A retrospective study of nabilone for PTSD-related nightmares also showed promising results ( Cameron et al, 2014).īut cannabinoids may do more than simply provide acute symptom relief. Nabilone reduced nightmares and improved sleep in both an open label and placebo-controlled trial, while also increasing clinician ratings of improvement and self-reported measures of well being ( Fraser, 2009 Jetly et al, 2015). Consistent with a potential therapeutic effect, oral cannabinoids such as dronabinol (synthetic Δ 9-tetrahydrocannabinol (THC), the primary psychoactive constituent of cannabis) and nabilone (a synthetic analog of THC), have been shown to reduce the acute response to fear stimuli as well as trauma-related symptomatology in those with PTSD. Many with PTSD report using cannabis to cope with anxiety, stress, and insomnia ( Cougle et al, 2011 Boden et al, 2013). Hyperconsolidation of emotional memories or impaired extinction of fear memories can lead to intrusive recollections and the re-experiencing of the original traumatic event through flashbacks or nightmares ( Sripada et al, 2013 Neumeister et al, 2013). PTSD, an anxiety disorder that can develop following exposure to a traumatic event is characterized by persistent alarm and distress, numbing, avoidance, increased arousal, as well as aberrant memory processes. We will take opposing positions to accommodate the circumspectives framework, but emphasize that there is considerable overlap and nuance in our viewpoints. An important caveat: clearly, cannabis is a pharmacologically complex plant with constituents that have the potential for producing both positive and negative effects. Each author will present data supporting one perspective regarding the link between cannabis use and the course of these disorders, and they will then present their shared perspectives on critical studies needed to move the field forward. We will discuss the influence of cannabis use on post-traumatic stress disorder (PTSD) and psychotic disorders. In light of these major policy changes, defining what is known about the potential consequences of cannabis use has considerable public health significance and is the purpose of this circumspectives piece.

And cannabis legalization creates a powerful profit motive to create and maintain cannabis users, with the burgeoning marijuana industry following a similar business strategy as the tobacco industry ( Richter and Levy, 2014), which will likely further increase cannabis use.

Already 2.6 million more people in the United States report near-daily cannabis use in 2013 compared with 2008 ( Substance Abuse and Mental Health Services Administration (SAMHSA), 2014). In adolescents, increased social acceptance and decreases in the perception of cannabis’ risks are associated with increased use ( Hall and Weier, 2015 Scheurmeyer et al, 2014). Even among scientists, debates on cannabis can be polarized and high in emotional content, making it difficult to distinguish evidence from hyperbole. Nationwide, marked public opinion and policy changes are occurring in what is largely a scientific vacuum, with well-controlled, scientific evidence contributing little to the debate on legalization of cannabis for medical or recreational use. Attitudes toward cannabis in the United States have undergone a substantive shift, with, for the first time in history, a majority of Americans favoring cannabis legalization.

What scid does marijuana fa