Cannabis use for the treatment of PTSD is in the news across the globe ( Australia, U.S., Canada, and the U.K. ) with the publication of a study in Canada by Lake, and associates (2019). They stated ” there is preliminary evidence that cannabis use may contribute to reducing the association between post-traumatic stress disorder and severe depressive and suicidal states.” In addition to this a recent approval by the Iowa state medical board for the use of medical marijuana in the treatment of PTSD has also highlighted the use of Cannabis for the treatment of PTSD . This may be of interest to your clients.
What should you know for your clients?
Cannabinoid use does not mean uncontrolled “smoking a joint”, often studies have used specific cannabinoid extracts (Hindocha, et al. 2019) , and dosage levels have been managed.
While there may be benefits to controlled use of cannabinoids, cannabis use has been linked to significant mental health problems. Bloomfield et al. (2019) have reviewed the long-term use of cannabis and outline some detrimental outcomes, including addiction and psychosis, and impaired executive functioning.
Bohnert et al., 2014 and Bonn-Miller et al., 2014 cross-sectional research has shown that rates of Cannabis Use Disorder is greater among PTSD populations in comparison to patients seeking cannabis without PTSD. Is this possibly a PTSD avoidance behaviour?
Hindocha, et al. (2019) completed a systematic review of studies in which individuals with PTSD used cannabinoids for the purpose of reducing PTSD symptoms. While they found that cannabinoids may decrease PTSD symptomology, in particular sleep disturbances and nightmares. They also found that only 1 of the 10 studies was an RCT. The authors concluded that the current evidence base is too limited for clinical recommendations about cannabinoids for PTSD.
Summary
While future well-controlled, randomized, double-blind clinical trials are highly recommended by most researchers, they jury seems to still be out. What’s more, drug use might just be functioning as the biggest PTSD symptom, Avoidance. Good behavioural treatment such as CPT focus on changing avoidance.
References
Bloomfield, M., Hindocha, C., Green, S. F., Wall, M. B., Lees, R., Petrilli, K., … Freeman, T. P. (2019). The neuropsychopharmacology of cannabis: A review of human imaging studies. Pharmacology & therapeutics, 195, 132–161. doi:10.1016/j.pharmthera.2018.10.006
Bonn-Miller, M. O., Babson, K. A., & Vandrey, R. (2014). Using cannabis to help you sleep: Heightened frequency of medical cannabis use among those with PTSD. Drug and Alcohol Dependence, 136, 162–165. doi:10.1016/j.drugalcdep.2013.12.008 [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]
Bohnert, K. M., Perron, B. E., Ashrafioun, L., Kleinberg, F., Jannausch, M., & Ilgen, M. A. (2014). Positive posttraumatic stress disorder screens among first-time medical cannabis patients: Prevalence and association with other substance use. Addictive Behaviors, 39(10), 1414–1417. doi:10.1016/j.addbeh.2014.05.022 [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
Hindocha, C., Cousijn, J., Rall, M., & Bloomfield, M. (2020). The Effectiveness of Cannabinoids in the Treatment of Posttraumatic Stress Disorder (PTSD): A Systematic Review. Journal of dual diagnosis, 16(1), 120–139. https://doi.org/10.1080/15504263.2019.1652380
Lake, S., Kerr, T., Buxton, J., Walsh, Z., Marshall, B. D., Wood, E., & Milloy, M.-J. (2020). Does cannabis use modify the effect of post-traumatic stress disorder on severe depression and suicidal ideation? Evidence from a population-based cross-sectional study of Canadians. Journal of Psychopharmacology, 34(2), 181–188. https://doi.org/10.1177/0269881119882806
