0.7%-3.5%, Ps < .05).

Conclusion: These findings demonstrate substantial regional differences in cannabis use and probable CUD among US veterans and underscore the importance of routine screening for cannabis-related problems in health care settings serving veterans, particularly in higher-prevalence regions of the United States.