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Can i use cbd oil for ptsd in missouri

Pilot Study of the Safety and Efficacy of Four Different Potencies of Smoked Marijuana in 76 Veterans With PTSD

This pilot study gathered preliminary evidence of the safety and efficacy of four potencies of smoked cannabis to manage chronic, treatment-resistant PTSD among veterans: (1) High THC/ Low CBD (High THC), (2) Low THC/High CBD (High CBD), (3) High THC/ High CBD (THC/CBD) and (4) Low THC/Low CBD (placebo). The study will produce preliminary evidence to help elucidate the potential effects of THC, CBD, or a combination of both constituents to reduce PTSD symptoms. Smoked cannabis will be tested in two stages of three weeks each (Stage 1 and Stage 2), with a two-week cessation period after each stage, verified by blood/urine cannabinoid analysis. The primary objective was to compare three active concentrations of smoked cannabis and placebo on PTSD symptom severity measured by CAPS-5 total severity scores during Stage 1.

Condition or disease Intervention/treatment Phase
Posttraumatic Stress Disorder Drug: High THC cannabis Drug: High CBD cannabis Drug: THC/CBD cannabis Drug: Placebo cannabis Phase 2

PTSD is a serious, worldwide public health problem resulting from traumatic experiences such as sexual assault, war, or abuse. PTSD is associated with high rates of psychiatric and medical co-morbidity, disability, suffering, and suicide. Despite available treatments for PTSD, many individuals continue to experience marked PTSD symptoms following treatment. In response to overwhelming demand for new treatments, several U.S. states have passed laws allowing the medical use of cannabis by individuals with PTSD.

Emerging observational and early clinical evidence suggest that cannabis may have the potential to reduce or ameliorate a number of symptoms experienced by those with PTSD, including sleep difficulty and anxiety. Indeed, some evidence has suggested that delta-9-tetrahydrocannabinol (THC) may serve to reduce nightmares among those with PTSD, while other studies have shown anxiolytic effects of cannabidiol (CBD). However, there have been no randomized controlled trials of cannabis, in any form, for PTSD.

The present triple-blind, randomized, placebo-controlled crossover trial aims to examine the safety and efficacy of four types of cannabis (i.e., high THC, low CBD; high CBD, low THC; equal ratio THC/CBD; and placebo) among 76 military veterans with chronic treatment-resistant PTSD of at least six months’ duration. The study will produce preliminary evidence to help elucidate the contribution of THC, CBD, or a combination of both constituents to potential attenuation of PTSD symptoms.

Smoked cannabis was tested in two stages lasting three weeks each (Stage 1 and Stage 2), with a two-week cessation after each stage, verified by blood/urine cannabinoid analysis. The primary objective was to compare three active concentrations of smoked cannabis and placebo on PTSD symptom severity measured by CAPS-5 total scores during Stage 1.

Study participants received one of four different types of cannabis during Stage 1 with crossover and re-randomization, less the placebo cannabis, at Stage 2. The four potencies of cannabis were High THC/ Low CBD (High THC), Low THC/High CBD (High CBD), High THC/High CBD (THC/CBD) and Low THC/Low CBD (placebo). “High” is defined as marijuana containing a target of 7-15% concentration by weight of the respective cannabinoid and “Low” is defined as < 2% concentration by weight. Prior to each stage, participants completed two introductory sessions where they were trained on cannabis self-administration. During each stage, participants were provided 1.8 grams of cannabis daily to smoke ad libitum. Each stage was followed by a two-week cessation period.

The primary objective was to compare three active concentrations of smoked cannabis and placebo on PTSD symptom severity measured by CAPS-5 total severity scores during Stage 1.

Layout table for study information

Study Type : Interventional (Clinical Trial)
Actual Enrollment : 80 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Placebo-Controlled, Triple-Blind, Randomized Crossover Pilot Study of the Safety and Efficacy of Four Different Potencies of Smoked Marijuana in 76 Veterans With Chronic, Treatment-Resistant Posttraumatic Stress Disorder (PTSD)
Actual Study Start Date : January 2, 2017
Actual Primary Completion Date : January 2019
Actual Study Completion Date : January 2019

Three weeks of smoking cannabis containing more THC than CBD with amount smoked limited to no more than 1.8 g per day.

Provided up to 1.8 g of cannabis per day of marijuana with more cannabidiol than tetrahydrocannabinol

Three weeks of smoking cannabis containing more CBD than THC with amount smoked limited to no more than 1.8 g per day.

Provided up to 1.8 g of cannabis per day with an approximately equal amount of tetrahydrocannabinol and cannabidiol

Three weeks of smoking cannabis containing equal amounts of THC and CBD with smoking limited to no more than 1.8 g per day.

  • Tetrahydrocannabinol
  • Cannabidiol

Three weeks of smoking cannabis with low levels of THC and CBD with smoking limited to no more than 1.8 per day.

    Baseline CAPS-5 Total Severity Score [ Time Frame: Baseline (3 weeks after randomization) ]

The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a clinician administered and scored assessment of PTSD symptoms via structured interview based upon PTSD diagnosis in DSM-5. It contains symptom subscales, a CAPS-5 total severity score, and a diagnostic score. The total severity score is a sum of symptom frequency and intensity scores for the subscales B (re-experiencing), C (avoidance), and D (hypervigilance), and ranges from 0 to 136, with higher scores indicating greater severity of PTSD symptoms.

The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a clinician administered and scored assessment of PTSD symptoms via structured interview based upon PTSD diagnosis in DSM-5. It contains symptom subscales, a CAPS-5 total severity score, and a diagnostic score. The total severity score is a sum of symptom frequency and intensity scores for the subscales B (re-experiencing), C (avoidance), and D (hypervigilance); and ranges from 0 to 136, with higher scores indicating greater severity of PTSD symptoms.

The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) is a clinician administered and scored assessment of PTSD symptoms via structured interview based upon PTSD diagnosis in DSM-5. It contains symptom subscales, a CAPS-5 total severity score, and a diagnostic score. The total severity score is a sum of symptom frequency and intensity scores for the subscales B (re-experiencing), C (avoidance), and D (hypervigilance); and ranges from 0 to 136, with higher scores indicating greater severity of PTSD symptoms.

    Change in PTSD Checklist (PCL-5) From Baseline to Stage 1 Primary Endpoint [ Time Frame: Baseline (3 weeks after randomization) to Stage 1 Primary Endpoint (Visit 6, 3 weeks post self-administration and prior to cessation) ]

The PTSD Checklist (PCL-5) is a 20-item self-report questionnaire in which respondents indicate the presence and severity of PTSD symptoms. Participants indicate how much distress they have experienced due to various PTSD symptoms on a five-point Likert-type scale (0=not at all, 4=extremely). The total PCL-5 score (a sum of all 20 items) ranges from 0 to 80, with higher scores indicating greater symptom severity.

The Inventory of Depression and Anxiety (IDAS) is a 64-item self-report measure of non-overlapping scales that assess specific depression and anxiety symptoms. Respondents indicate on a scale of 1 (not at all) to 5 (extremely) how much they have felt or experienced several symptoms in the past two weeks. The IDAS consists of 10 symptom scales: Suicidality, Lassitude, Insomnia, Appetite Loss, Appetite Gain, Ill Temper, Well-Being, Panic, Social Anxiety, and Traumatic Intrusions. Items that assess social anxiety are summed and range from 5 to 25 with higher scores indicating greater anxiety symptoms.

The Inventory of Psychosocial Functioning (IPF) is an 80-item measure that was developed for use among individuals with PTSD. It assesses current psychosocial functioning across seven domains: romantic relationships, family, work, friendships, parenting, education, and self-care. Items are scored on a 0 (never) to 6 (always) scale. Summation of scores across domains yields a total score for psychosocial functioning, with higher scores indicating greater functional impairment.

The Inventory of Depression and Anxiety (IDAS) is a 64-item self-report measure of non-overlapping scales that assess specific depression and anxiety symptoms. Respondents indicate on a scale of 1 (not at all) to 5 (extremely) how much they have felt or experienced several symptoms in the past two weeks. The IDAS consists of 10 symptom scales: Suicidality, Lassitude, Insomnia, Appetite Loss, Appetite Gain, Ill Temper, Well-Being, Panic, Social Anxiety, and Traumatic Intrusions. Items that assess general depression are summed and range from 20 to 100 with higher scores indicating greater depressive symptoms.

The Insomnia Severity Index (ISI) is a brief self-reported measure of insomnia. It consists of seven questions, with responses made on a five-point Likert scale. Three items address difficulty at sleep onset, maintaining sleep, and early waking, and four questions address perceived quality of sleep and effects of sleep difficulties on daily function. Questions are summed into a total score that ranges from 0 to 28 and can be interpreted as ranging from no signs of insomnia to severe insomnia. Higher scores indicate more severe insomnia.

  1. Actigraph Change in Sleep Efficiency [ Time Frame: Change in sleep efficiency from baseline to end of 4-week treatment period (visit 6) ]

Daily sleep measures were collected using the Actigraph Watch at baseline and throughout the study period. Data were processed using the Actigraph Software according to the User Manual to measure “sleep efficiency,” which is defined as the proportion of the estimated sleep periods spent asleep. Change in sleep efficiency was calculated and compared across the four treatment groups to assess whether there was any improvement or worsening in sleep efficiency before and after the 4-week treatment period. Other measures included number of days data were collected and average duration in minutes of time that were excluded and not recorded. Daily data were aggregated to analyze participants’ average weekly sleep patterns.

Medical Marijuana for PTSD Proves Effective

Cannabis-derived products have been shown to provide medical benefits for a variety of conditions. As we learn more about what it can do, we’re also finding that it can also treat emotional and psychiatric conditions as well. For example, medical marijuana for PTSD is proving to be an effective treatment.

Can You Treat PTSD with Medical Marijuana?

A more recent development in the use of MMJ is as a way to combat the effects of post-traumatic stress disorder (PTSD). Medical marijuana has had success in the treatment of PTSD, partially because of the fluid nature of the condition. The symptoms for PTSD vary from person to person . M any of these symptoms involve difficulty processing complex or traumatic emotions.

Research on Medical Marijuana and PTSD

A recent study in the journal Molecular Psychiatry offered results demonstrating that “plant-derived cannabinoids [psychoactive chemicals] such as marijuana may possess some benefits in individuals with PTSD by helping relieve haunting nightmares and other symptoms.”

Another study published in Science Daily found that as a result of using medical marijuana, participants had a decrease in hyper-arousal and the re-experiencing of their initial trauma. It’s important to note that narcotics and opioids for PTSD have been found to offer limited relief from these symptoms. Additionally, taking them still runs a high risk of dependency that isn’t a factor with cannabis-derived solutions.

Our MMJ Doctors Know PTSD and Medical Marijuana!

People Report Cannabis Works for PTSD

While not the result of a formal study, anecdotal evidence is also pointing to the effectiveness of medical marijuana. Results are especially effective when used in conjunction with other therapies like support groups, cognitive-behavioral therapy (CBT), or one-on-one counseling.

PTSD Is a Common Qualifying Condition for a Medical Marijuana Card

According to MMJ laws, PTSD is a qualifying condition for a Missouri medical marijuana card. In Oklahoma, it is a condition that could merit a physician’s signature for a medical cannabis card.

Best Marijuana Strains for PTSD

So which strains are best for dealing with the effects of PTSD? Post-traumatic stress disorder can trigger a state of heightened awareness and tension, which is often called “reliving the event”. This produces a number of negative side-effects that result in dramatic mood swings during the day and poor sleep at night. Depending on what your goals are, your cannabis needs will differ.

For a more mood-stabilizing effect during the day, you’re likely to find more success with strains that are high in CBD and low in THC. These include Cannatonic, Harlequin, or Canna Tsu. They let you maintain a decent level of activity while reducing the occurrence of anxiety or panic attacks.

If you need help relaxing at the end of the day or getting a good night’s sleep, then you’d want to go the opposite direction and find a strain with relatively higher levels of THC. To this end, you should try strains like Blue Dream, OG Kush, or Pineapple Express.

If you’re suffering from PTSD, there are a number of effective therapies that can let you get the upper hand on this difficult condition. Check with your doctor and get their opinion on medical marijuana’s viability as part of a treatment plan.

Elevate Holistics is ready to help you achieve your wellness goals. Give us a few moments of your time and we can put you in touch with a high-rated roster of medical professionals and a list of knowledgeable, well-stocked dispensaries in your area.