Posttraumatic stress disorder (PTSD) is one of the most common and complex psychiatric disorders military personnel face today.
Estimates vary, but most experts agree that the prevalence of PTSD falls somewhere between five and 15 percent of Iraq and Afghanistan veterans. Considering that this translates to potentially several hundred thousand current and former military personnel who struggle with the disorder, it is unfortunate that we have not made major gains in its treatment. Indeed, advances in the treatment of PTSD have been modest at best.
Cognitive and behavioral therapies remain at the top of the treatment list when it comes to combating the varied symptoms associated with this trauma-based disorder.
Specifically, Prolonged Exposure and Cognitive Processing Therapy receive the lion’s share of training, funding, and research attention.
Recent research has revealed that these therapies are effective, but are far from a cure.
Medication sits alongside these therapies at the top.
Although the data supporting greater efficacy of talk therapies compared to medications is available, for many service members and veterans, the first treatment trial for PTSD comes in the form of a pill. And if talk therapy and medication fail, there are a variety of alternative and complementary treatments available such as equine and art therapy, acupuncture, meditation, and many more.
Understandably the lack of progress in more traditional approaches to treating PTSD has led to experimental and arguably questionable treatment methods.
Experimental Treatment Methods
A perfect example is MDMA (3,4-methylenedioxy-methamphetamine). Better known by the names ecstasy and Molly, this synthetic drug is currently being studied as a treatment for PTSD.
Preliminary data has revealed that MDMA may provide some benefit as an adjunctive treatment to talk therapy, but we are far from calling it a bona fide treatment.
Progress has been slow because of a variety of regulatory, ethical, and legal issues.
Another experimental and controversial treatment for PTSD is marijuana.
Over the past decade, a significant push from a small group of researchers and a much larger group of marijuana advocates has fueled the debate on the merits of cannabis use as a viable alternative to talk therapies and psychotropic medications.
The success has been somewhat surprising.
Although not sponsored by the Department of Defense or Department of Veterans Affairs, a number of states have sanctioned medical marijuana use for PTSD.
The benefits of marijuana use for PTSD are uncertain. To date, most of the reported therapeutic benefits of the drug are anecdotal, many from testimonials by veterans who use the drug.
And as a clinician and/or behavioral scientist, you are likely well aware that anecdotal evidence resides quite some distance away from fact.
Although many will argue the “data is in” and will cite theoretical and uncontrolled studies of marijuana’s efficacy, there is little to no rigorous scientific research supporting the use of marijuana for PTSD, especially in combat veterans.
Moreover, relatively few clinicians and researchers currently support its use.
The issue of whether or not marijuana can or should be used for combat PTSD should not be taken lightly and the discussion should not be driven by non-healthcare advocacy groups.
Reputable organizations like The National Center for PTSD report that marijuana can actually be harmful to individuals with PTSD.
The ill effects of marijuana use should come as no surprise. Decades of research have highlighted problems like respiratory disease, memory loss, reduced motivation and attention, and psychiatric problems.
Regarding the latter, even short-term use can lead to psychotic symptoms like paranoia and hallucinations in certain people. And it is possible that these problems will become more commonplace as stronger strains of the drug are engineered.
As a psychologist who has treated countless military personnel with PTSD, I welcome any new and seemingly unlikely means for relieving the distress associated with combat trauma.
An Unpopular Position
I do, however, remain cautious and skeptical at this time. Until the scientific community adequately studies the issue and can clearly demonstrate the safety and benefits of the drug, I do not believe the wholesale support of using marijuana for PTSD should occur at the state or federal levels.
This is not a recommendation I make lightly and I am acutely aware of how unpopular this position is with some. I am also acutely aware of the limitations of our current treatments for veterans. However, considering the existing rate of drug and alcohol abuse among our service members and veterans and the various psychological and physical health effects of the drug, we should maintain healthy doses of both compassion and skepticism when our patients opine to us about the remarkable benefits of pot.
*This article was adapted from a previous article written by Dr. Moore for his column “Kevlar for the Mind” and the website “Lifezette.”
Marijuana photo available from Shutterstock