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Medical Cannabis and Post-Traumatic Stress Disorder (PTSD) in Kentucky

January 25, 2024

Cognitive behavioral therapy (CBT) is hands down the most strongly recommended first line of treatment for individuals suffering from PTSD.  This recommendation holds true across virtually all of the most prominent medical associations dealing with PTSD, including the United States Department of Veteran Affairs. CBT is a form of treatment that helps individuals focus on the relationships between their thoughts, feelings and behaviors.  The first step is to identify the dysfunctional patterns between their thoughts, feelings and behaviors that are resulting in the harmful symptoms they are experiencing, in addition to any personal, professional or legal problems that their PTSD may be worsening.  The next step is to explore making changes to these patterns in ways that help the individual to overcome their harmful effect on their lives. The second line of treatment for PTSD is medication.  The most commonly used medications are what are known as selective serotonin reuptake inhibitors (SSRIs), such as Zoloft or Paxil.

However, if conventional therapies have failed to work for a given individual, cannabis can be considered as an alternative or adjunct form of treatment. There are numerous anecdotal cases and small studies where patients suffering from PTSD have reported an improvement in their symptoms with the use of cannabis.  Within the state of Kentucky, Senate Bill 47 will make medical cannabis legal effective January 1, 2025.  However, in the meantime, Executive Order 2022-798 provides limited legal protection for possession to individuals with PTSD who have procured medical cannabis through legal channels and under the formal recommendation of a licensed physician.  The current legal limit for possession for such individuals in the state of Kentucky is 8 ounces.

It must be noted that the data for the benefits of cannabis in the treatment of PTSD are not of particularly high quality.  A randomized control trial performed among military veterans with PTSD did not show any benefit compared to placebo.  And while another small study did show reported improvement of PTSD symptoms among veterans, a confounding factor was that the participants were already using cannabis prior to the study, raising the issues of selection bias and begging the question of why their symptoms had not improved with their cannabis use prior to initiation of the trial.

The use of cannabis in the treatment for PTSD is, therefore, something for which there is not enough compelling statistical evidence to make a strong generalized recommendation.  However, many individuals do report improvements in their PTSD symptoms and cannabis could be explored alongside their physician on a case by case basis to determine whether or not this is a good option worth trying for them.

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