Post-traumatic stress disorder (PTSD) can be debilitating, leading to nightmares, flashbacks, panic attacks, and irritability.
In the hope of finding relief, many people with PTSD have started using medicinal marijuana.
But a new analysis concludes there’s still no evidence to prove that these drugs can provide much help.
PTSD affects 7 to 8 percent of the population at some point in their lives.
The condition is also one that can be ongoing, with half of those with PTSD experiencing symptoms for more than three months.
Treating the condition can include a mix of talk therapy and antidepressants or other medications.
However, some people still need to keep searching for a way to cope with issues such as irritability, outbursts of anger, difficulty concentrating, flashbacks, or nightmares.
For some people with PTSD, medical marijuana has been the drug that seems to provide relief.
Experts have seen a rise in patients using medicinal marijuana products to help with PTSD as more and more states legalize the product.
Currently, 29 states and the District of Columbia have legalized medicinal marijuana and cannabis. However, regulations surrounding the drug make it difficult to obtain reliable information about how it can help or hurt people.
One-third of people using medical marijuana in states where it’s legal have cited PTSD as their reason for using the drug, according to a recent study published in the Annals of Internal Medicine.
But that study also found that there is still no evidence available that the drug can help, or alternately hurt, people experiencing PTSD symptoms.
The researchers from the Veterans Affairs Portland Health Care System and Oregon Health & Science University looked at two systematic reviews and three individual studies to see if they could clarify whether or not the drug is helpful.
However, they concluded that there was mixed evidence about whether or not cannabis products did much in helping PTSD symptoms.
Many veterans of the Iraq and Afghanistan conflicts have reportedly relied on the drug to help them with PTSD symptoms.
“We found insufficient evidence regarding the benefits and harms of plant-based cannabis preparations for patients with PTSD,” the authors wrote. “The body of literature currently available is limited by small sample sizes, lack of adjustment for important potential confounders, cross-sectional study designs, and a paucity of studies with non-cannabis-using control groups.”
The team does point to multiple ongoing studies that will hopefully give some clarity on the issue in the future.
The difficulty for researchers
Since marijuana is considered a Schedule 1 narcotic — the same categorization as heroin — by the Drug Enforcement Agency (DEA), it’s difficult for researchers to launch large studies that could examine the drug’s positive or negative health effects.
Experts say that without better information on medical marijuana it’s difficult knowing what to tell people about it.
Scott Krakower, DO, assistant unit chief of psychiatry at Zucker Hillside Hospital in New York, said without better data he would advise people with PTSD to steer clear of the drug in favor of treatments with more medical research behind them.
There’s “no specific data to indicate better outcomes with marijuana,” he said. “It doesn't mean in the future there won't be studies” on it.
In addition, because the drug’s level of THC can vary widely depending on the strain and how it was prepared, it can be difficult to know how different products will affect people.
Krakower explained people might seek out products that have low levels of THC in the hopes that they won’t get high.
However, with no federal oversight it’s difficult to ensure there isn’t variability even in the same product.
“It might have more THC than they expect, they might get super high, super quickly... they may not be able to focus,” Krakower said.
Dr. Joseph Calabrese, director of the Mood Disorders Program at University Hospitals Cleveland Medical Center, said it’s important to remember that PTSD doesn’t occur in a vacuum and is often accompanied by other conditions that may be alleviated by the drug.
“Probably the most important thing to share with people is [that PTSD] almost never occurs by itself,” he said. “The most common co-occurring illnesses with PTSD is depression, major depressive disorder and anxiety, generalized anxiety disorder, and number three is alcohol and drug abuse.”
He said it’s likely that cannabis products can help with some symptoms that accompany a PTSD diagnosis, but not the core problem itself.
Additionally, he said more and better studies need to be done to find the right medications that could help people with PTSD.
“It helps the anxiety, but it doesn't make these illnesses go away,” he said.