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 P. Duprey Jr studied medicine as a 2nd career medical student who went to medical school in his 40’s after honorable discharge and ‘retirement’ from 25 years in the US Military (USCG & US Army). He was a registered nurse (RN) with specialty training as a psychiatric RN in the US Army for 15 years. During this time he also became a Master’s level psychotherapist in 2002. While on US Army active duty he also became a Psychiatric Nurse Practitioner while working full time in 2011. He served as a Psych NP on active duty, to include a combat tour in Iraq, until his ‘retirement’ in 2014 and moved to Philippines with his 3 children. At this time he started medical school overseas at Oceania University of Medicine based out of Samoa accredited by Philippine Accrediting Association of Schools, Colleges and Universities (PAASCU). He continued to work as a Psych NP throughout medical school to support his children and to not have to take out loans for medical school tuition. Originally from Rhode Island, he completed medical school clerkship rotations throughout the USA with a graduation in May 2019 earning the esteemed credential of MD. He has successfully completed USMLE Steps 1, 2CS, and 2CK. He will take Step 3 this September as he applies for Psychiatry Residency. Having been and RN, NP and now MD, he is a believer of Physician led multidisciplinary healthcare teams