Post Traumatic Stress Disorder (PTSD) was first observed in World War I combat veterans. Doctors dubbed it “shell shock,” based on the belief that only men who’d been exposed to exploding shells, or bombs, were affected.
Now we know anyone exposed to a distressing or traumatic event can develop PTSD, which is characterized by intrusive thoughts and feelings related to the past trauma; fear, sadness and anger; and feeling disconnected from others.
Targeted psychotherapy is the most widely recommended treatment for PTSD, and medications for depression and anxiety may also be prescribed. But many PTSD patients don’t get better with drug therapy; remission rates are only about 20% to 30%. According to the American Psychiatric Association, PTSD related to combat may be more resistant to drug treatment than “civilian trauma.”
Several alternative treatments for PTSD are now under investigation, including medical marijuana.
Thousands of vets say cannabis has helped them deal with anxiety and other symptoms of PTSD. Veterans and their allies have pushed federal and state legislators to legalize medicinal cannabis and relax restrictions on marijuana research. Some supporters argue that treating PTSD with medical marijuana could help reduce veterans’ sky-high suicide rates.
Public support for medical marijuana is growing, and the tide may be turning. In 2017, Governor Andrew Cuomo chose Veterans Day to make PTSD a qualifying condition for medical marijuana in New York. Twenty-seven states now allow medical marijuana for PTSD.
While legal restraints on cannabis research have loosened somewhat in the US with the Farm Bill, marijuana is still a Schedule 1 controlled substance under federal law, meaning it has no accepted medical use and a high abuse potential.
In Canada, where cannabis is legal across the country, a company called Canada House Clinics (formerly Marijuana For Trauma) was founded in 2013 by Canadian Forces veterans Fabian Henry and Mike Southwell. The goal was to provide veterans suffering from PTSD with medical cannabis, and the company grew quickly. They now operate 11 clinics in 6 provinces located near military bases, and Veterans Affairs in Canada covers the cost of treatment.
Is there scientific evidence that cannabis can reduce PTSD symptoms, aside from individual reports and small studies? To date, very little. No randomized controlled trials that have been published, which is considered to be the “gold standard” for evaluating a drug’s effectiveness.
That’s about to change. An FDA-approved clinical trial of cannabis in 76 US vets with PTSD just concluded, although no results have been reported. Vets received 1.8 grams of cannabis each day and were randomly assigned to different potencies: high THC (12%), high CBD (12%), 1:1 ratio of THC to CBD (8%/8%), or placebo (no potency). They chose how much they wanted to smoke and were asked to keep a daily journal. The study was also triple-blinded, meaning the participants, researchers and evaluators didn’t know who was receiving what potency of cannabis.
The Multidisciplinary Association for Psychedelic Studies (MAPS), a California nonprofit, sponsored the study, and the Colorado Department of Public Health and Environment provided a $2.2 million grant.
But this is just a first step. More trials will be required before the FDA makes a decision, and pushback from the DEA is expected.
Roxanne Nelson is a registered nurse who has written for a wide range of publications for healthcare professionals and consumers, including Medscape, The Lancet, Prevention, Scientific American, WebMD, American Journal of Nursing, Frontline, National Geographic, Hematology Adviser, American Journal of Medical Genetics and the Washington Post, among others.