Medical marijuana for PTSD (post-traumatic stress disorder) treatment is a controversial topic that divides the opinions of PTSD patients and medical professionals alike. Treating PTSD and other anxiety disorders can be complicated from a medical point of view since patients with mental health problems can react differently to different therapies and treatments.
Anecdotal evidence and some academic studies suggest that medical marijuana may help with PTSD symptoms in the short term. However, long-term use appears to pose several risks, including a worsening of symptoms at baseline. Before trying cannabis-derived products for PTSD relief, it’s important to be aware of the potential benefits and risks, inform yourself about other treatment options, and consult an experienced medical professional.
Before deciding to try medical cannabis, there are some important considerations to take into account. It may also be helpful to discuss these points with your primary care physician.
1. Medical Marijuana Isn’t Legal in Every State
Medical marijuana is a federally controlled substance that isn’t currently legal everywhere in the United States. Though access to medical-grade cannabis is fairly widespread (recreational cannabis to a lesser degree), marijuana is still illegal in some states. In states where it is legal, patients may need to obtain a medical marijuana card, which requires the recommendation of an eligible medical professional and a formal application process.
Once you obtain a medical marijuana card (if your state offers this program), subsequent purchases of medical cannabis must comply with state regulations, including purchase and possession limits. It’s illegal to transport cannabis products over state lines and you aren’t generally allowed to consume marijuana if you work in a federal government-sponsored or safety-sensitive job.
2. Cannabis Use Disorder Is Prevalent Among Veterans
According to Veterans Affairs, a growing number of veterans are using marijuana to treat PTSD symptoms, chronic pain, and severe anxiety. At the same time, cases of substance use disorder are also on the rise with rates of cannabis use disorder at 2.7% among veterans in 2019-2020 and 5.6% among younger veterans, compared to a CUD rate of 1.7% among young veterans in 2005 and lower rates among older veterans.
A study conducted in 2022 also reported that veterans with a cannabis use disorder diagnosis reported worse long-term symptoms of PTSD, more severe and persistent alcohol abuse, and worse psychosocial functioning. This and other studies note the critical importance of substance abuse treatments and continuing psychological and physical support for returning veterans—both as preventative measures against substance abuse and for treatment in cases where drug or alcohol abuse becomes a problem.
3. Different Cannabis Products May Yield Different Results in PTSD Sufferers
With so many different cannabis products on the market, making generalizations about the effects of marijuana on PTSD symptoms doesn’t necessarily tell the whole story. Many different compounds can be extracted from the cannabis plant. Products that contain THC cause the psychedelic effects often associated with marijuana, but products that only contain CBD don’t cause the user to become “high” and offer a range of potential therapeutic effects.
Elms et al. (2019) investigated the impact of orally administered CBD on PTSD patients. The study concluded that 91% of the subjects experienced a decrease in PTSD symptom severity and no one discontinued the treatment due to side effects. CBD seemed particularly useful in treating patients who suffered from frequent nightmares.
Another study that explored the two most commonly researched compounds found in cannabis, THC and CBD, found that both cannabinoids helped with sleeping disorders caused by PTSD in the short term. It was noted that the reported amounts of THC and CBD in the products may have been inaccurate or misrepresented and the products that were taken were self-selected rather than dictated by the research protocol.
4. Academic Studies Don’t Agree on the Efficacy of Cannabis to Treat PTSD
Some scientific studies appear to show a positive correlation between marijuana use and a reduction in acute stress disorder symptoms. However, other studies report just the opposite, finding that marijuana can exacerbate the symptoms of PTSD and anxiety disorders.
Academic Studies that Indicate Cannabis Could Help with PTSD Symptoms
La France et al. (2020) reported that symptoms of PTSD—including intrusive thoughts, flashbacks, irritability, and/or anxiety were reduced by more than 50% after cannabis use. The authors also observed that symptom relief offered by cannabis is only temporary and that marijuana may not offer an effective long-term solution since an increase in the dosage needed over time is indicative of the development of tolerance.
In a systematic review, Rehman et al. (2021) suggested that since cannabis has shown promise in treating psychological conditions such as depression and anxiety, cannabis may help to alleviate PTSD symptoms too.
Academic Studies that Indicate Cannabis May Worsen PTSD Symptoms over Time
Metrik et al. (2020) reported greater severity of trauma-related intrusion symptoms over time with cannabis use and noted a strong correlation between PTSD and cannabis use disorder.
In an observational study published in 2015 in the Journal of Clinical Psychiatry, long-term marijuana use was associated with worsened PTSD symptom severity, violent behavior, and higher rates of alcohol and drug abuse when compared with people who ceased consumption or who had never used marijuana. It was also noted that marijuana use can nullify other courses of treatment that could otherwise have the potential to improve veterans’ quality of life.
Though some studies concede that marijuana may have some positive effects on PTSD, cannabis is generally seen as a problematic course of treatment due to the high risk of addiction and dependence, especially when used by young PTSD sufferers. These risks have led many in the medical community to recommend that patients suffering from PTSD symptoms try evidence-based pharmacological treatments and, crucially, psychological treatments, before turning to cannabis as a solution.
Try Other Treatments for PTSD First
Veterans who are considering using marijuana to alleviate PTSD symptoms should approach the subject with caution, always consulting their primary care physician and researching the potential side effects carefully before starting a course of treatment. The risk of developing tolerance to this potentially addictive substance should be at the forefront of veterans’ minds when considering cannabis for PTSD.
For patients who decide to explore the possibility of medical cannabis, it’s critical to consume only legal, medical-grade marijuana purchased from a reputable dispensary and to seek medical advice regarding products and dosages. Regular dialogue with your doctor and a careful analysis of the effects of cannabis on your symptoms (as well as any side effects or a build-up of tolerance) can help you keep your consumption moderate and transition to alternative treatment options, if required.