(PS4-C64) Examining the Functional Impact of Cannabis Use Among Treatment-seeking Individuals with PTSD

Background:   Many individuals with posttraumatic stress disorder (PTSD) report using cannabis to improve PTSD symptoms (e.g., sleep disturbances, anxiety). Although there is mixed emerging evidence of the therapeutic potential of cannabis for PTSD, cannabis use disorder is prevalent among individuals with PTSD and is associated with negative outcomes such as depression. Therefore, it is crucial to understand the functional impacts of cannabis use among individuals with PTSD.

Method:   The present study examined general functioning (e.g., social, emotional, physical) among individuals (N = 43) with PTSD and either heavy cannabis use (5+ days cannabis use per week for 3+ months; n = 26) or no use (n = 17) as part of a larger study examining how cannabis affects recovery from PTSD (NCT02874898). Participants were mostly Non-Hispanic (93%), White (72%), females (78%) ages 19 to 55 (M = 31 years, SD = 9.07) who completed a baseline assessment of trauma history, cannabis use patterns, and PTSD symptoms with a trained assessor. Cannabis status was confirmed with a urine drug screen. Self-report measures administered at baseline assessed past-month and past week cannabis use characteristics and functioning in several health domains (i.e., physical health, role limitations due to physical health, role limitations due to emotional problems, energy/fatigue, emotional well-being, social functioning, pain, and general health), with higher domain scores indicating better functioning on the 36-Item Short Form Survey Instrument.

Results:   At baseline, 92% of the participants with heavy cannabis use reported using cannabis to treat a medical/psychological condition, including PTSD (46%), anxiety (46%), sleep/insomnia (46%), pain/pain condition (35%), depression (19%), appetite (19%), and stress (12%). Fifty percent reported cannabis made their conditions/symptoms “much better.” Group means were higher but not statistically significant among the PTSD + cannabis use group compared to the PTSD no cannabis use group for several outcomes: physical functioning (d = 0.02), pain (d = 0.11), energy/fatigue (d = 0.52), role limitations due to physical health (d = 0.07), and general health (d = 0.40). Interestingly, group means for the PTSD no cannabis use group were higher but not statistically significant for role limitations due to emotional health (d = 0.30), emotional well-being (d = 0.09) and social functioning domains (d = 0.22).

Conclusions: The present findings indicate that individuals with PTSD who use cannabis report that cannabis has a substantial positive impact on a variety of physical and mental/emotional symptoms. This is consistent with other studies examining reasons for using cannabis. Results indicate there may not be substantial differences in functioning between treatment-seeking individuals who do and do not use cannabis for PTSD symptom management. Clinicians treating individuals with PTSD and cannabis use should consider potential perceived physical functioning benefits when assessing positive and negative consequences of cannabis use. Future studies should determine whether emotional/social functioning is improved or worsened if cannabis use is reduced.