Are Other Forms of Substance Use Common in Medical Marijuana Users with PTSD?

More than a third of all U.S. states have passed laws making it legal to use the drug marijuana with a doctor’s prescription. Increasingly, one of the ailments that might lead to the issuance of such a prescription is posttraumatic stress disorder, widely known by the abbreviation PTSD. In a study slated for publication in October 2014 in the journal Addictive Behaviors, researchers from three U.S. institutions investigated the common characteristics of people with PTSD who seek an initial prescription for medical marijuana. These researchers concluded that one key characteristic is an unusual level of involvement in the intake of certain other substances of abuse.

Medical Marijuana

Two substances contained in marijuana and other forms of cannabis, called THC and cannabidiol, have proven or potential usefulness as medications when used in standardized or purified form. However, federal law in the U.S. makes a clear distinction between legal medications that include regulated forms of these ingredients and illegal marijuana, hashish and hashish oil products. Despite the active status of the relevant law, 22 U.S. states and the District of Columbia have made it legal for a doctor to prescribe non-standardized, unpurified marijuana as a medical treatment. In addition, four states (Colorado, Washington, Alaska and Oregon) and the District of Columbia have also legalized possession of small amounts of the drug for non-medical use. The specific circumstances under which a doctor can prescribe marijuana vary from state to state. There is also state-to-state variation in the types of health problems for which a doctor can write a marijuana prescription. Despite its semi-legal status in medical contexts, marijuana intake leads to the onset of addiction in a significant number of consumers.


Posttraumatic stress disorder is part of a larger diagnostic category of mental health conditions called trauma- and stressor-related disorders. People affected by the disorder develop certain symptoms in the aftermath of exposure to events that either present a real threat to life or have the apparent capacity to pose such a threat. In addition to combat and terrorism exposure, examples of possible triggering events include natural disasters, car crashes and sexual and/or physical assaults that take place in childhood or adulthood. Specific symptoms that can appear in any person with PTSD include avoidance of anything that stirs up memories of a traumatic experience, involuntary re-experiencing of a traumatic event while sleeping or awake, a noticeable spike in negative states of mind and ongoing activation of the normally temporary “fight-or-flight” survival response. Doctors only diagnose the disorder in people who continue to experience symptoms a month or longer after trauma exposure, or develop symptoms for the first time a month or more after exposure.

Involvement with Substance Use

In the study scheduled for publication in Addictive Behaviors, researchers from the U.S. Department of Veterans Affairs, the University of Michigan and Bowling Green State University gathered data on 186 people who were first-time seekers of medical marijuana prescriptions. These researchers wanted to know how many such individuals have diagnosable symptoms of PTSD. They also wanted to identify any other underlying characteristics that commonly appear in these new medical marijuana users. The researchers undertook this project, in part, because of the lack of available information on medical marijuana use in PTSD-affected people. They were also prompted by an increase in the number of states that allow doctors to use the presence of PTSD as a reason for writing a medical marijuana prescription.

The researchers concluded that roughly 23 percent of study participants had symptoms that would qualify them for a PTSD diagnosis. When they compared the substance use patterns of these individuals to the patterns found in participants unaffected by PTSD, they also concluded that the PTSD-affected individuals were substantially more likely to have a past history of using opioid medications, opioid drugs, sedative medications and the stimulant drug cocaine. In addition, the participants with PTSD had a higher level of current involvement in the use of sedative medications.

The study’s authors emphasize the fact that their work reveals a trend of increased involvement with potential substances of abuse among first-time medical marijuana users with diagnosable cases of posttraumatic stress disorder. In light of this fact and the increasing likelihood that the presence of PTSD will serve as the medical rationale for a marijuana prescription, the authors also emphasize a need to increase the level of understanding regarding the interactions between the effects of posttraumatic stress disorder and the intake of marijuana in a medical context.

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