Cannabis (aka Marijuana) Research on PTSD: More Obstacles

Is medical cannabis effective treatment for PTSD? The controversy surrounding this important question could benefit from high-quality scientific research. More hurdles stand in the way, however, for cannabis than for almost any other substance. I had previously thought that once a researcher had been able to obtain cannabis from the single available source, the University of Mississippi, the obstacles to such research had been overcome. The bad news is that more problems exist.

Placebo-controlled, triple-blinded randomized study

Dr. Suzanne Sisley is a research psychiatrist and internist who is conducting the first placebo-controlled, triple-blinded randomized study using whole plant cannabis to address the PTSD question. When her supply of cannabis arrived, she decided to independently test it instead of simply accepting what the Mississippi University asserted about it. To her dismay, she found that it:

• Was contaminated with mold and lead
• Had a concentration of 8% THC instead of the 12% that it was supposed to contain
• Contained stems, sticks, and leaves which been ground up with the flower. This further contributed to quality concerns, because the substance is given to the research subjects by weight

To its credit, NIDA responded to the complaints, but it is not clear whether the situation has been remedied.

Finally, despite support from the FDA, the final Phase 3 of the study cannot be completed because of the requirement that the cannabis used be connected to a stable supply that could be put on the market. Because whole plant cannabis is Schedule I, such a supply does not exist on a Federal level. 

The cannabis quality problem

The cannabis quality problem is not surprising given the monopoly held by the University of Mississippi. The DEA now allows research cannabis to be supplied by other vendors, as is the case with cannabis in other countries as well as other Schedule I drugs in the U.S. Although several sites were approved by the DEA, the final approval necessary has not been given by higher levels of the DOJ.

Although no one has taken responsibility for the lack of action, the assumption has been that the reason was the intransigence of former Secretary Sessions toward relaxation of laws regarding cannabis. William Barr, the man likely to be the next DOJ Secretary, is no fan of cannabis but his opposition appears to be less extreme than was his predecessor. If anyone comes upon a quote that reflects his position on allowing multiple sources of supply for cannabis, I would appreciate an email to that effect at gkolodner@kolmac.com.