cannabis use

Study: Impact of Cannabis on Alcohol

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

As of 2015, about 22 million individuals in the United States reported using cannabis / marijuana in the last month (1). In 2011, almost 70 million Americans reported binge drinking in the last month ( binge drinking defined by the survey as 5 or more drinks on one occasion) (2).

Some individuals may consider marijuana use as they are reducing alcohol use. A recent study looked at how cannabis use might impact alcohol use.

What was the study? (3)

1,383 newly abstinent alcohol dependent individuals were  participating in a multi-site randomized control trial for treatment options of alcohol use disorder in the landmark COMBINE study (4-5).

Researchers compared alcohol use among those who used cannabis versus those who did not use cannabis.

What were the study results?

The authors (3) found that compared to no cannabis use, ANY cannabis use during treatment for alcohol use disorder was related to LESS alcohol abstinence at end of treatment.

They found that each additional day of cannabis use was associated with approximately 4–5 fewer days of abstinence from alcohol (3).

In this study, cannabis use impacted how often the participants drank, but not how many drinks they had (3).

Further study in this area is needed.

What does this mean?

This study suggests that it may not be a good idea to use cannabis if you are trying to abstain from alcohol.

What are some useful resources regarding cannabis?

Drug treatment group at OSU Office of Student Life Counseling and Consultation Service.

Treatment Facilities Here in Columbus

 

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). 2016. http://www.samhsa.gov.proxy.lib.ohio-state.edu/data/
  2. Center for Behavioral Health Statistics and Quality. Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50); 2015.
  3. Subbaraman, M. S., Metrik, J., Patterson, D., and Swift, R. (2016) Cannabis use during treatment for alcohol use disorders predicts alcohol treatment outcomes. Addiction, doi: 10.1111/add.13693.
  4. Anton R. F., O’Malley S. S., Ciraulo D. A., Cisler R. A., Couper D., Donovan D. M.et al. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA 2006; 295: 2003–2017.
  5. Combine Study Research Group. Testing combined pharmacotherapies and behavioral interventions in alcohol dependence: rationale and methods. Alcohol Clin Exp Res 2003; 27: 1107–1122.

Study: Does Marijuana help with PTSD?

By R. Ryan Patel DO, FAPA OSU-CCS Psychiatrist

About 7-8 % of people may experience PTSD (or Post Traumatic Stress Disorder) at some point in their lives (2).
Individuals with PTSD are more likely to use marijuana to try and cope with their symptoms (3).
A recent study tried to look at how marijuanna impacts PTSD (4).

What is PTSD?
• PTSD can occur after an individual witnesses or experiences a traumatic or dangerous event (1).
• Symptom areas can include re-experiencing trauma, avoidance behaviors, increased reactivity or “on edge” feelings, as well as mood and cognitive (thought) related symptoms (1).
• Depression, substance abuse, or other anxiety conditions can often co-occur with PTSD (1).

Who were the study participants?
• 2276 veterans were over a 9 year period who were admitted to specialized Veterans Affairs treatment programs.
• Participants were mostly male and average age was in the 50’s.
• They were assessed at the beginning of PTSD treatment and 4 months after discharge from the PTSD treatment program.

What was asked in the study?
• Participants were asked about the severity of PTSD symptoms, drug and alcohol use, violent behavior, and employment.

What were the study results?
• After PTSD treatment, the group that stopped using marijuana or never used marijuana had the lowest levels of PTSD symptoms (P < .0001); –they improved the most.
• According to the study, those who kept using marijuana were significantly more likely to have:
o Worse outcomes in PTSD symptom severity (P < .01),
o Violent behavior (P < .01),
o Higher use of alcohol and drugs (P < .01)
• Those who started using Marijuana after PTSD treatment had the highest levels of violent behavior (P < .0001).

What are some caveats?
• This is a large study done over the long term in this subject.
• Since most of the participants were older males, it is possible that results may be different in other age groups or populations.
• This study used a survey method which tells us about snapshot in time but does not about cause and effect.
• This study did not include individuals who were using alcohol or other drugs.
• It may be that participants were self-medicating because they were not feeling better or the use of marijuana prevented them from feeling better (4).
• The amount and type of marijuana use was not identified.
• Other smaller studies show mixed results, but also had different methods.

Do you have PTSD? Are you smoking Marijuana? Is it worsening your ptsd symptoms?

What are some resources regarding PTSD?
• OSU Student Life-Counseling and Consultation Service
• National Institue for Mental Health
• National Center for PTSD

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References

1. http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
2. http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp
3. Cougle, J.R., et. al. (2011). Posttraumatic stress disorder and cannabis use in a nationally representative sample. Psychology of Addictive Behaviors, 25, 554-558.
4. Wilkinson ST et al. Marijuana use is associated with worse outcomes in symptom severity and violent behavior in patients with posttraumatic stress disorder. J Clin Psychiatry 2015 Sep; 76:1174.