Marijuana Is Not the Solution for PTSD — Evidence shows it does not treat PTSD in the long-term, and may worsen symptoms
A growing number of states have identified post-traumatic stress disorder (PTSD) as an approved condition for medical marijuana. According to Colorado's Medical Marijuana Registry, there are 70,533 patients as of February 2023 with an active medical marijuana registration in the state, and 10,734 of them indicate PTSD as the reason they are using medical marijuana. This is despite the lack of any high-quality, randomized, controlled studies proving that marijuana helps PTSD in the long-term. Because of this lack of evidence, the American Psychiatric Association adopted a policy in 2019 opposed to using medical cannabis treatment for PTSD.
While many people find that cannabis seems to initially help PTSD symptoms, it likely does this by providing some temporary relief, numbing the individual and disconnecting them from the traumatic emotions. However, to keep the symptoms at bay, the individual often needs to use daily, sometimes multiple times a day, which can then set them up for significant consequences associated with daily cannabis use, such as cannabis use disorder (CUD), psychotic symptoms, cognitive problems, suicidal ideation, worsening depression and anxiety, and cannabinoid hyperemesis syndrome.
Outcomes of Marijuana Use for PTSD: A Review of the Literature
The problems with regular cannabis use in those with PTSD were demonstrated by a 2020 study from Canada in which anonymous data was obtained from a phone app, Strainprint. In the study, 404 medical cannabis users, self-identified as having PTSD, used the app to track symptoms of intrusive thoughts, flashbacks, irritability, and anxiety. The users would then indicate the strain of cannabis they were about to use and the effects on their symptoms. The results indicated that acute cannabis intoxication provided temporary relief from intrusions, flashbacks, irritability, and anxiety. However, baseline PTSD symptom ratings did not change over time, and the researchers detected evidence that people used higher doses over time to manage anxiety, indicating the development of tolerance to the drug. They concluded that while these results indicate that cannabis may reduce PTSD symptoms in the short-term, it may not be an effective long-term remedy for the disorder.
There have been an increasing number of studies demonstrating that the use of marijuana can worsen PTSD over time. An observational study assessed 2,276 veterans treated in VA PTSD treatment programs at the time of intake and then again 4 months after discharge. They found that those who had been using marijuana prior to the program but stopped had the lowest level of PTSD symptoms 4 months post-discharge, and second lowest were those who never used marijuana. Those who started using marijuana again after the treatment program had the highest levels of violent behavior, alcohol use, and PTSD symptoms.
A more recent study using the 2019-2020 National Health and Resilience in Veterans Study (NHRVS) data on 4,069 U.S. military veterans from around the country found that frequent cannabis use worsens PTSD symptoms in veterans. Those who used cannabis frequently were roughly twice as likely to screen positive for co-occurring major depressive disorder, generalized anxiety disorder, and suicidal ideation. They also showed small-to-moderate decrements in cognitive functioning.
