RALEIGH, N.C. — Each time Chayse Roth drives home to North Carolina, he notices the highway welcome signs that declare: “Nation’s Most Military Friendly State.”

“That’s a powerful thing to claim,” said Roth, a former Marine Corps gunnery sergeant who served multiple deployments to Iraq, Afghanistan and Pakistan.

Now he says he’s calling on the state to live up to those words. A Wilmington resident, Roth is advocating for lawmakers to pass a bill that would legalize medical marijuana and allow veterans with post-traumatic stress disorder and other debilitating conditions to use it for treatment.

“I’ve lost more men to suicide since we went to Afghanistan in ’01 than I have in combat,” said Roth, who said he doesn’t use cannabis himself but wants others to have the option. “It’s just unacceptable for these guys to go overseas and win the battle and come home and lose the battle to themselves.”

He is among several veterans brought together by a recently formed advocacy group called NC Families for Medical Cannabis. These veterans have testified before the legislature and visited lawmakers individually.

In a state that’s home to eight military bases, one of the largest veteran populations in the country and a Republican-controlled legislature that prides itself on supporting the troops, they hope their voices will act as a crucial lever to push through a bill that has faced opposition in the past.

“If we really want to be the most veteran-friendly state in the union, this is just another thing we can do to solidify that statement,” Roth said.

From California to Massachusetts, veterans have been active in the push for medical marijuana legalization for decades. But now, as the movement focuses on the remaining 14 states that have not enacted comprehensive medical marijuana programs or full marijuana legalization, their voices may have outsize influence, experts say.

Many of these remaining states are in the traditionally conservative South and dominated by Republican legislatures. “The group carrying the message here makes a huge difference,” said Julius Hobson Jr., a former lobbyist for the American Medical Association who now teaches lobbying at George Washington University. “When you’ve got veterans coming in advocating for that, and they’re considered to be a more conservative bunch of folks, that has more impact.”

Veterans also have the power of numbers in many of these states, Hobson said. “That’s what gives them clout.”

Successes are already evident. In Texas and Louisiana, veterans played a key role in the recent expansion of medical marijuana programs. In Mississippi, they supported a successful ballot initiative for medical cannabis in 2020, though the result was later overturned by the state Supreme Court. And in Alabama, the case of an out-of-state veteran arrested and jailed for possession of medical marijuana incited national outrage and calls for legalization. The state legalized medical marijuana earlier this year.

To be sure, not every veteran supports these efforts, and the developments in red states have been influenced by other factors: advocacy from cancer patients and parents whose children have epilepsy, lawmakers who see this as a states’ rights issue, a search for alternative pain relief amid the opioid epidemic and a push from industries seeking economic gains.

But the attention to the addiction and suicide epidemics among veterans, and calls to give them more treatment options, are also powerful forces.

In states like North Carolina, where statewide ballot initiatives are banned, veterans can kick-start a conversation with lawmakers who hold the power to make change, said Garrett Perdue, the son of former North Carolina Gov. Beverly Perdue and a spokesperson for NC Families for Medical Cannabis and CEO of Root Bioscience, a company that makes hemp products.

“It fits right in with the general assembly’s historical support of those communities,” Perdue said. “For [lawmakers] to hear stories of those people that are trusted to protect us and enforce the right of law” and see them as advocates for this policy “is pretty compelling.”

Gary Hess, a Marine Corps veteran from Louisiana, said he first realized the power of his platform in 2019, when he testified in front of the state legislature about seeing friends decapitated by explosions, reliving the trauma day-to-day, taking a cocktail of prescription medications that did little to help his symptoms and finally finding relief with cannabis. His story resonated with lawmakers who had served in the military themselves, Hess said.

He recalled one former colonel serving in the Louisiana House telling him: “They’re not going to say no to a veteran because of the crisis you’re all in. As someone who is put together well and can tell the story of marijuana’s efficacy, you have a powerful platform.”

Hess has since started his own nonprofit to advocate for medical marijuana legalization and has traveled to other state and national events, including hearings before the North Carolina legislature.

“Once I saw the power my story had,” he said, “the goal became: How do I expedite this process for others?”

Experts trace the push for medical marijuana legalization back to the AIDS epidemic of the 1980s and ’90s, particularly in California’s Bay Area.

As the movement tried to expand, medical marijuana activists realized other regions were not as sympathetic to the LGBTQ community, said Lee Hannah, an associate professor of political science at Wright State University who is writing a book about the rise of legal marijuana in the U.S. They had to find “more target populations that evoke sympathy, understanding and support,” Hannah said.

Over time, the medical marijuana conversation grew from providing symptom relief for patients with AIDS to include such conditions as cancer, pediatric epilepsy and PTSD, Hannah and his colleagues noted in a 2020 research paper. With each condition added, the movement gained wider appeal.

“It helped change the view of who a marijuana user is,” said Daniel Mallinson, a co-author on the 2020 paper and the upcoming book with Hannah, and an assistant professor at the Penn State-Harrisburg School of Public Affairs. “That makes it more palatable in these legislatures where it wouldn’t have been before.”

In 2009, New Mexico became the first state to make PTSD patients eligible for medical marijuana. The condition has since been included in most state medical marijuana programs.

The movement got another boost in 2016 when the American Legion, a veterans organization with 1.8 million members known for its conservative politics, urged Congress to remove marijuana from its list of prohibited drugs and allow research into its medical uses.

“I think knowing an organization like the American Legion supports it frankly gives [lawmakers] a little bit of political cover to do something that they may have all along supported but had concerns about voter reaction,” said Lawrence Montreuil, the group’s legislative director.

In Texas, when the Republican governor recently approved a law expanding the state’s limited medical marijuana program, he tweeted: “Veterans could qualify for medical marijuana under new law. I will sign it.”

It’s smart political messaging, Hannah said. Elected officials “are always looking to paint laws they support in the most positive light, and the approval rate of veterans is universally high.”

Nationally, veteran-related marijuana bills seem to be among the few cannabis-related reforms that have gained bipartisan support. Bills with Democratic and Republican co-sponsors in Congress this session deal with promoting research into medical marijuana treatment for veterans, allowing Veterans Affairs doctors to discuss cannabis with patients in states where it is legal and protecting veterans from federal penalization for using state-legalized cannabis.

Rep. Dave Joyce, an Ohio Republican who has co-sponsored two bipartisan bills concerning veterans and medical marijuana this session, said the interest of veterans is “what drew me to cannabis in the first place.”

In North Carolina, veterans like Roth and Hess, along with various advocacy groups, continue to drum up support for the medical marijuana bill. They know it’s a long battle. The bill must clear several Senate committees, a full Senate vote and then repeat the process in the House. But Roth said he’s optimistic “the veteran aspect of it will be heavily considered by lawmakers.”

An early indication of that came at a Senate committee hearing earlier this summer. Standing at the podium, Roth scrolled through his phone to show lawmakers how many of his veteran contacts were now dead due to suicide. Other veterans testified about the times they had contemplated suicide and how the dozens of prescription medications they had tried before cannabis had done little to quiet those thoughts.

The hearing room was silent as each person spoke. At the end, the lawmakers stood and gave a round of applause “for those veterans who are with us today and those who are not.”

The bill later passed that committee with a nearly unanimous vote.