Medical Cannabis for Chronic Posttraumatic StressDisorder in Dutch Veterans: A Health CareEvaluation

Introduction: Medical cannabis has emerged as a promising treatment
for Posttraumatic Stress Disorder (PTSD), particularly among veterans.
Given the high prevalence of PTSD in this population and the limited
availability of effective therapeutic options, medical cannabis has
garnered increased interest. However, evidence remains scarce
endorsing its efficacy and patients’ experiences with this treatment.
Method: To gain more insight into patients’ experiences with medical
cannabis, we interviewed 18 Dutch veterans diagnosed with chronic PTSD
who were prescribed off-label medical cannabis for symptom relief at
an outpatient clinic in the Dutch Military Mental Health Service. The
interviews were recorded and transcribed verbatim, followed by a
framework analysis with thematic coding.
Results: A group of 18 patients turned to medical cannabis as an
alternative to traditional treatments due to persistent symptoms iof PTSD.
Of these, 15 continued using the Bediol strain, primarily before bedtime
to aid sleep. They reported significant improvements, including increased
peace of mind and reduced irritability. Although patients expressed
satisfaction, they often asked assistance in dosage and reimbursement.
Despite initial reservations from some family members, there was notable
support, signaling a changing perception of medical cannabis through
increased education. However, a few patients still faced lingering
stigma. Through the analysis, five overarching themes were identified: (1)
assessment phase, (2) intervention phase, (3) termination phase, (4)
access and availability, and (5) social support.
Conclusion: Based on the data collected, we advocate for the continued
prescription of medical cannabis, as most of the interviewed patients
reported positive effects, including alleviation of core symptoms like
sleep disturbances, irritability, and hyperarousal. Secondly, we
recommend the continued reimbursement of medical cannabis due to its
positive impacts, as many patients expressed potential financial hardship
if
this reimbursement were halted. Furthermore, we propose the
appointment of a cannabis coach to provide patient-centered care.
Reliable information on cannabis use is often challenging for patients to
access, and proper use, including dosage, strain, cannabidiol (CBD) to
Tetrahydrocannabinol (THC) ratio, and timing of administration, is
essential to ensure optimal benefits and minimize risks. Lastly, we
emphasize the necessity for further research, including longitudinal
studies and randomized controlled trials, to explore individualized
treatment approaches that work best under specific conditions. Greater
clarity on dosages and product selection is also essential to minimize
confusion and potential over- or under-consumption risks. Overall, these
recommendations can guide the advancement of medical cannabis
treatment for chronic PTSD in veterans, enhancing patient outcomes and
paving the way for evidence-based practices.
Keywords: PTSD, Cannabis, Veterans, Health Care Evaluation.