Cannabis could improve stuttering; the effects of cannabis use on PTSD treatment in veterans; and more
Research regarding the utilization of medical cannabis to treat conditions such as PTSD, OCD, stuttering and non-cancer-related pain for August 11, 2021 (1,440 words, 7 minutes)
As medical cannabis research advances, questions regarding its viability for treating mental and physical conditions have emerged, and new studies are being conducted to answer some of these questions. At the same time, this growing body of research also allows for further exploration of the substance as an alternative treatment for several conditions, including stuttering.
This edition of CJMC Fortnightly explores recent research into the effects of cannabis use on post-traumatic stress disorder (PTSD) treatment outcomes in veterans. It also examines the use of medical cannabis potentially to improve stuttering. Today we also summarize a study regarding the risks and benefits of cannabis for non-cancer-related chronic pain. On a different note, this issue highlights research published in the Journal of Obsessive-Compulsive and Related Disorders that aims to analyze the patterns of cannabis use among individuals with obsessive-compulsive disorder (OCD).
If you are new to our e-newsletter, welcome to our community. We are delighted to have you join us. Every two weeks, CJMC Fortnightly provides readers with an update on new findings regarding medical cannabis. Delivering your cannabis currents this week is Cristela Tello Ruiz of the Canadian Journal of Medical Cannabis (CJMC), a publication for physicians produced in Toronto, Canada.
Cannabis improves stuttering: Case report and interview with the patient
A case study recently published by the journal Cannabis and Cannabinoid Research examined the potential that using medical cannabis might improve stuttering. According to the study’s abstract, stuttering (speech dysfluency) is a speech disorder that affects about 5% of children. Although symptoms improve in adulthood in the majority of people, stuttering persists in some cases. The study also notes that while stuttering is not detrimental to a person’s health, it can significantly impair everyday functioning and quality of life.
The case study also explains that treatment for stuttering often involves speech therapy, cognitive behavioural therapy and relaxation techniques. However, a substantial number of patients do not benefit sufficiently from these treatment strategies or are even treatment-resistant, leading to the study of other options such as medical cannabis.
Study framework
The researchers presented the case of a 20-year-old male with treatment-resistant stuttering who had shown symptom improvement after using medical cannabis.
The subject was interviewed and asked about his symptoms and experience with medical cannabis.
Findings
Improved speech fluency.
Remission of social anxiety.
Improved mood.
Reduced stress.
Overall improvement of quality of life.
The patient also reported improved attention, concentration, sleep, increased confidence and a better social life.
No side effects were observed.
The treatment was effective for more than one year.
Bottom line
The researchers conclude that medical cannabis could be effective in treating refractory stuttering, but these initial data need to be confirmed in controlled studies. However, the research sets an important foundation and first step for studies to come.
Insights from the world of medical cannabis research
“Recently we have been learning about the role that medical cannabis can play in recovery from traumatic brain injuries. Emerging animal studies show that significant brain injuries, such as strokes, were dramatically reduced in mice that were given doses of CBD prior to and/or immediately after the injury. Human beings aren’t mice, however, so there is a lot of work to be done.”
-- Dr. Taylor Lougheed, family, sport, emergency, and cannabinoid medicine physician at North Bay Regional Health Centre in North Bay, Ont. (CJMC 2019; 4:14).
Effect of cannabis use on PTSD treatment outcomes in veterans
A group of researchers located in Michigan conducted a study that evaluated the effects of cannabis use on PTSD treatment in veterans.
They write that previous research has found that anandamide (an endocannabinoid) encourages the extinction of unpleasant memories. According to the researchers, some theorize that cannabinoids may provide a new treatment approach for PTSD. In contrast, they also note that other researchers suggest cannabis may worsen the symptomology of PTSD.
Study framework
The researchers obtained a list of veterans enrolled in the Battle Creek Veterans’ Affairs Medical Center outpatient PTSD Clinical Team Clinic in Michigan between Oct. 1, 2008, and Oct. 1, 2016.
Researchers chose a random sample from among the patients. In total, 340 veterans were included in the study sample. Of those, 81 belonged to a cannabis use group and 259 to a no-cannabis use group.
The study participants were veterans between 18 and 85 years, with a diagnosis of PTSD and at least 2 PTSD Checklist scores.
The data collected included mental health medications, the type and number of evidence-based psychotherapies used, and the presence of co-occurring behavioural health diagnoses.
The cannabis use group was compared to the no-cannabis-use group.
Findings
More subjects in the cannabis use group received supportive psychotherapy than in the no-cannabis use group.
The treatment success rate was similar between the two groups.
Cannabis use did not affect the odds of treatment success in this PTSD program.
Antidepressant use was associated with a 40% increased odds of treatment success.
Bottom line
In this study, cannabis was not found to significantly associate with the success rate of intensive outpatient treatment of PTSD. The authors note that it is important to stipulate that the sample was predominantly white and male, limiting the findings' generalizability. Other limitations included symptom severity and the retrospective nature of the study. Further research needs to be conducted to reach more definitive conclusions, they write.
Risk and benefit of a cannabis medical document for chronic non-cancer pain
In a review published in the Journal of Addictive Diseases, researchers from Tel Aviv University in Israel studied the risks and benefits of cannabis use for chronic non-cancer-related pain. The purpose of this systematic review was to investigate whether cannabis usage was associated with reduced opioid usage and to determine the rates of opioid and cannabis use disorders among chronic pain patients who had been prescribed medical cannabis.
Study framework
A randomly selected sample of chronic pain patients prescribed medical cannabis were interviewed by phone regarding their opioid and cannabis usage.
Cannabis and opioid use disorders were assessed with Portenoy's criteria, which emphasizes specific behavioural aspects of prescription opioid addiction.
Findings
Of the 100 participants, 76 had used opioids before.
Of those, 93% decreased or stopped using opioids after cannabis initiation.
Ten patients met the criteria for cannabis use disorder.
Compared to those who did not meet the criteria, their lifetime depression was higher, and they were less educated.
Most of these patients were among the youngest in the group.
Bottom line
The study concluded that cannabis usage was associated with reduced opioid usage for pain management. The researchers also wrote that while medical cannabis may help reduce opioid use in chronic non-cancer pain patients, younger age, depression, and other risk factors should be carefully evaluated before cannabis is prescribed.
Insights from the world of medical cannabis research
“One of the most unique benefits of CBM [cannabinoid-based medicines] is its multi-modality. This is especially exciting as a treatment option for seniors since the number of drugs being prescribed to seniors is the number one cause of hospitalizations related to adverse drug reactions.”
--Dr. Blake Pearson, Chief Executive Officer and Founder at Greenly Health and Medical Director at Pearson Health in Sarnia, Ont. (CJMC 2019; 2:10).
Patterns of cannabis use among individuals with obsessive-compulsive disorder: Results from an internet survey
Researchers from different parts of the United States studied the patterns of cannabis use among patients diagnosed with obsessive-compulsive disorder (OCD) through an online survey. Their findings were recently published in the Journal of Obsessive-Compulsive and Related Disorders.
According to the paper’s abstract, there has been an increase in cannabis use among Americans in general, including those with psychiatric disorders. However, the authors write that little is known about cannabis use among individuals living with OCD and how the substance may affect them and the condition.
Study framework
The researchers used online sources to recruit adults diagnosed with OCD who also reported cannabis use.
Participants were asked to complete a survey on demographic information, medical/psychiatric history, cannabis use patterns, and perceived cannabis effects.
Findings
Inhalation and cannabis flower smoking were the most common methods/formulation used by participants.
Most identified using high-potency cannabis products.
Out of the 601 people who completed the survey and met the inclusion criteria, 42% also met the criteria for cannabis use disorder.
Nearly 90% self-reported using cannabis medicinally, 33.8% had a physician's prescription, and 29% used cannabis specifically to manage OCD symptoms.
Most participants reported that cannabis improved obsessions or compulsions, but those with increased obsession severity perceived less benefit.
Bottom line
The study concludes that participants with OCD reported subjective benefits and harms from cannabis use. The researchers express that future research should clarify the risks and benefits of cannabis use in people diagnosed with OCD and develop treatment models to better support this population.
The next edition of CJMC Fortnightly will be distributed on Wednesday, August 25. Sign up for a free subscription by clicking the link below.
If you are a healthcare provider and you found this newsletter valuable, you may wish to request a subscription to the Canadian Journal of Medical Cannabis, our quarterly Medical Cannabis research publication, at www.cjmc.ca