The Use of Medicinal Marijuana for Posttraumatic Stress Disorder

Abstract

Posttraumatic stress disorder is 1 of the approved conditions for medicinal marijuana in some states. While the literature to date is suggestive of a potential decrease in PTSD symptomatology with the use of medicinal marijuana, there is a notable lack of large-scale trials, making any final conclusions difficult to confirm at this time.

PTSD: from neurobiology to pharmacological treatments

“…First, there has long been the concern for impairing cognition, as well as paranoia (Yarnell, 2015). Second, there is a concern for potential long-term worsening of PTSD outcomes with cannabis (Wilkinson, Yarnell, Radhakrishnan, Ball, & D'Souza, 2016).…”

“…Marijuana use is positively correlated with PTSD symptoms, but, according to self-reports, cannabis was used with intent to cope with these PTSD symptoms (Bonn-Miller, Vujanovic, Feldner, Bernstein, & Zvolensky, 2007). Therefore, the directionality of the effects of cannabis use on PTSD symptoms cannot be fully differentiated (Yarnell, 2015). Regardless, there appears also to be a correlation between PTSD and problematic cannabis use (Wilkinson et al, 2016; Yarnell, 2015).…”

“…Therefore, the directionality of the effects of cannabis use on PTSD symptoms cannot be fully differentiated (Yarnell, 2015). Regardless, there appears also to be a correlation between PTSD and problematic cannabis use (Wilkinson et al, 2016; Yarnell, 2015). Third, extended use may result in down-regulation of CB1 receptors (Leweke & Koethe, 2008), predisposing to a rebound anxious/depressive phenotype (Haller, Bakos, Szirmay, Ledent, & Freund, 2002; Haller, Varga, Ledent, & Freund, 2004).…”

“…This finding is consistent with other studies that have shown cannabinoids can facilitate fear extinction learning without affecting positive memory formation (Chhatwal, Davis, Maguschak, & Ressler, 2005; Marsicano et al, 2002). Others have suggested using CB1 antagonists (Yarnell, 2015). However, cannabinoid-deficient mice required significantly longer time to forget an association with painful foot shocks and bell ringing than wild-type control (Chhatwal et al, 2005; Lutz, 2007; Marsicano et al, 2002) suggesting antagonism may not be beneficial.…”

Associations of PTSD, chronic pain, and their comorbidity on cannabis use disorder: Results from an American nationally representative study

“…There has been recent work examining cannabis as a treatment for PTSD (Betthauser, Pilz, & Vollmer, ; Bonn‐Miller, Babson, & Vandrey, ; Yarnell, ). Much of this work has focused on the utility of medical cannabis in PTSD populations (Yarnell, ); specifically, how cannabis can attenuate PTSD symptomatology (Bonn‐Miller et al, ; Drost et al, ; Greer, Grob, & Halberstadt, ).…”