Systematically Testing the Evidence on Marijuana

On this page you will find a series of video clips of Veterans discussing their experiences with cannabis. These in-depth interviews were conducted as part of the Systematically Testing the Evidence on Marijuana (STEM) project in an effort to learn about Veteran experiences using cannabis for both medical and recreational purposes, the information sources they have relied on, their perspectives on the risks and benefits of cannabis, and their thoughts on how clinicians can support patients who use cannabis. 

Our research team interviewed 27 Veterans from several states where cannabis is legal both medically and recreationally, who self-identified as current cannabis users (i.e., having used cannabis at least once during the past 30 days prior to their interview). While the Veterans we spoke with represent a wide range in age, branch and era of service, and in their experience both in the military and after their reintegration into civilian life, there are undoubtedly other points of view that are not fully captured in these videos. 

All the participants in this project agreed on the importance of sharing their story to help clinicians and researchers better understand patients’ views about cannabis use and health. We appreciate their time and their candor.    

Interviews were analyzed using a qualitative inductive thematic approach to identify themes and subthemes. Excerpts of video or audio interview recordings, depending on participant preference, were then curated to highlight various identified themes and subthemes. The full film consists of four chapters that have been broken into 12 thematic sections.

Introduction

In the following video, Dr. Devan Kansagara, MD MCR, a professor of medicine at Oregon Health & Science University and staff physician at the VA Portland Health Care System, provides background information on this topic and describes how viewers can learn about cannabis use from the Veteran perspective.

Chapter One: Deciding to Use Cannabis for Physical or Mental Health Issues

Chapter One – Film 1.1:

In this first chapter, Veterans describe a variety of mental and physical ailments they have experienced and the challenges they have faced navigating everyday life.

Chapter One – Film 1.2:

Veterans recall how using cannabis as a medical therapy was first brought to their attention, their considerations before trying it, and how they gradually came around to the idea of using cannabis as it became legal and increasingly available in their states.

Chapter One – Film 1.3:

Participants describe the effects of cannabis use and the varying degree of success they have had in using it to handle their particular symptoms.

Chapter Two: Gathering Information about Cannabis

Chapter Two – Film 2.1:

In chapter two, Veterans discuss the various sources they have used to gather information about cannabis. While most described relying on word-of-mouth sources like their friends and the budtenders at local dispensaries for advice, some discussed reading magazine articles, searching the web for specific information and engaging in online chat forums with other cannabis users.

Chapter Two – Film 2.2:

Veterans shared their thoughts on the quality of the information sources available to them noting the unpredictable nature of cannabis and the varied individual response to it. Many felt it important to have a source they knew and could trust.

Chapter Two – Film 2.3:

Although they have gained a certain amount of knowledge from their various sources of information and from their own cannabis use, some Veterans still have questions and wish there was more specific information available to them.

Chapter Three: Perceived Risks and Benefits of Cannabis Use

Chapter Three – Film 3.1

In chapter three, Veterans discuss the perceived benefits and risks of using cannabis in conjunction with, or as an alternative to, other medications and therapies. They share what they have noticed about how their cannabis use affects their physical and mental health and overall quality of life.

Chapter Three – Film 3.2

Beyond discussing the risks and benefits to their physical and mental health, Veterans spoke of the social impacts they have noticed associated with cannabis use including the potential risks associated with being in an impaired state of mind, the economic impact, and the enduring stigma surrounding cannabis, despite it being legal to buy and consume in their states.

Chapter Three – Film 3.3

Participants were asked how they would feel and what, if anything, they might do if research showed that cannabis was harmful to their health. They spoke of various factors they would consider in evaluating this information including the quality of the research and potential biases that might be present, weighing the risk against the benefit in their individual case, and determining the degree and prevalence of the potential harms presented in the research.

Chapter Four: Talking with Clinicians About Cannabis

Chapter Four – Film 4.1

In the fourth chapter, Veterans share their experiences communicating about their cannabis use with their primary care provider or another clinician. These interactions have been met with varying degrees of success. For some participants, cannabis has been an easy subject to broach during their medical visit, and they have found their clinician to be open and receptive. However, some also mentioned that despite their willingness to talk about it, it can be difficult to have a meaningful discussion as many clinicians are lacking in knowledge and resources or seem unwilling to engage in an ongoing conversation about it.

Chapter Four – Film 4.2

For others, communicating with their clinician about cannabis has been challenging from the outset for many different reasons including their own reluctance to talk about it, their fear of judgement, issues with clinician attrition at their clinic, and perceived VA restrictions on discussing or providing information about cannabis and how that might affect their benefit status or their relationship with their clinician given that cannabis in not legal at the federal level.

Chapter Four – Film 4.3

While the range of Veteran experiences talking with their clinicians was varied, all hoped that discussing their cannabis use with their doctor might get easier in the future and many shared ideas and recommendations on how clinicians could better support their patients that use cannabis, including learning to engage patients without judgement, and providing them with helpful information.

Published Study Findings

The findings of the qualitative analysis of the interviews in this study have been published in the Journal of General Internal Medicine. Read it here: In Their Own Words: A Qualitative Exploration of Veterans’ Perspectives and Experiences of Medical Cannabis Use

Credits and Information

The Veterans in this film generously shared their stories and experiences, with the goal of helping others. Each gave their consent to use their information in video or audio format. We thank the participants for sharing these experiences.

This film was created by a team of researchers at the VA Portland Health Care System and Oregon Health & Science University, Health Experiences Research Network, with funding from the Department of Veterans Affairs’, Office of Rural Health, Veterans Rural Health Resource Center (Project Number ORH-VRHRC-PDX). This project also received assistance from the Oregon Clinical & Translational Research Institute, which is supported by the National Center for Advancing Translational Sciences, National Institutes of Health (Grant Award Number UL1TR002369).

Principal Investigator: Devan Kansagara, MD, MCR

Lead researcher: Vivian Christensen, PhD

Filmmaker and research team member: Lauren Tarlow, MS

Research team member: Melissa Varnum, MPH

Research team member: Chelsea Ayers, MPH

Research team member: Rachel Ward, BA

Research team member: Shawna Chapman, PhD

Administrative support: Nicole Thompson, BA