Cannabis For Post Traumatic Stress Disorder: Risk-Benefit, Ethical Issues And Proposed Guidelines For The Physician

Despite the lack of controlled studies demonstrating the efficacy of cannabis for Post Traumatic Stress Disorder (PTSD), there appears to be an increasing trend to recommend this treatment without clear clinical guidelines for its use.The physician should have an appropriate knowledge of cannabis in order to select and manage those patients with PTSD who are likely to benefit from this treatment such as patients suffering from sleep disturbance as a result of hyperarousal symptoms. The physician should be sufficiently acquainted with the patient so as to minimise the possibility of non-medical use of the cannabis such as recreational use or diversion (giving or selling the cannabis to persons without a permit). The physician should also maintain contact with the patient's family. Patients should remain in medical follow up in order to monitor side effects and potential for abuse. Urine tests should be considered for those patients with a high index of suspicion for substance abuse. Use of cannabis should be avoided in persons with a pre-existing history of substance abuse over the past 12 months, severe personality disorder or psychotic illness. Use of cannabis should be avoided in pregnancy and in persons under the age of 25.Risk-benefit, ethical issues and proposed guidelines are presented for using cannabis in post traumatic stress disorder.