Study Explores Natural Product Use Among Veterans, Including Cannabis for Pain

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A survey aimed to gather information on US veteran use of natural products (NPs), including cannabis, for chronic pain. The goal was to develop a new, more comprehensive survey for veterans on the reasons for using these products, concerns while using them, medications being substituted, and more. Additionally, patients do not commonly report NP usage with their health providers, the study introduction stated, leading to a lack of knowledge about the frequency and types of products. The study (1), “Natural Product Use for Chronic Pain: A New Survey of Patterns of Use, Beliefs, Concerns, and Disclosure to Providers,” was published in February 2025 in Global Advances in Integrative Medicine and Health. Additionally, it was conducted as a supplement to the “wHOPE study,” an ongoing study on pain management from Veterans Affairs clinicians.

The self-administered survey was completed by 52 veterans (average age was 57 years old and 42% of participants were female). All participants were Veterans Health Administration (VA) primary care and were open to NP use at the start of the study. All participants had chronic pain, with 88% of participants experiencing chronic pain daily. For medications, 67% had been prescribed non-opioid pain medication and 15% had been prescribed opioids.

The survey asked about use of NPs in the past three months. Products listed in the survey included vitamins, minerals, cannabis (THC- or CBD-predominant, roughly equal, unknown), and other products. Participants were asked about the frequency and purpose of the NPs.

Results included:

• 40% (21 participants) reported using cannabis, 94% reported using vitamins and/or minerals, and 60% reported using non-cannabis herbals
• Of the 21 who reported using cannabis products, most reported using a mix of CBD and THC
• Pain or mobility (81%), sleep (62%), PTSD or anxiety (43%), stress (43%), and depression (29%) were the indications noted for the participants reporting cannabis use
• Vitamin D was the most frequently reported individual NP (67%), followed by multivitamins (61%), and cannabis products (40%), green tea and magnesium (both 36% each), fish oil/omega-3 (33%), and melatonin (33%)
• Cannabis products were the most frequently reported NPs for pain (33%)

A notable result was the use of multiple NPs at the same time and a replacement of medications for NPs, which has the potential to result in harm, the researchers noted.

Some limitations of the study included a small and potentially biased sample size and the lack of verification of the products through records.

“In sum, this study on NP use in a small, yet diverse sample of veterans with chronic pain participating in a multi-site pragmatic trial produced an acceptable and feasible survey as well as descriptive information about NPs for pain, an area in which there has been a knowledge gap,” the researchers stated in the conclusion.

The study authors received funding from a cooperative agreement from the Office of Dietary Supplements and the National Center for Complementary and Integrative Health, National Institutes of Health (NIH) for the study’s research, authorship, and/or publication.

Reference

1. Seal, KH.; Feinberg, T.; Moore, L.; Woodruff, NA.; Purcell, N.; Bertenthal, D.; McCamish, N.; Becker, WR. Natural Product Use for Chronic Pain: A New Survey of Patterns of Use, Beliefs, Concerns, and Disclosure to Providers. Global Advances in Integrative Medicine and Health. 2025. DOI: 10.1177/27536130251320101