Post-traumatic stress disorder (PTSD) is a severe and often debilitating condition affecting millions, including a significant number of military veterans. Characterized by intrusive memories, hypervigilance, insomnia, and severe anxiety, PTSD often resists conventional treatments. Traditional therapies like cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) can provide relief but fail to help a substantial portion of sufferers. As a result, many have turned to medicinal cannabis as a potential alternative, hoping its therapeutic effects might offer a new avenue for symptom management.
A pivotal study published in PLOS ONE (2021) and recently cited in the 2025 VA PTSD guidelines provides new insights into this debate. Conducted by Bonn-Miller and colleagues from the Multidisciplinary Association for Psychedelic Studies (MAPS), this was the first randomized controlled trial to evaluate the short-term effectiveness of different smoked cannabis preparations on PTSD symptoms.
Study Design and Methodology The study involved 80 U.S. military veterans diagnosed with PTSD. Participants were randomly assigned to one of four groups for a three-week treatment period:
High-THC cannabis (12% THC, <1% CBD)
High-CBD cannabis (<1% THC, 12% CBD)
THC/CBD mix (balanced ratio of 8% THC and 8% CBD)
Placebo (cannabis with cannabinoids removed but retaining flavor and aroma)
Participants were instructed to smoke their assigned preparation ad libitum up to 1.8 grams per day. The short duration of the study was intended to assess immediate effects and tolerability rather than long-term efficacy. Symptom changes were measured using the Clinician-Administered PTSD Scale (CAPS-5) and self-reported assessments.
Key Findings and Detailed Analysis Surprisingly, all groups, including the placebo group, showed significant reductions in PTSD symptoms over the three-week trial. The placebo group exhibited nearly the same level of improvement as the cannabis groups, indicating a strong placebo effect.
High-THC Group: Reported the greatest reduction in hyperarousal symptoms like anxiety and insomnia, suggesting that THC's psychoactive effects might offer temporary relief for stress-related symptoms.
High-CBD Group: Showed more modest improvements, aligning with previous findings that CBD may help manage anxiety without the psychoactive effects of THC.
THC/CBD Mix: Demonstrated intermediate effects, potentially offering a balanced approach for those seeking symptom relief without the full psychoactive impact of high-THC strains.
Placebo Group: Displayed substantial symptom reductions, highlighting the potential influence of expectation and perception in cannabis treatment.
The Role of the Placebo Effect The strong placebo response observed raises questions about the psychological and contextual factors influencing cannabis's efficacy. Expectations of relief may play a significant role, especially for individuals familiar with cannabis’s perceived benefits. This finding complicates interpretations of cannabis's therapeutic potential, suggesting that at least part of its impact may derive from psychological factors rather than pharmacological action alone.
Tolerability and Safety Profile The study provided valuable insights into the tolerability of smoked cannabis for PTSD. Reported side effects were generally mild and included dry mouth, dizziness, and transient paranoia, primarily in the high-THC group. Notably, no severe adverse events were recorded, reinforcing the relative short-term safety of smoked cannabis even at higher THC levels.
Implications for Future Research The study's results highlight the need for more comprehensive trials, particularly those exploring different forms of cannabis administration, such as edibles, tinctures, and vaporization, which may offer more controlled dosing and potentially different outcomes. Additionally, longer-term studies could help determine if cannabis's effects on PTSD are sustainable or diminish as tolerance develops.
While the findings challenge the notion of smoked cannabis as an effective short-term treatment for PTSD, they underscore the complexity of the placebo effect in cannabis research. Veterans and others considering cannabis for PTSD should consult healthcare providers to carefully weigh potential risks and benefits.
As cannabis continues to gain acceptance, these insights serve as a reminder of the importance of evidence-based treatment approaches. Stay tuned to #THCannabisStore for ongoing updates and in-depth analysis of the latest cannabis research and developments.
link to the study: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0246990#:~:text=The%20study%20used%20a%20double,of%20treatment%20in%20Stage%201
THCannabis Marketing Team