The U.S. Department of Veterans Affairs and Department of Defense are against marijuana as a treatment for post-traumatic disorder (PTSD), but they take a neutral stance on psychedelics such as psilocybin or LSD. They simply say that more research is needed.
The departments updated their joint clinical guidelines and provided recommendations for a range of therapeutics that can be used to treat PTSD, acute stress disorder or other conditions that are common among military veterans. While many veterans have used marijuana to treat the symptoms of these conditions, the VA/DOD Management of Posttraumatic Stress Disorder Work Group has said that it is against this alternative treatment.
The Work Group advises against using cannabis or cannabis-derived products to treat patients with PTSD due to the lack of [randomized controlled trials] that evaluate the efficacy and side effects of cannabis derivatives on large samples of people with PTSD.
The 2017 VA/DoD PTSD (clinical practice guidelines) indicates that cannabis use is associated with significant harm. It argues that marijuana has been linked to problems with attention, memory and IQ, as well as driving.
The departments have a “strongly against” recommendation for medical marijuana, but they also said that their confidence in the available evidence was “very low,” due to “a lack of randomized controlled clinical trials, which are methodologically sound; small sample size, and selection bias.”
The document published last month states that “the benefits of cannabis are outweighed by its potential serious side effects.” “Patient preferences and values varied because some patients sought new, novel treatment while others may not want to use cannabis or its derivatives. The Work Group recommended against using cannabis or cannabis derivatives to treat PTSD.
While the workgroup claims it has “found no new evidence”, on cannabis as a treatment for PTSD, since the last joint assessment in 2017, and relies heavily on this prior assessment in the current document. The departments have actively sought out new data on psychedelics which were not even mentioned in the previous review six years ago.
The guidelines and first report of Psychedelic Alpha state that the investigation into the potential therapeutic benefit of psilocybin (ayahuasca), DMT, ibogaine, and LSD for PTSD turned up “no study meeting the search criteria which assessed the effects of psychedelics”.
It continues, “Note that these agents are not legally prescribed in the U.S. without a research study.” Due to the lack of research, these agents may have unidentified risks or adverse effects (although adverse events have been reported anecdotally). There is insufficient evidence to support or oppose the use of these psychedelics as a treatment option for PTSD.
It added that “Patient preferences and values varied, as some patients may want to try psychedelics while others may not.” The Work Group concluded that there is not enough evidence to recommend psilocybin or ayahuasca or dimethyltryptamine or ibogaine or lysergic acids diethylamide as a treatment for PTSD.
In a separate section, VA and DOD addressed MDMA, which has been designated “breakthrough therapy by the Food and Drug Administration” based on evidence from preclinical studies that it can help treat PTSD.
Despite early evidence that MDMA-assisted treatment for PTSD is effective, the report said there was “insufficient evidence” to support or deny its effectiveness.
The study acknowledged that five randomized controlled trials had found the psychedelic “benefits individuals with PTSD,” but the studies “have varied notably in terms of the control condition used.” These differences “could potentially bias the results.”
It would be difficult to integrate MDMA-assisted therapy into the current VA and DoD healthcare systems. It continues, “The treatment protocol requires high investments in resources.” The allocation of staff for MDMA-assisted therapy could negatively impact access to other patients. It is possible that the success of MDMA assisted psychotherapy will also require patients to stop taking SSRIs. The willingness of patients to participate in this treatment would also vary considerably.”
“The benefits and harms of MDMA have to be balanced against the possible harms. These include worsening of symptoms and increased suicidal thoughts (study that is not part of the evidence base or has no impact on the strength of the recommendations). Patients’ values and preferences vary mainly due to their comfort level with psychedelic treatments. Thus, the Work Group made the following recommendation: There is insufficient evidence to recommend for or against 3,4-methylenedioxymethamphetamine assisted psychotherapy for the treatment of PTSD.”
Bipartisan members of Congress want federal agencies to do more in exploring their potential therapeutic efficacy. VA and DOD may not be ready yet to endorse psychedelics, but they oppose marijuana. They also want to stop situations where cannabis is illegal in states and veterans are punished.
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Two identical amendments , which were filed recently in the House for a VA Spending Bill, would protect veterans who use medical cannabis in states where it is legal, as well VA doctors who make recommendations for participation in such programs.
It is unclear if this will happen, especially after the same panel a href=”https://www.marijuanamoment.net/gop-controlled-housecommittee blocks-every marijuana and psychedelics amendment to defense bill from getting a floor vote/” rel=”noopener” target=”_blank”>blocked more than a dozen cannabis and psychedelics amendments that were filed for the National Defense Authorization Act (NDAA The chances of that happening are uncertain, particularly after the same panel last week blocked more than a dozen amendments to the National Defense Authorization Act.
While the amendments were not included, the House Armed Services Committee had previously attached two measures to the base text for the NDAA.
The psychedelics bill from Rep. Morgan Luttrell, R-TX, is advancing. Under this measure, the Defense Secretary would be required by law to conduct a clinical trial on the therapeutic benefits of psychedelics in active duty servicemen with PTSD, traumatic head injury, or chronic traumatic encephalopathy.
The clinical studies must involve psilocybin or MDMA. Ibogaine, DMT, and ibogaine would also be acceptable. Within one year after the enactment, the secretary must provide lawmakers with a detailed report on the results of the trials. Several of the revisions to the NDAA rejected by the Rules Committee attempted to amend this language.
Rep. Dan Crenshaw, (R-TX), is sponsoring a similar standalone bill . He said he wanted to the Rules Committee adopt an amendment Luttrell’s amendment, because staff of the House Armed Services Committee had removed language without authorization from his measure that provided funding for research. They also changed the requirement to clinical studies instead of clinical trials. The panel did not follow suit and the psychedelics bill became more hollow.
Crenshaw said that he had the commitment of House Speaker to work to expand the scope of this measure in discussions with the Senate.
A cannabis amendment, which was attached to the bill by Rep. Nancy Mace(R-SC), calls for the Defense Department medical cannabis pilot program. This would study the health effects of marijuana use among veterans and servicemen who are VA recipients. The VA participant must have been diagnosed with PTSD or depression, anxiety or pain management to be eligible for this program.
Democrat senators, meanwhile, are trying to pass a number of marijuana reform amendments in their version of the NDAA.
One of the proposals led by Sen. Brian Schatz, (D-HI), allows veterans to use medical marijuana in states and territories that allow it. This is similar to a separate bill that Senator Schatz introduced back in April.
The law would also protect doctors who fill out and discuss paperwork to recommend medical cannabis for veterans. VA would be required to fund clinical trials that investigate the therapeutic effects cannabis has on conditions like PTSD and pain.
According to a recent study , over 90 percent of U.S. veterans who use medical cannabis say it improves their life quality. Many of them also use cannabis as a substitute for prescription and over-the counter medications.
The Senate Appropriations Committee approved a separate amendment to allowing VA doctors to give medical cannabis recommendations. released its report for the relevant budget bill, which calls on the Department to facilitate access to medical marijuana for veterans and to explore the therapeutic potentials of psychedelics.
A GOP congresswoman touts the recently released FDA guidelines on psychedelics and , calling for more work to be done in order to study the therapeutic effects of cannabis for veterans.
Minneapolis’ Mayor Issues Executive order Making Psychedelics the City’s Lowest Priority in Law Enforcement’
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