Veterans and Chronic Pain: Why 60% Are Using Botanical Supplements Their Doctors Don't Know About

A 2025 study funded by NIH and the Department of Veterans Affairs found something nobody wants to hear: more than half of veterans using botanical supplements for chronic pain never tell their doctors.

The study looked at 52 veterans in the VA's wHOPE trial. Sixty percent used herbal or botanical products. Only 52% mentioned it to healthcare providers. That gap matters – drug interactions happen, contaminated products slip through, and doctors make decisions without knowing what their patients are taking.

The Pain Numbers

Veterans deal with chronic pain way more than civilians. Recent national data puts it around 28% for veterans versus 19% for everyone else. Among veterans actually using VA primary care? Nearly half.

Musculoskeletal stuff dominates. Knees, backs, sciatica. The VA's 2024 report shows 38% of service-connected disabilities involve bones and joints. Younger veterans aged 18-39 report severe pain at double the civilian rate – 7.8% compared to 3.2%.

Meanwhile, the VA cut opioid prescriptions by 67% between 2012 and 2023. That's 875,000 veterans down to 289,000. Good policy for addressing the opioid crisis, but it created a gap that needed filling.

Where Veterans Are Looking

Botanical supplements rushed in. That same NIH/VA study found 40% used cannabis products, and a third said they'd substituted natural products for pain meds.

Kratom has become one of the bigger debates. Things like full-spectrum kratom tinctures are showing up more in veteran circles, though there's no solid data on how many vets specifically use it. General U.S. numbers suggest maybe 1.7-2 million people used it in the past year, based on 2019 surveys.

Why the interest? Kratom's main alkaloid works on opioid receptors but differently than prescription painkillers. Partial agonist, weaker respiratory depression risk. Sounds promising on paper.

Except that the science is really thin. One randomized trial exists – 26 guys in Malaysia. No big clinical studies. Nothing specific to veterans.

The FDA hasn't approved kratom for medical use. In July 2025, the agency recommended scheduling 7-hydroxymitragynine (concentrated derivative) as Schedule I. But they specifically said that action doesn't target natural kratom leaf. So there's this weird split forming.

Why Veterans Aren't Talking

Here's the thing that matters most: veterans aren't having these conversations with their doctors.

Another study in the Journal of General Internal Medicine dug into why. Veterans think natural products are safer than pharmaceuticals. They worry doctors will judge them or dismiss them. They assume providers won't know much about botanicals anyway.

But get this – 98% of veterans surveyed said they think providers should discuss natural product use with them. They want the conversation. It's just not happening.

Real risks emerge from this silence. Unregulated supplements get contaminated – Salmonella outbreaks, heavy metals, some kratom products found spiked with fentanyl. When doctors don't know what patients take, they miss adverse effects, dangerous interactions with prescribed meds.

What Gets Lost

The VA offers eight complementary therapies now. Acupuncture, massage, meditation, yoga, and others. Usage jumped 70% from 2017 to 2019. The Whole Health program ($108 million budget) shows participants cutting opioid use three times more than non-participants.

These programs reach maybe a fraction of veterans with chronic pain. And none include botanicals like kratom – those stay outside VA-supported approaches.

The supplement market overall? $38-55 billion globally, growing 8-10% yearly. Three-quarters of Americans use supplements now. Veterans are part of that, just with higher pain rates and more complex medication situations that make the non-disclosure thing particularly dangerous.

The research gap creates problems, too. No veteran-specific data, no trials testing these products in populations actually using them. Veterans and doctors both making decisions without information.

That 52% non-disclosure rate is not just a statistic. It shows a breakdown between patients and providers in the exact population needing coordinated care the most. Veterans want these talks. Doctors need to know what patients are taking. Until that gap closes, veterans keep managing their own pain – with or without anyone watching.