Controlled Inhalation of THC-Predominant Cannabis Flos Improves Quality of Sleep, General Mood, and Severity of PTSD Symptoms in UK Civilians

BACKGROUND: Approximately 4% of the UK population experiences PTSD. Individuals must exhibit symptoms across four clusters to receive a diagnosis: intrusion, avoidance, altered reactivity and altered mood.

OBJECTIVES: Evidence suggests that cannabinoid agonists such as nabilone and tetrahydrocannabinol (THC) may alleviate PTSD symptoms. We investigated the safety and effectiveness of THC-predominant cannabis flowers for inhalation to manage PTSD symptoms.

METHODS: We analysed data from the UK patient registry, T21. Validated questionnaires were used to collect PROMs for health-related quality of life (HRQoL), mood/anxiety, sleep, and PTSD-specific symptoms. Inclusion criteria were i) a confirmed diagnosis of PTSD, ii) completed PROMs questionnaires at baseline and at the 3-month follow-up, and iii) received a prescription for a chemotype 1 (THC-predominant) cannabis flower.

RESULTS: Fifty-eight patients were included, 34 of which also had PROMs recorded at 6 months. Most were males (65.5%) with an average age of 39.2 years who had previously used cannabis illicitly (95.6%). At 3 months, participants reported significant improvements in overall health, mood, and sleep quality (P<0.001) but not in the proxy for HRQoL (P=0.052). Similarly, participants reported substantial benefits in managing intrusion symptoms (P<0.001), mood alterations (P<0.001), and reactivity alterations (P=0.002), which were sustained or further improved at 6 months. Participants did not report any side effects associated with CBMPs.

CONCLUSIONS: Inhalation of THC is well-tolerated and useful for managing symptoms of PTSD in cannabis-experienced individuals. However, further research is needed to evaluate the long-term safety and outcomes of controlled inhalation of CBMP in patients naïve to cannabis.

Learning Objectives:

1. Discuss the basics of the endocannabinoid deficiency observed in PTSD patients.

2. Recognize the limitations encountered so far by randomized clinical trials aimed at assessing the efficacy of cannabis flowers in PTSD patients.

3. Summarize the benefits of an add-on treatment with chemotype-1 cannabis flowers for PTSD patients.