A cross-sectional examination of choice and behavior of veterans with access to free medicinal cannabis

Loflin, Mallory; Babson, Kimberly A.; Sottile, James E.; Norman, Sonya B.; Gruber, Staci A.; Bonn‐Miller, Marcel O.

doi:10.1080/00952990.2019.1604722

Cited by 17 publications

(19 citation statements)

References 72 publications

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“…Average cannabis quantity that most cannabis users consume is difficult to estimate from epidemiological studies due to differences in cannabis potency and route of administration. However, large scale studies of medicinal cannabis users treating chronic pain and anxiety report average daily use in ranges closer to 1-3g/day [44,45]. Likewise, two smaller studies that assessed military veterans who use medical cannabis to self-treat PTSD reported median daily use of .85g to 1.14g/day [46] and average use of 3.8g/day [33].…”

Section: Plos Onementioning

confidence: 99%

“…This is a major limitation of previous research because there is substantial individual variability in cannabinoid tolerability [31]. Indeed, military veterans who use cannabis for PTSD tend to selftitrate to much larger doses than those tested in research studies [32,33].…”

Section: Introductionmentioning

confidence: 99%

“…While these data appear promising, the potential therapeutic effects of smoked, herbal cannabis on PTSD have not been examined in a randomized, placebo controlled trial. Military veterans with PTSD are overwhelmingly choosing smoked cannabis to self-treat PTSD and related conditions [30]. Moreover, herbal cannabis varies significantly across plants in its THC and CBD content [29].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, herbal cannabis varies significantly across plants in its THC and CBD content [29]. While both cannabinoids could hold therapeutic value, unlike THC, CBD is non-intoxicating and does not carry significant risk of abuse [30]. In addition, CBD may temper the anxiogenic effects of THC in cannabis preparations that contain both CBD and THC [31,32].…”

Section: Introductionmentioning

confidence: 99%

“…While both cannabinoids could hold therapeutic value, unlike THC, CBD is non-intoxicating and does not carry significant risk of abuse [30]. In addition, CBD may temper the anxiogenic effects of THC in cannabis preparations that contain both CBD and THC [31,32]. It is unclear whether THC, CBD, or some combination of compounds may lead to greater reductions in PTSD symptoms with better safety profiles compared to other combinations.…”

Section: Introductionmentioning

confidence: 99%

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The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial

et al. 2021

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Importance There is a pressing need for development of novel pharmacology for the treatment of Posttraumatic Stress Disorder (PTSD). Given increasing use of medical cannabis among US military veterans to self-treat PTSD, there is strong public interest in whether cannabis may be a safe and effective treatment for PTSD. Objective The aim of the present study was to collect preliminary data on the safety and potential efficacy of three active concentrations of smoked cannabis (i.e., High THC = approximately 12% THC and < 0.05% CBD; High CBD = 11% CBD and 0.50% THC; THC+CBD = approximately 7.9% THC and 8.1% CBD, and placebo = < 0.03% THC and < 0.01% CBD) compared to placebo in the treatment of PTSD among military veterans. Methods The study used a double-blind, cross-over design, where participants were randomly assigned to receive three weeks of either active treatment or placebo in Stage 1 (N = 80), and then were re-randomized after a 2-week washout period to receive one of the other three active treatments in Stage 2 (N = 74). The primary outcome measure was change in PTSD symptom severity from baseline to end of treatment in Stage 1. Results The study did not find a significant difference in change in PTSD symptom severity between the active cannabis concentrations and placebo by the end of Stage 1. All three active concentrations of smoked cannabis were generally well tolerated. Conclusions and relevance The present study is the first randomized placebo-controlled trial of smoked cannabis for PTSD. All treatment groups, including placebo, showed good tolerability and significant improvements in PTSD symptoms during three weeks of treatment, but no active treatment statistically outperformed placebo in this brief, preliminary trial. Additional well-controlled and adequately powered studies with cannabis suitable for FDA drug development are needed to determine whether smoked cannabis improves symptoms of PTSD. Trial registration Identifier: NCT02759185; ClinicalTrials.gov.

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Section: Plos Onementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial

et al. 2021

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Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: Psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms

Hill

Loflin

Nichter

et al. 2022

Journal of Traumatic Stress

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Cannabis use is common among individuals with posttraumatic stress disorder (PTSD) symptoms, but its impact on psychiatric symptoms and functioning in this population is unclear. To clarify the clinical and functional correlates of cannabis use in individuals with PTSD symptoms, we analyzed data from the 2019–2020 National Health and Resilience in Veterans Study, a nationally representative survey of U.S. military veterans. Participants with current subthreshold or full PTSD (N = 608) reported on their past‐6‐month cannabis use and current psychiatric symptoms, functioning, treatment utilization, and PTSD symptom management strategies. Veterans with subthreshold/full PTSD who used cannabis more than weekly were more likely to screen positive for co‐occurring depression, anxiety, and suicidal ideation than those who did not use cannabis, ORs = 3.4–3.8, or used cannabis less than weekly, ORs = 2.7–3.7. Veterans who used cannabis more than weekly also scored lower in cognitive functioning than veterans with no use, d = 0.25, or infrequent use, d = 0.71, and were substantially more likely to endorse avoidance coping strategies, ORs = 8.2–12.2, including substance use, OR = 4.4, and behavioral disengagement, ORs = 2.7–9.1, to manage PTSD symptoms. Despite more psychiatric and functional problems, veterans with frequent cannabis use were not more likely to engage in mental health treatment, ORs = 0.87–0.99. The results suggest enhanced cannabis use screening, interventions targeting risky use, and strategies promoting treatment engagement may help ameliorate more severe clinical presentations associated with frequent cannabis use among veterans with subthreshold/full PTSD.

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Self-reported Medicinal Cannabis Use as an Alternative to Prescription and Over-the-counter Medication Use Among US Military Veterans

McNabb,

Durante,

Trocchio

et al. 2023

Clinical Therapeutics

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A cross-sectional examination of choice and behavior of veterans with access to free medicinal cannabis

Cited by 17 publications

References 72 publications

The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial

The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial

Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: Psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms

Self-reported Medicinal Cannabis Use as an Alternative to Prescription and Over-the-counter Medication Use Among US Military Veterans

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