SAN FRANCISCO — The past few years have seen significant increases in diagnoses for cannabis and stimulant use disorder at the VA, especially among older adults.

That is according to a new study published in the American Journal of Addiction. Noting that substance use disorder (SUD) represents a substantial health burden for veterans, research led by the San Francisco VA Health Care System and the University of California, San Francisco sought to quantify recent time trends in veterans’ substance-specific disorders using VHA data.

The study team identified VA patients for fiscal years (FY) 2010-2019 (Oct. 1, 2009-Sept. 9, 2019) and extracted patient demographics and diagnoses from electronic health record, about 6 million annually. Researchers used ICD-9 and 10 codes to define alcohol, cannabis, cocaine, opioid, sedative and stimulant use disorders. They focused on variables for polysubstance use disorder, drug use disorder (DUD) and SUD.

Results indicated that diagnoses for substance-specific disorders (excluding cocaine), polysubstance use disorder, DUD and SUD increased 2%-13% annually for FY10-FY15. Subsequently, the authors wrote, “Alcohol, cannabis, and stimulant use disorders increased 4%-18% annually for FY16-FY19, while cocaine, opioid, and sedative use disorders changed by ≤1%. Stimulant and cannabis use disorder diagnoses increased most rapidly, and older veterans had the largest increases across substances.”

The study emphasized that rapid increases in cannabis and stimulant use disorder present a treatment challenge at the VA, adding that “key subgroups (e.g., older adults) may require tailored screening and treatment options.” The researchers advised, “Diagnoses for SUD are increasing among Veterans overall, but there is important heterogeneity by substance and subgroup. Efforts to ensure access to evidence-based treatment for SUD may require greater focus on cannabis and stimulants, particularly for older adults.”

The study points out that it is the first assessment of time trends in substance-specific disorders among veterans, overall and by age and sex.


  1. Hoggatt KJ, Chawla N, Washington DL, Yano EM. Trends in substance use disorder diagnoses among Veterans, 2009-2019. Am J Addict. 2023 Mar 8. doi: 10.1111/ajad.13413. Epub ahead of print. PMID: 36883297.