Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders.

Philip Smith,Isaac Galatzer-Levy,Kathryn Smith,Alina Shevorykin,Denise Hien,Santiago Papini,Vanja Radoncic,Lesia Ruglass

doi:10.3390/jcm6020014

Abstract

Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa. Moreover, results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Conclusion: Cannabis use was not associated with adverse outcomes in end-of-treatment PTSD and primary substance use, suggesting independent pathways of change. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed.

Highlights

Decades of research have demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and SubstanceUse Disorders (SUDs) in general [1,2,3,4] and cannabis use disorders in particular [5]
This study examined the associations between cannabis use and in-treatment and end-of-treatment
Cannabis users were more likely to have comorbid cocaine use disorders, whereas nonusers were more likely to have an alcohol use disorder. This finding is consistent with prior studies showing that approximately 60% to 90% of those with cocaine use disorder use cannabis [58]

Summary

Introduction

Decades of research have demonstrated a strong link between trauma, PTSD and SubstanceUse Disorders (SUDs) in general [1,2,3,4] and cannabis use disorders in particular [5]. The susceptibility hypothesis proposes that chronic substance use impairs one’s neurobiological system, which enhances the likelihood of developing PTSD after trauma exposure [9,11]. Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed

Methods

Results

Conclusion