Post-traumatic stress disorder (PTSD) is a serious condition that involves a person developing characteristic symptoms — such as flashbacks, numbing, and avoidance — after experiencing a traumatic stressor such as a violent assault or war. Finding pharmaceutical options dangerous or ineffective, thousands of veterans and other patients have turned to medical cannabis for relief,[1] and states now almost universally include PTSD as a qualifying condition for medical cannabis.
Upon the recommendation of an eight-member advisory board of physicians, New Mexico became the first state to specifically list PTSD as a qualifying condition in 2009. Now, all but two of the medical cannabis programs — Alaska’s and South Dakota’s — allow medical cannabis for PTSD. Thirty-one states specifically list it as a qualifying condition — either by statute or in regulations — while six more and Washington, D.C. allow doctors broad latitude to recommend cannabis for any serious condition. (See below for a chart of the states’ approaches.) Although PTSD is not a qualifying condition for medical cannabis in Alaska the state allows all adults 21 and older to use and access cannabis.
The limitations of other medications
Pharmaceutical drugs such as antipsychotics and antidepressants are often used to treat PTSD;[2] however, according to researchers, such medications can be ineffective[3] or even harmful.[4],[5] The New York Times summarized the results of the largest study on antipsychotics’ use in treating PTSD, saying, “Drugs widely prescribed to treat severe post-traumatic stress symptoms for veterans are no more effective than placebos and come with serious side effects … ”[6]
Science, studies, and research
U.S. federal law has made it very difficult to conduct clinical research on cannabis’ therapeutic benefits.[7] However, research has been conducted outside the U.S., including clinical trials in Israel, where a 2012 open pilot study in the Abarbanel Mental Hospital found that “medical cannabis was associated with a reduction in PTSD symptoms.”[8]
In addition, a study conducted by Canadian researcher Dr. George Fraser involved administering nabilone — a prescription drug made of a synthetic cannabinoid (component of marijuana) — to patients who had PTSD with treatment-resistant nightmares. Fraser reported, "The majority of patients (72%) receiving nabilone experienced either cessation of nightmares or a significant reduction in nightmare intensity. Subjective improvement in sleep time, the quality of sleep, and the reduction of day-time flashbacks and night sweats were also noted by some patients."[9]
In New Mexico, a study of 80 patients who administered cannabis for PTSD, pursuant to state law, found “greater than 75% reduction in [Clinician Administered Post-traumatic Scale] symptom scores were reported when patients were using cannabis than when they were not… There is extensive evidence that cannabinoids may facilitate extinction of aversive memories."[10] A 2020 survey of 404 medical cannabis patients with PTSD found "symptoms were reduced by more than 50% immediately after cannabis use."[11]
Most States Allow Medical Cannabis for PTSD
Jurisdiction
Is PTSD Specifically Listed?
Allowed by Legislation, Initiative, or Administratively?
Alabama
PTSD is listed in the law
Legislation
Alaska
PTSD is not listed as a qualifying condition for medical cannabis
N/A — However all adults 21+ may use cannabis in Alaska
Arizona
PTSD is listed in regulations
Administratively
Arkansas
PTSD is listed in the law
Initiative
California
No, the law allows broad discretion for doctors
Initiative
Colorado
PTSD is listed in the law
Legislation
Connecticut
PTSD is listed in the law
Legislation
Delaware
PTSD is listed in the law
Legislation
Florida
PTSD is listed in the law
Initiative
Hawaii
PTSD is listed in the law
Legislation
Illinois
PTSD is listed in the law
Legislation
Kentucky
PTSD is listed in the law
Legislation
Louisiana
PTSD is listed in the law
Legislation
Maine
PTSD is listed in the law
Legislation
Maryland
The law allows broad discretion for providers; regulations encourage certifying patients with PTSD
Legislation
Massachusetts
No, the law allows broad discretion for doctors
Initiative
Mississippi
PTSD is listed in the law
Legislation
Michigan
PTSD is listed in regulations
Administratively
Minnesota
PTSD allowed by rule
Administratively
Missouri
PTSD is listed in the law
Initiative
Montana
PTSD is listed in the law
Initiative
Nebraska
The law allows broad discretion for providers
Initiative
Nevada
PTSD is listed in regulations
Administratively
New Hampshire
PTSD is listed in the law
Legislation
New Jersey
PTSD is listed in the law
Legislation
New Mexico
PTSD is listed in regulations
Administratively
New York
PTSD is listed in the law
Legislation
North Dakota
PTSD is listed in the law, with limits
Initiative
Ohio
PTSD is listed in the law
Legislation
Oklahoma
No, the law allows broad discretion for doctors
Initiative
Oregon
PTSD is listed in the law
Legislation
Pennsylvania
PTSD is listed in the law
Legislation
Rhode Island
PTSD is listed in the law
Legislation
South Dakota
PTSD is not listed as a qualifying condition for medical cannabis, but the Department of Health can add qualifying conditions
[5] J. Lloyd, “CDC: Antidepressant Use Skyrockets 400% in Past 20 Years,” USA Today, Oct. 20, 2011.
[6] Carey, Benedict, “Drugs Found Ineffective for Veterans’ Stress,” The New York Times, Aug. 2, 2011.
[7] Cannabis’ schedule I status, a uniquely onerous approval process for research on cannabis’ benefits, and the low-quality of cannabis that has been available for research are among the barriers. For details, see MPP's, "Federal Obstruction of Medical Marijuana Research" memo.
[8] Mashiah, Mordechai, “Medical Cannabis as Treatment for Chronic Combat PTSD: Promising Results in an Open Pilot Study,” Abarbanel Mental Hospital, Israel, presented at Patients Out of Time Conference (2012).
[9] Fraser, George, “The Use of a Synthetic Cannabinoid in the Management of Treatment-Resistant Nightmares in Posttraumatic Stress Disorder (PTSD),” CNS Neuroscience & Therapeutics 15, no 1. (2009): 84-88.
[10] George Greer, et al., “PTSD Symptom Reports of Patients Evaluated for the New Mexico Medical Cannabis Program,” Journal of Psychoactive Drugs, March 2014.
[11] LaFrance EM, Glodosky NC, Bonn-Miller M, Cuttler C. Short and Long-Term Effects of Cannabis on Symptoms of Post-Traumatic Stress Disorder. J Affect Disord. 2020 Sep 1;274:298-304. doi: 10.1016/j.jad.2020.05.132. Epub 2020 May 24. PMID: 32469819.
