Experiences with medical cannabis in the treatment of veterans with PTSD: Results from a focus group discussion

Krediet, Erwin; Janssen, Debbie G. A.; Heerdink, Eibert R.; Egberts, Toine C. G.; Vermetten, Eric

doi:10.1016/j.euroneuro.2020.04.009

Cited by 34 publications

(20 citation statements)

References 38 publications

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“…Despite conflicting results, this pharmacological approach is still being recommended (Germain et al., 2017 ; Zhang et al., 2020 ), as is doxazosin and terazosin (Pallesen et al., 2020 ; Smith & Koola, 2016 ). Targeting the endocannabinoid system also has yielded promising results (Jetly et al., 2015 ; Krediet et al., 2020 ). However, evidence of the underutilization of (Seal et al, 2010 ) and high attrition rates for (DeViva, 2014 ) standard‐of‐care PTSD treatment, coupled with findings that SD often persists following trauma‐focused treatment, demonstrate that there is a need for novel interventions that can target both sleep disturbance and PTSD (Germain et al., 2017 ).…”

Section: Sleep Quality Improvements After Mdma‐assisted Psychotherapy For the Treatment Of Posttraumatic Stress Disordermentioning

confidence: 99%

Sleep Quality Improvements After MDMA‐Assisted Psychotherapy for the Treatment of Posttraumatic Stress Disorder

Ponté

Jerome

Hamilton

et al. 2021

Journal of Traumatic Stress

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Sleep disturbances (SDs) are among the most distressing and commonly reported symptoms in posttraumatic stress disorder (PTSD). Despite increased attention on sleep in clinical PTSD research, SDs remain difficult to treat. In Phase 2 trials, 3,4‐methylenedioxymethamphetamine (MDMA)–assisted psychotherapy has been shown to greatly improve PTSD symptoms. We hypothesized that MDMA‐assisted psychotherapy would improve self‐reported sleep quality (SQ) in individuals with PTSD and be associated with declining PTSD symptoms. Participants in four studies (n = 63) were randomized to receive 2–3 sessions of active MDMA (75–125 mg; n = 47) or placebo/control MDMA (0–40 mg, n = 16) during all‐day psychotherapy sessions. The PSQI was used to assess change in SQ from baseline to the primary endpoint, 1–2 months after the blinded sessions. Additionally, PSQI scores were measured at treatment exit (TE) and 12‐month follow‐up. Symptoms of PTSD were measured using the CAPS‐IV. At the primary endpoint, CAPS‐IV total severity scores dropped more after active MDMA than after placebo/control (−34.0 vs. −12.4), p = .003. Participants in the active dose group showed more improvement in SQ compared to those in the control group (PSQI total score ΔM = −3.5 vs. 0.6), p = .003. Compared to baseline, SQ had improved at TE, p < .001, with further significant gains reported at 12‐month follow‐up (TE to 12‐months ΔM = −1.0), p = .030. Data from these randomized controlled double‐blind studies provide evidence for the beneficial effects of MDMA‐assisted psychotherapy in treating SDs in individuals with PTSD.

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Section: Sleep Quality Improvements After Mdma‐assisted Psychotherapy For the Treatment Of Posttraumatic Stress Disordermentioning

confidence: 99%

Sleep Quality Improvements After MDMA‐Assisted Psychotherapy for the Treatment of Posttraumatic Stress Disorder

Ponté

Jerome

Hamilton

et al. 2021

Journal of Traumatic Stress

Self Cite

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“…In addition to the risk of developing CUD, participants emphasized the paradoxical nature of cannabis use in medicating post-traumatic stress symptoms. Despite accumulating evidence of the beneficial effect of cannabis use on sleep disturbances associated with PTSD (16,44), cannabis use appears to be ineffective in long-term reduction of the majority of PTSD symptoms (45). Among heavy users, cannabis use may even be associated with a poorer PTSD outcome, namely increase in intrusive symptoms severity (46).…”

Section: Discussionmentioning

confidence: 99%

From Enchantment to Disillusion: A Narrative Exploration of Cannabis Use Disorder Among Young Israeli Combat Veterans

2021

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Introduction: Substance use is common among military personnel and war veterans, especially combat veterans. Despite substantially high prevalence of cannabis use and Cannabis Use Disorder (CUD) consistently reported among veterans, little is known about psychological factors which may underlie CUD among this population.Methods: In this study, we used narrative analysis in order to interpret retrospective in-depth interviews of combat veterans (N = 12) who were released from mandatory military duty during the past 5 years and currently qualified for a diagnosis of CUD. Participants were recruited from a larger quantitative study were eligible for participation if they screened positive for a diagnosis of CUD according to the Cannabis Use Disorder Identification Test- Revised (CUDIT-R) questionnaire. CUD diagnosis was validated in-person using the cannabis section of the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 (AUDADIS-5) interview protocol. All interviews were transcribed and coded using the content analysis procedure.Findings: Five main themes were extracted: (a) Traumatic events (b) Attitudes toward cannabis use (c) Combatant identity (d) The role of authority/father figures, and (e) Moral crisis. A meta-theme has been identified, “from enchantment to disillusion,” representing a gradual psychological shift from a hopeful, highly motivated stance into the current state of mental rupture and moral injury, which are unsuccessfully compensated by excessive use of cannabis.Conclusions: This study shed light on the etiology of CUD among young combat veterans, highlighting the role of supposed self-medication for trauma and sense of betrayal.

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“…Over the past 50 years, not only has cannabis been increasingly adopted by adolescents and young adults for recreational use, mainly in social settings to increase sociability and produce euphoric and tranquilizing effects [ 34 ], but the age of use initiation is shifting back with younger children and adolescents reporting daily cannabis use [ 35 ]. Although cannabis remains illegal in most countries, there have been significant changes in its use as a therapeutic medicine [ 36 , 37 , 38 ]. Accumulating evidence suggests that some cannabinoids, particularly CBD, may be an effective and safe anxiolytic and potentially also antidepressant agents [ 32 , 39 , 40 , 41 , 42 , 43 , 44 ].…”

Section: Introductionmentioning

confidence: 99%

Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review

Hen-Shoval

Weller

Weizman

et al. 2022

IJERPH

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Depression and anxiety disorders are two of the most common and growing mental health concerns in adolescents. Consequently, antidepressant medication (AD) use has increased widely during the last decades. Several classes of antidepressants are used mainly to treat depression, anxiety, and obsessive-compulsive disorders by targeting relevant brain neurochemical pathways. Almost all randomized clinical trials of antidepressants examined patients with no concomitant medications or drugs. This does not address the expected course of therapy and outcome in cannabis users. Cannabis is the most commonly used illicit substance globally. Substantial changes in its regulation are recently taking place. Many countries and US states are becoming more permissive towards its medical and recreational use. The psychological and physiological effects of cannabis (mainly of its major components, tetrahydrocannabinol (THC) and cannabidiol (CBD)) have been extensively characterized. Cannabis use can be a risk factor for depressive and anxiety symptoms, but some constituents or mixtures may have antidepressant and/or anxiolytic potential. The aim of this literature review is to explore whether simultaneous use of AD and cannabis in adolescence can affect AD treatment outcomes. Based on the current literature, it is reasonable to assume that antidepressants are less effective for adolescents with depression/anxiety who frequently use cannabis. The mechanisms of action of antidepressants and cannabis point to several similarities and conjunctions that merit future investigation regarding the potential effectiveness of antidepressants among adolescents who consume cannabis regularly.

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Experiences with medical cannabis in the treatment of veterans with PTSD: Results from a focus group discussion

Cited by 34 publications

References 38 publications

Sleep Quality Improvements After MDMA‐Assisted Psychotherapy for the Treatment of Posttraumatic Stress Disorder

Sleep Quality Improvements After MDMA‐Assisted Psychotherapy for the Treatment of Posttraumatic Stress Disorder

From Enchantment to Disillusion: A Narrative Exploration of Cannabis Use Disorder Among Young Israeli Combat Veterans

Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review

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