Calling Mary Jane & Her Cousin CBD, but for PTSD: What the……….

“Last November, researchers completed recruitment of 76 subjects in a phase 2 clinical trial of medical marijuana for the treatment of post-traumatic stress disorder (PTSD) in military veterans. It was the first such study for PTSD approved by the US Food and Drug Administration (FDA), and it took almost a decade to enroll those patients (1).

            I’ve seen Iraq Combat Veterans on Marinolfor both PTSD and phantom limb pain. I’ve seen Vietnam Combat Veterans using medical marijuana for PTSD. I’ve seen other trauma patients “medicating” their own PTSD with recreational marijuana. Is there something to this? Evidently these anecdotes have been out there for some time, and now according to this article (1), the medical and research community is taking a look. 

“In the last few years, approximately 93 trials involving marijuana or cannabinoids for neurologic disorders or symptoms were either completed or actively recruiting patients, according to the federal online registry, clinicaltrials.gov(1).”

            I’m going to take my judgmental antidrug hat off for a moment and be open minded to the notion put forth by the article where:

“Most neurology providers I speak with are open to anything that helps patients improve their care. The key is that we are scientists, and at the end of the day, we need evidence from studies performed properly. We are for anything that will make that happen,”(1)

            I think the responsible thing to do is the research. Marijuana and cannabis extracts have shown promise in helping patients with some neurological disorders, medical research in this area is being held back by federal prohibition combined with government red tape for researchers trying to study the drug, witnesses told congressional hearings in early February (1). However, I suspect as more and more states legalize marijuana the constraints will lighten up. The anecdotes are many, I also suspect there is some truth to the benefit. I’m not referring to the chronic pot smokers living in their mamas basement, but those who are truly seeking relief from their suffering. As a combat veteran myself working in mental health, I’ve seen PTSD as about raw as it gets, and they need relief. Sources are now starting to reference this notion (2-5). 

“Administration of oral CBD in addition to routine psychiatric care was associated with PTSD symptom reduction in adults with PTSD (2).”

REFERENCES:

  1. https://journals.lww.com/neurotodayonline/Pages/articleviewer.aspx?year=2019&issue=03210&article=00008&type=Fulltext
  2. Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392–397. doi:10.1089/acm.2018.0437, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482919/
  3. Koppel BS, Brust JC, Fife T, et al Systematic Review: efficacy and safety of medical marijuana in selected neurologic disorders. Report of the Guideline Development Subcommittee of the American Academy of Neurology https://n.neurology.org/content/82/17/1556/tab-article-infoNeurology 2014;82(17):1556–63.
  4. AAN Position: Use of medical marijuana for neurological conditions. 2018. http://bit.ly/NT-AANposition.
  5. Fife TD, Moawad H, Moschonas M., et al. Clinical perspectives on medical marijuana (cannabis) for neurologic disorders https://cp.neurology.org/content/5/4/344Neurology Clin Practice 2015;5(4):345–351.
  6. Gloss DS, Maa EH. Medical marijuana: Between a plant and a hard place https://cp.neurology.org/content/5/4/281Neurology Clin Practice 2015;5:281–284.
  7. National Conference of State Legislatures: State medical marijuana laws: http://bit.ly/NT-state-cannabis.

Robert Duprey MD

Robert is a 2nd career physician (MD); a combat Veteran with the US Army; a former psychiatric nurse practitioner; an independent researcher; a medical writer; and now having passed USMLE Steps 1, 2CK, 2CS, and 3, is a residency applicant.

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