From the Editor: Easing Trauma

Trauma—a significant problem that’s inadequately addressed—figures prominently in this issue of CRx. Because existing therapeutic approaches are often ineffective, researchers are exploring whether cannabis may help fill a treatment gap.

In a case study, Joseph Friedman, RPh, MBA, discusses his success treating a patient who suffered from trauma resulting from an accident in which his arm was severed. Patients who’ve experienced the trauma of limb separation, Friedman observes, typically are afflicted with anxiety, depression, and severe pain. Sometimes, their distress is so great that they may have suicidal tendencies.

Two articles in the issue more specifically address posttraumatic stress disorder (PTSD), a behavioral health condition characterized by anxiety, flashbacks, nightmares, and persistent thoughts about a frightening event that was experienced or observed.

Jennifer Van Pelt, MA, explores a topic not directly related to cannabis but of increasing interest to cannabis practitioners—the use of psychedelics in the treatment of PTSD. And in our cover story, Jamie Santa Cruz looks more exhaustively into evidence, both scientific and anecdotal, for the use of cannabis for individuals suffering from PTSD. Although, as Van Pelt observes, there are only two drugs approved for the treatment of PTSD, research suggests that cannabis, and even drugs such as LSD and psilocybin, may show promise for the relief of symptoms. But the research is uneven.

PTSD, according to the American Psychiatric Association, affects roughly 3.5% of adults in the United States, and women are twice as likely as men to experience it. While PTSD is most often discussed with reference to combat veterans, practitioners should be mindful that it may occur in patients who’ve been victims of sexual assault, other types of violence, natural disasters, accidents, mental illness or incarceration in the family—and other events. Similarly, trauma arises from numerous circumstances—for example, adoption, illness, grief, accidents, divorce, bullying, neglect, and even stress—and may not be immediately apparent. It’s important for health care providers to be alert to the signs and symptoms of trauma and PTSD in the general population and carefully consider the evidence for and against cannabis for alleviating refractory symptoms.

— Kate Jackson