Introduction: It is not known whether medical cannabis reimbursement is producing a net benefit for Veterans living with pain. The aims of this study were to compare never, past, and current cannabis users and to understand current use behaviours. Methods: Canadian Veterans (N = 589) living with chronic pain were administered an online survey. Descriptive statistics were calculated and inferential analyses conducted using chi-square tests of association, extended McNemar-Bowker tests, and an ordinal logistic regression. Results: 1) Over a quarter of never users report stigma as their reason for non-use, 2) 34% of past users discontinued due to lack of symptomatic improvement, 3) the predominant reasons for cannabis use are symptom relief (83%), medication substitution (59%), and avoiding side effects from prescription opioids (45%), 4) 89% of male current users found cannabis helpful in reducing the intensity of chronic pain, while only 70% of female current users reported the same, χ 2 (1, N = 310) = 15.92, p < 0.001, 5) 50% of current users endorse neuropathic pain compared to 40% of those not currently using cannabis, χ 2 (1, N = 522) = 5.71, p = 0.017, and 6) a majority of Veterans prescribed 0.5 to 2 grams per day or 4 or more grams per day of cannabis reported using the full amount; however, less than 40% of Veterans prescribed 3 grams per day use the full amount regardless of sex, age, or pain category, χ 2 (3, N = 248) = 64.33, p < 0.001, g = 0.37. Discussion: Many Veterans report a net benefit from medical cannabis use, though this result is less consistent for female participants. Some Veterans do not use their full reimbursed amount.
Introduction: Although significant strides have been made in advancing policies and legal protections for individuals who are not heterosexual (hereafter referred to as sexual minorities), reports of harassment and discrimination persist both across the globe and within Canada. To date, there is no published quantitative research that has examined the interpersonal mistreatment experiences of sexual minority Canadian Armed Forces (CAF) members. This study attempts to address that gap in the literature. Methods: Using data from the CAF Harassment and Discrimination Survey, this study investigated the interpersonal mistreatment experiences of Regular Force members (N = 4,046) who self-identified as either a sexual minority (homosexual, bisexual, pansexual, or asexual) or a heterosexual. Interpersonal mistreatment types included personal harassment, abuse of authority, microaggression, and discrimination. Results: Sexual orientation was associated with interpersonal mistreatment, as sexual minority members reported higher levels of each type of mistreatment than heterosexual members. After controlling for gender, designated group member (DGM; i.e., Indigenous Peoples, persons with disabilities, and racialized members) status, age group, and rank group, the results showed that sexual orientation remained significantly associated with experiences of personal harassment and microaggressions. Sexual minorities were also more likely than heterosexuals to attribute their experiences of personal harassment, discrimination, and microaggressions to their sexual orientation. Discussion: The results suggest that sexual minorities are at increased risk for interpersonal mistreatment. Future studies are encouraged to incorporate longitudinal and qualitative components into the research design to investigate the experiences of sexual minorities further.
Introduction: The aim of this study was to determine the feasibility of a virtually delivered, individual, cognitive rehabilitation protocol called Symptom-Targeted Rehabilitation for Cognitive Complaints after Concussion (STAR-C) for Canadian Armed Forces and Royal Canadian Mounted Police Veterans with mild traumatic brain injury (mTBI). Methods: A randomized controlled clinical trial was conducted comparing STAR-C to provision of self-management educational materials for mTBI. STAR-C was delivered by a speech-language pathologist or occupational therapist. Outcomes were recruitment numbers and participant and clinician ratings on a standard measure of acceptability, appropriateness, and feasibility of intervention. Results: Of 136 veterans who contacted the study coordinator, 56 were eligible and were randomized to either STAR-C (n = 28) or educational materials (Control group, n = 28). Of the 19 active group participants who completed all post-treatment measures, 17 gave high ratings of acceptability, appropriateness, and feasibility. Clinicians gave the intervention high ratings of appropriateness and feasibility for the active participants who completed the STAR-C treatment. The 20 control group participants gave a wider range of scores for the educational materials. Discussion: STAR-C was rated as acceptable, appropriate, and feasible by both participants who completed the study and clinicians, with significantly higher participant ratings for STAR-C versus control. There were significant challenges in recruitment, however, raising questions about feasibility and whether awareness-raising efforts might be needed prior to studying treatment efficacy and effectiveness.
Introduction: Veterans experience elevated physical and mental health needs, and they often face challenges navigating civilian health care systems. This scoping review synthesized qualitative evidence on barriers and facilitators to health care access among Veterans in Five Eyes countries a multidimensional access work. Methods: Following Joanna Briggs Institute and PRISMA-ScR guidance, five databases (CINAHL, APA PsycInfo, Medline, Embase, and Scopus) and one journal were searched to Sep. 26, 2025. Qualitative studies examining access to physical or mental health care among Veterans were included, and findings were mapped across dimensions of health care access. Results: Eighty-four studies met inclusion criteria, most from the United States (83%) and published within the past decade. Barriers and facilitators were identified across all 10 dimensions of access. Key supply-side barriers included poor appropriateness (e.g., negative care experiences, fragmented coordination), limited availability (e.g., wait times, geographic distance), and low acceptability (e.g., limited cultural competence, gender insensitivity). Demand-side barriers primarily affected early stages of access, including the ability to perceive need and seek care. Distrust of health care systems, low health literacy, stigma, and difficulties navigating services were particularly prominent, while relatively few facilitators addressed these early stages. Discussion: The literature reviewed suggests that improving Veteran health care access requires culturally competent care and approaches that address early barriers, including stigma, distrust, and difficulties navigating care, to help-seeking behaviours. However, important evidence gaps remain, including limited use of comprehensive access-to-care frameworks, a lack of research conducted outside the United States, and under-representation of equity-deserving Veteran populations.
