Cannabis Research for PTSD in America:

Challenges and Opportunities

Cannabis, also known as marijuana, is a plant that contains various compounds, such as tetrahydrocannabinol (THC) and cannabidiol (CBD), that can affect the brain and body in different ways. Cannabis has been used for medical and recreational purposes for centuries, but its legal status and scientific evidence remain controversial and inconsistent. In the United States, cannabis is classified as a Schedule I drug under federal law, meaning that it has no accepted medical use and a high potential for abuse. However, 37 states and the District of Columbia have legalized cannabis for medical or recreational use, creating a complex and conflicting policy landscape.

One of the potential medical uses of cannabis that has attracted considerable interest and attention is the treatment of post-traumatic stress disorder (PTSD), a mental health condition that can develop after experiencing or witnessing a traumatic event, such as war, violence, abuse, or natural disasters. PTSD can cause symptoms such as intrusive memories, nightmares, flashbacks, avoidance of reminders, negative mood and thoughts, hyperarousal, and impaired functioning. PTSD affects approximately 8 to 9% of individuals in their lifetime and is overrepresented in the veteran population.

Many people with PTSD use cannabis to cope with their symptoms, either with or without a medical recommendation. Some studies have suggested that cannabis may have beneficial effects on PTSD symptoms, such as reducing anxiety, improving sleep quality, and enhancing mood. However, other studies have indicated that cannabis may have no benefits or even harmful effects on PTSD outcomes, such as worsening memory, increasing depression, and impairing treatment response ⁵⁶. The National Academies of Sciences, Engineering and Medicine’s report on the Health Effects of Cannabis and Cannabinoids found strong evidence in support of the use of cannabinoids for chemotherapy-induced nausea and vomiting as well as pain, but limited evidence for other conditions, including PTSD.

Barriers to Cannabis Research for PTSD

Despite the widespread availability and use of cannabis products for PTSD, there is a lack of rigorous scientific research on their safety and efficacy. This is largely due to the federal prohibition of cannabis and the numerous challenges and barriers that researchers face when trying to conduct studies on this substance. Some of the main obstacles include:

The US regulatory status of cannabis and cannabinoids:

Cannabis is illegal under federal law and researchers need to obtain special permits from the Drug Enforcement Administration (DEA) to possess, distribute, or administer cannabis or its derivatives for research purposes. The DEA also regulates the sources and quality of cannabis products that researchers can use in their studies. These processes are often lengthy, complex, and restrictive, limiting the number and scope of studies that can be conducted.

Sources for cannabis and cannabinoid study medications:

Currently, the only federally authorized source of cannabis for research is the National Institute on Drug Abuse (NIDA) Drug Supply Program, which contracts with the University of Mississippi to grow and distribute cannabis products to approved researchers. However, the NIDA-supplied cannabis has been criticized for its low potency, limited variety, poor quality, and lack of resemblance to the products available in state-legal markets. Researchers have also reported difficulties in obtaining adequate amounts and types of cannabis products from NIDA to meet their study needs.

Limited funding and resources to support studies: 

Cannabis research is not a high priority for federal funding agencies such as NIH or the Department of Veterans Affairs (VA), which have limited budgets and competing interests. Cannabis research also requires additional resources such as security measures, storage facilities, analytical equipment, trained personnel, and ethical approvals that are not typically needed for other types of research. Moreover, cannabis research faces stigma and resistance from some institutions, policymakers, health care providers, and patients who may not support or participate in such studies.

Opportunities for Cannabis Research for PTSD

Despite these challenges and barriers, there are also opportunities and initiatives to advance cannabis research for PTSD in the United States. Some of these include:

New federal legislation for cannabis research:

On December 2nd 2022 President Joe Biden signed into law a bill that streamlines access to marijuana for medical research. The new law is expected to speed up the issuance of government permits to scientists who want to study cannabis; expedite applications from producers who want to grow and supply cannabis for research; oblige the federal government to ensure an adequate and uninterrupted supply of cannabis for research; and allow researchers to study cannabis products that have been approved by the FDA .

State-level support for cannabis research:

Some states that have legalized cannabis for medical or recreational use have also established programs or funds to support cannabis research, such as Michigan, California, Colorado, Pennsylvania, and Washington. These states have allocated a portion of the tax revenue from cannabis sales or fees from cannabis licenses to fund research projects on various aspects of cannabis, including its health effects, therapeutic potential, social impact, and regulatory issues.

Collaboration and innovation among researchers: 

Cannabis researchers have formed networks and partnerships to share information, resources, and best practices to overcome the challenges and barriers they face. For example, the International Cannabinoid Research Society (ICRS) is a scientific organization that promotes research on cannabinoids and related compounds. The Cannabis Research Network (CRN) is a consortium of academic institutions in California that collaborate on cannabis research projects and policy recommendations. The Center for Medicinal Cannabis Research (CMCR) at UC San Diego is a leading institution that conducts clinical trials of cannabis and cannabinoids for various medical conditions, including PTSD .

Conclusion

Cannabis research for PTSD in America is a complex and evolving field that faces many challenges and barriers, but also offers many opportunities and possibilities. There is a need for more rigorous and comprehensive studies on the safety and efficacy of cannabis products for PTSD, as well as their mechanisms of action, optimal dosages, formulations, routes of administration, and potential interactions with other medications or treatments. Such studies could provide evidence-based information to inform patients, health care providers, policymakers, and the public about the benefits and risks of cannabis use for PTSD.

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