Marijuana Law, Policy & Reform

Editor: Douglas A. Berman
Moritz College of Law

Monday, September 5, 2016

"Study: Can marijuana improve PTSD symptoms for veterans?"

Main-logoThe title of this post is the headline of this interesting lengthy new Stars & Stripes article. Here is how it gets started:

Roberto Pickering’s story is all too familiar. The infantry Marine says he fought during the invasion of Iraq in 2003, lost some “good buddies” and returned to civilian life a “basket case” from battling a new enemy: post-traumatic stress disorder.

Pickering says he was pumped full of medications — from Valium to Zoloft, OxyContin, Seroquel, Lithium, Ambien and more — by Department of Veterans Affairs doctors. He tried to go back to school but had trouble adjusting.

He recoiled further after one friend took his own life and another died of a heroin overdose after becoming dependent on opioids through his medical care. Pickering moved into his parents’ California basement and found solace in the bottle while his life spiraled out of control.

Unlike thousands of post-9/11 veterans who have committed suicide, Pickering then found another way to cope: He began experimenting with marijuana about 10 years ago. “This war doesn’t end when you come back,” he said. Cannabis “really improved my quality of life … I found what works for me.”

Using marijuana regularly, he said, his angry outbursts diminished and he was able to get a good night’s sleep. He said he was able to kick his drinking habit and, best of all, he didn’t have to take the litany of pills he calls toxic. Pickering said he usually smokes a bit at night and calls himself a responsible family man, far from the stereotype of a coach-potato stoner.

He doesn’t know why marijuana changed his life, and researchers can only guess, because the plant has never been studied as a treatment for veterans’ PTSD. Despite state ballot initiatives to legalize marijuana for medical and nonmedical use in recent years, earlier this month it again received the highest drug classification by the Drug Enforcement Administration.

A recently approved $2.15 million study — paid for by the state of Colorado and conducted by researchers from the Multidisciplinary Association for Psychedelic Studies, the University of Pennsylvania, the University of Colorado, Johns Hopkins University and the Scottsdale Research Institute — could change all of that....

The study, which is about to begin accepting participants, is a two-phase random, placebo-controlled, multisite study that will assess the safety and efficacy of four types of smoked marijuana to manage chronic, treatment-resistant PTSD symptoms, said Rebecca Matthews, a MAPS clinical trial leader working with the team. In the first phase, 76 participants will smoke randomly assigned types of marijuana, including a placebo strain, from a pipe for three weeks. They will keep a diary to describe their experiences. They will then abstain from smoking for two weeks.

The second phase is a repeat of the first. Afterward, participants will follow up with the researchers for six months. The team will track measurements of PTSD and PTSD symptoms and safety data throughout.

The aim is to provide information on “marijuana dosing, composition, side effects and specific areas of benefit to clinicians and legislators considering marijuana as an acceptable treatment for PTSD,” Matthews said.

Researchers plan to start recruiting veterans in September, adding two participants per month, per site. The study should run about two years. “By working with chronic treatment-resistant veterans, we address a national emergency and limit variability at the potential expense of generalizability,” Matthews said. “Further research will be needed to determine if these results will apply to other groups of PTSD sufferers.”

The study’s principal investigator, Dr. Sue Sisley of the Scottsdale Research Institute in Phoenix, said the hypothesis for the study is that cannabis may improve PTSD symptoms in a dose-dependent manner. “I have no preconceived notions about the outcome of the study,” she said. “I’m not pro-cannabis; I am strictly pro-science. I’m actually not a fan of cannabis, and I’ve never tried it personally. I care deeply about our military veterans, and I am determined to find new treatments for PTSD — besides the only two [Food and Drug Administration] approved medicines on the market, Zoloft and Paxil, which are both highly disappointing.”

The study could discount or verify an argument by VA doctors and opponents of pot for PTSD treatment, who claim cannabis masks symptoms and doesn’t treat them like exposure therapy is thought to, Sisley said. “Nobody is arguing [cannabis] is a cure [for PTSD],” she added. “ ... What we are hoping is that cannabis is alleviating the suffering of PTSD patients and not just masking it. This is a distinction that can only be evaluated through a randomized controlled trial.”

http://lawprofessors.typepad.com/marijuana_law/2016/09/study-can-marijuana-improve-ptsd-symptoms-for-veterans.html

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