PTSD Treatment: VA and DOD Shun Marijuana, Embrace Psychedelic Possibilities; Congress Pushes for Research Advancement
In a recent update to their joint clinical practice guidelines, the U.S. Department of Veterans Affairs (VA) and Department of Defense (DOD) have taken a firm stance against the use of marijuana for the treatment of post-traumatic stress disorder (PTSD). However, they are adopting a neutral position on psychedelics such as psilocybin and LSD, emphasizing the need for further research in this realm.
According to the VA/DOD Management of Posttraumatic Stress Disorder and Acute Stress Disorder Work Group, they strongly discourage the use of cannabis or cannabis derivatives for PTSD treatment due to a lack of well-designed randomized control trials and serious associated side effects. The existing evidence supporting medical marijuana came with low confidence, largely due to small sample sizes and potential selection bias.
While marijuana faced staunch disapproval from the departments, they actively sought new data on psychedelics, which had not been previously mentioned in the joint review six years ago. The investigation focused on psilocybin, ayahuasca, DMT, ibogaine, and LSD, but unfortunately, no studies meeting the criteria were found to assess the effects of psychedelics for PTSD treatment.
Addressing the potential therapeutic benefits of MDMA, which has received “breakthrough therapy” designation from the FDA, the VA and DOD recognized the need for more evidence before endorsing MDMA-assisted therapy for PTSD. While some randomized control trials have shown positive results, the variations in the control conditions used and the potential challenges of implementing the treatment in current healthcare systems prompted caution.
Despite the reservations from VA and DOD, bipartisan congressional lawmakers are urging federal agencies to further explore the potential efficacy of psychedelics as a treatment for PTSD. They are also seeking to protect veterans who use medical marijuana in states where it is legal and ensure VA doctors can issue recommendations for participation in medical marijuana programs.
In the House, Rep. Morgan Luttrell’s psychedelics measure calls for a clinical study into the therapeutic benefits of psychedelics for active duty service members with PTSD, traumatic brain injury, or chronic traumatic encephalopathy, focusing on psilocybin, MDMA, ibogaine, or DMT. Rep. Dan Crenshaw is advocating for broader scope and funding for the research, while Rep. Nancy Mace’s cannabis amendment proposes a medical cannabis pilot program to examine marijuana’s health impacts on veterans and service members with PTSD, depression, anxiety, or pain management needs.
Democratic senators are also taking action, introducing a proposal led by Sen. Brian Schatz that would allow veterans to use medical cannabis in states and territories where it is legal, protect doctors who recommend medical marijuana, and require VA support for clinical trials investigating cannabis’s therapeutic effects on conditions like pain and PTSD.
A recent study revealed that over 90 percent of U.S. military veterans using medical marijuana find that it improves their quality of life, often replacing over-the-counter and prescription medications. Concurrently, the Senate Appropriations Committee approved an amendment to enable VA doctors to issue medical cannabis recommendations and encouraged the department to facilitate medical marijuana access for veterans while exploring the therapeutic potential of psychedelics.
One GOP congresswoman is praising the recently released FDA guidance on psychedelics research and advocating for more studies to assess marijuana’s therapeutic benefits for military veterans.
As the debate on alternative therapies continues, both veterans and researchers eagerly await further advancements in PTSD treatment, hoping that a comprehensive approach will offer new hope and relief for those affected.
