In an update to its clinical guidelines, the US Department of Veterans Affairs (VA) has stated its opposition to the use of cannabis for post-traumatic stress disorder (PTSD) in veterans.
The guidelines are designed to provide advice to clinicians provided on therapeutics that could be used to treat PTSD in veterans.
Cannabis is a treatment used by many veterans for treating PTSD, with a recent analysis revealing an increase of 56% in overall cannabis use in veternas from 2013 to 2019, and one in ten veterans noting that had used cannabis in the past year.
The updated VA guidelines note that there is a lack of evidence to support the use of cannabis in veterans with PTSD: “The Work Group recommends against the use of cannabis or cannabis derivatives in treating patients with PTSD because of the lack of well-designed RCTs evaluating the efficacy of cannabis derivatives in large samples of individuals with PTSD and the serious side effects associated with their use.”
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The guidelines cite evidence has shown how cannabis “impairs attention, memory, IQ, and driving ability, and early and persistent use has been associated with the emergence of psychosis”, pointing to a 2017 study by Steenkamp et al which noted adverse psychiatric outcomes associated with cannabis use in patients with PTSD. These included depression, anxiety, psychosis, and substance misuse.
It also notes: “The benefits of cannabis were outweighed by the potential serious adverse effects. Patient values and preferences varied largely because some patients seek new, novel treatments although others might be unwilling to use cannabis or cannabis derivatives. Thus, the Work Group made the following recommendation: We recommend against cannabis or cannabis derivatives for the treatment of PTSD.”
The publication of its position follows recent calls for the VA The U.S. to enable access to medical cannabis for veterans.
The 2024 Fiscal Year bill, which provides funding for the VA, includes a provision that would prohibit “the use of funds to interfere with the ability of veterans to participate in State-approved medicinal cannabis programs or deny service to such veterans.”
